When I glanced at the title and abstract of this JAMA study the other day I decided to skip the rest of the article. It looked pretty ho-hum. Investigators found that survival from in hospital cardiac arrest was lower at night and on week ends. Well, duh. But after reading this post from Dr. Wes about the article I thought I’d give it a closer look. At the end of the discussion section the authors suggest the use of performance enhancing drugs for night shift workers: Chronobiologic scheduling, naps, or use of medications such as modafinil may also improve nighttime staff performance. Modafinil, in case you don’t know, is Provigil, a wakefulness promoting drug used in patients with narcolepsy and sleepiness associated with sleep apnea. Before you decide this suggestion is completely off the wall, note that Provigil is approved for shift work sleep disorder (ICD-9 307.45).
Another interesting tidbit, from the paper’s introduction, is the authors’ suggestion that the night and weekend deaths are a result of “medical error.” I can see the next Medicare initiative coming: DRG payment penalties for unexpected night and weekend deaths.