Accumulating sleep debt before residency: Sleep deprivation in first-year medical students

Concern about healthy sleep habits has yet to appear as a mainstream public health concern, even though workplace sleep deprivation can lead to inefficiencies and fatal errors. Considerable changes have been made to address the problem of sleep deprivation in medical residency, including limiting work hours. But how much sleep debt have residents previously accumulated? What do their sleep habits reveal about their attitude about sleep and sleep deprivation? We asked first-year medical students about their sleep habits in an online survey; 19 (21.1% response rate) provided complete data. Respondents were 72.0% female, 18-29 years, 8% Hispanic/Latino, 30.4% Asian, 4.3% Black, 4.3% American Indian. Most (91.7%) used an alarm clock to wake up on weekdays, whereas one-quarter (25%) used alarm clocks on weekends. Almost half (41.7%) reported almost always having a hard time getting out of bed on days they had class, and one-quarter (25%) reported more often than not having a hard time getting out of bed. Over half reported going to bed at midnight (26.1%) or later (25.9%) on nights before class, yet ironically half (52.2%) said that their main reason for going to bed on those nights was to get enough sleep for the next day. More than one-third (39.1%) reported falling asleep in less than 15 minutes; a possible sign of sleep debt. Almost half (45.5%) reported less than an average of 7 hours of sleep per night. Over half (54.6%) reported not getting enough sleep for 8 or more days in the past month.