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Sleepiness is medical personnel has been the subject of many studies, discussions and controversies. Even if very few firm conclusions can be derived from these studies, public authorities have taken measures to limit working hours especially as far as physicians in training are concerned. These measures are certainly full of good sense but are not based on robust scientific evidences.
Against this background, it appeared necessary to objectively assess the consequences of a night on-call on the working capacities of medical personnel.
We evaluated, in a first experiment, the cognitive and behavioural performances of twenty-four medical students in training after a night on call in the emergency room. Several tests were performed after a night on call as well as after a normal sleep night : The Brown Peterson, the classic Buschke, the semantic shifting fluencies, PVT (reaction time test) and the OSLER test (a behaviour measure of sleepiness). Objective neurophysiologic consequences of sleepiness were evaluated in a second experiment. Twenty medical students were equipped with an EEG recorder during one on-call and the following morning of work in the emergency room but also during a normal sleep night followed by a morning of work in the emergency room.
We were not able to show a decrease of cognitive performances, except for one measurement of the Buschke classic. EEG signs of sleepiness were not more frequent after a night on-call. On the other hand, the OSLER performances were significantly decreased after the night on-call.
Sleepiness is clearly increased after a night on-call but its frank expression seems limited to periods of boring and monotonous tasks in sleep prone conditions. When confronted with demanding tasks or with real-life working conditions, working performances appear as not being influenced by the previous night sleep deprivation

Sleep Disorders --- Sleep Deprivation

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The sleepiness daytime denotes a propensity to fall asleep unintentionally during the day. The sleepiness increases reactions times, increases periods of non-responding or delays responding during attention-based tasks and reduces vigilance. This leads to increase the risk of road accidents, industrial accidents and accidents in the home when the sleepiness is maximum (from 3 till 5 in the morning and from 1 till 3 in the afternoon). There is a limited number of studies on habitual napping. This is most likely due to the relatively infrequent practise of daily naps in the most northern European and North American countries.
This study’s is to assess the effects of nap on sleepiness during afternoon in a population where napping is not a habit. The OSLER test estimates the sleepiness objectively. The pencil and paper tests (“Fluences verbales”, classic Buschke and Brown Peterson) are used to estimate the short-term and long-term memory. We compare these results during a control afternoon (no nap) with the results during an afternoon when the subjects are napping.
The results do not indicate a significant difference between these afternoons. Nevertheless, the major of observations indicates better answers during the afternoon with a nap La somnolence dénote une propension à tomber endormi au cours de la journée. La somnolence augmente le temps de réaction, augmente les périodes sans réponses ou retarde les réponses durant les tâches basées sur l’attention, réduit la vigilance. Ces troubles augmentent le risque d’accidents de la route, professionnels et domestiques aux heures où la somnolence est maximale (de 2 à 5 heures et de 13 à 15 heures). Un nombre limité d’études à été réalisé sur l’habitude d’effectuer des siestes. C’est probablement dû à une pratique relativement rare dans la plupart des pays d’Europe du Nord et d’Amérique du Nord.
L’objectif de cette étude est d’évaluer l’effet d’une sieste sur la somnolence au cours de l’après-midi dans une population qui ne fait pas la sieste d’habitude. La somnolence est appréciée objectivement par le test d’OSLER. Les tests « papier et crayon » (Fluences verbales, Buschke classique et Brown Peterson) sont utilisés pour estimer la mémoire à court terme et à long terme. Nous comparons les résultats de ces tests au cours d’une après-midi contrôle (sans sieste) avec les résultats récoltés au cours de l’après-midi où les sujets ont effectués une sieste.
Les résultats des tests ne montrent pas de différences significatives entre les deux après-midi. Néanmoins, la majorité des observations va dans le sens d’une amélioration des réponses pendant l’après-midi avec la sieste

Sleep --- Sleep Apnea Syndromes --- Circadian Rhythm