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
Turkish Journal of Emergency Medicine - 2026;26(3):189-196
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 .
