Clinical Performance in Critical Care Simulation under Sleep Deprivation: Effects of Power Napping in the Recovery Napping Protocol for Anesthesiologist Performance (R-NAP) Randomized Controlled Trial
Primary resultResult — go to the resultDifference 14.8 points 95% CI 2.8–26.9Authors' conclusion
Napping appears to enhance clinical performance, while the nap opportunity, nap duration, and previous sleep deprivation each influenced technical and nontechnical performance in distinct ways.
Study context
- Population
- Anesthesia residents tested in simulated crisis after a 24-h shift27 in primary analysis
- Participants
- 35 residents
- Comparison
- 30-min nap opportunity vs control after a 24-h shift
- Nap opportunityn = 19
- Controln = 16reference
- Primary endpoint
- Overall simulated clinical performance (0 to 200; combined technical and nontechnical scores)
Methodological detailssimulation-based, partial sleep deprivation after 24-h shift, Actigraphy assessed sleep and nap duration, Residents tested twice: rested and after a 24-h shift; trained in fatigue management between sessions
- Simulation-based
- Partial sleep deprivation after 24-h shift
- Actigraphy assessed sleep and nap duration
- Residents tested twice: rested and after a 24-h shift; trained in fatigue management between sessions
Primary result
As reported in the abstract
Difference
14.8 points
95% CI 2.8–26.9
P = 0.018
Nap opportunity vs Control
difference 14.8 points (95% CI 2.8–26.9); P = 0.018
Secondary outcomes
| Outcome | Difference (points) (95% CI) | P value |
|---|---|---|
| Nontechnical skills | +11.0 (2.2–19.8) | P = 0.016 |
- Nontechnical skills: including significant effects of leadership and resource utilization
Technical skills
- No significant difference between groups; more sleep associated with better technical performance
Nap duration and performance domains (exploratory)
- Longer nap duration associated with multiple performance domains, strongest for technical skills
- P = 0.010
- Exploratory analyses
Original publication
Clinical Performance in Critical Care Simulation under Sleep Deprivation: Effects of Power Napping in the Recovery Napping Protocol for Anesthesiologist Performance (R-NAP) Randomized Controlled Trial. Anesthesiology. Published 8 May 2026. doi:10.
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