Effect of an electroencephalogramverified 20-min power nap on fatigue and daytime sleepiness among emergency doctors following night shifts: A randomized controlled trial

Wan Noorulfaten Azreen Wan Hussin; Mohd Johar Jaafar; Hui Jan Tan; Mohd Hisham Mohd Isa; Siti Zaleha Sahibulddin; Nur Arifah Mohd Khaili; Ismail Mohd Saiboon

doi:10.4103/tjem.tjem_293_25

Wan Noorulfaten Azreen Wan Hussin¹, Mohd Johar Jaafar¹, Hui Jan Tan², Mohd Hisham Mohd Isa¹, Siti Zaleha Sahibulddin², Nur Arifah Mohd Khaili², Ismail Mohd Saiboon¹

¹Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
²Department of Neurology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Keywords: Emergency doctors’ fatigue, power nap, shift work, sleep deprivation, sleep latency

Abstract

OBJECTIVE: To assess whether a 20 min power nap reduces fatigue and daytime sleepiness among emergency doctors following night shifts.

METHODS: We conducted a randomized controlled trial involving 54 emergency doctors randomly assigned to intervention (n = 27) or control (n = 27) groups matched for gender, body mass index, and work zone. The intervention group received a 20 min power nap monitored by an electroencephalogram (EEG), whereas the control group remained awake. We measured fatigue using the Fatigue Assessment Scale (FAS) and daytime sleepiness using the Epworth Sleepiness Scale (ESS) before and after intervention.

RESULTS: Both groups demonstrated comparable baseline fatigue levels with median FAS scores of 28 (interquartile range [IQR]: 21–32) versus 26 (IQR: 21–30) for intervention and control groups, respectively (P = 0.56). Following the intervention, the power nap group showed a median 3 point FAS reduction (IQR: −7 to 1), whereas controls experienced a median 4 point increase (IQR: 0 to 6) (between group difference P < 0.001, Cliff’s delta = 0.71, 95% confidence interval [CI]: 0.48–0.85). For daytime sleepiness, the intervention group showed a median 5 point ESS reduction (IQR: −7 to − 1) versus a median 4 point increase (IQR: 0 to 6) in controls (P < 0.001, Cliff’s delta = 0.78, 95% CI: 0.57–0.89). Both outcomes demonstrated large effect sizes. EEG monitoring revealed that 81.4% of intervention participants achieved sleep onset within 0–4 min.

CONCLUSION: A 20 min power nap significantly reduces fatigue and daytime sleepiness among emergency doctors following night shifts, with large effect sizes indicating substantial practical benefits and rapid sleep onset indicating severe sleep deprivation. This practical intervention supports implementing evidence based power nap protocols in emergency departments.

How to cite this article: Hussin WN, Jaafar MJ, Tan HJ, Isa MH, Sahibulddin SZ, Khaili NA, et al. Effect of an electroencephalogram-verified 20- min power nap on fatigue and daytime sleepiness among emergency doctors following night shifts: A randomized controlled trial. Turk J Emerg Med 2026;26:189-96.