How much do residents sleep on 24-hour call?

In one study, interns slept about 2.2 hours on call nights, and about 1 in 6 (17.5%) didn't sleep at all.

Is it riskier to drive home after 24-hour call?

Yes. In a study of 2,737 interns, crashes and near misses were more likely after shifts of 24 hours or more, and each extended shift in a month raised the risk of a crash on the drive home by 16.2%.

How long is the break after 24-hour call?

Residents need at least 14 hours free of clinical work and education after 24 hours of in-house call.

24-hour call and recovery

Updated October 12, 2026 · with an example to try

On a schedule with shifts of 24 hours or more, interns made 36% more serious medical errors than on shifts capped at 16 hours, and had more than twice as many lapses of attention at night. After a shift of 24 hours or more, interns were more than twice as likely to report a crash on the drive home. They slept about 2 hours on call nights, and a nap after call didn't make it up.

See alertness after a 24-hour call

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Shift 1 starts onStartEnd

Shift 2 starts onStartEnd

Shift 3 starts onStartEnd

Shift 4 starts onStartEnd

An end time at or before the start means the shift ends the next day.

Usual bedtimeSleep you needMorning or evening type

Shifts
Assumed sleep
Predicted alertness
Below 7: likely sleepy

Lowest predicted alertness in each shift
Shift	Lowest alertness	At the end	Sleep in the 24 h before	Awake at start
Mon, Nov 2 07:00 to 07:00	4.7 at 05:45, below 7	4.9 at 07:00	7 h	1 h
Tue, Nov 3 07:00 to 11:00	4.9 at 07:00, below 7	6.5 at 11:00	0 h	25 h
Wed, Nov 4 07:00 to 17:00The first shift after 28 hours in a row: interns' naps after call didn't make up the lost sleep (why).	11.5 at 07:15	12.7 at 17:00	15 h	1 h
Thu, Nov 5 07:00 to 17:00	10.8 at 07:00	12.3 at 17:00	7 h	1 h

An estimate from a model that combines time awake, the body clock and assumed sleep: not a measurement of how you slept or feel, and naps aren't modeled. Higher is more alert; below 7, people are likely sleepy. "At the end" is the drive home. The model counts one good sleep as enough, so it can't show the slower recovery marked in amber.

Or use your real shifts, free, with no account:

Open the schedule check What the checks see

A 24-hour call from 07:00 Monday, with handoffs until 11:00 Tuesday (24+4), then day shifts Wednesday and Thursday. Alertness is lowest before dawn on call, and at 11:00, when you'd drive home, it's still below 7. The curve then counts the sleep after call as enough for Wednesday; the studies below found it isn't, so Wednesday is marked. How the model works.

What the studies found

20 ICU interns worked both schedules: with 24-hour-plus shifts they averaged 84.9 hours a week; capped at 16 hours, 65.4. On the capped schedule they slept 5.8 hours a week more and had less than half the lapses of attention on call nights, read from sleep-study recordings worn through their shifts (Lockley and colleagues, 2004).
Over 2,203 patient-days, interns on every-third-night 24-hour call made 35.9% more serious medical errors (136.0 against 100.1 per 1,000 patient-days) and 5.6 times as many serious diagnostic errors (Landrigan and colleagues, 2004).
In 2,737 interns, after a shift of 24 hours or more the odds of reporting a crash were 2.3 times, and of a near miss 5.9 times, those after shorter shifts; each extended shift in a month raised the risk of a crash on the drive home by 16.2% (Barger and colleagues, 2005).
Interns slept 2.2 hours on call nights and 17.5% didn't sleep at all; 90.8% napped after call, for 2.8 hours, and still slept 1.7 hours less per 24 hours than on regular days (Basner and colleagues, 2017).

After call

Sleep before you drive, or get a ride home.
Expect to need more than one sleep to catch up: interns' naps after call didn't make up the night. These studies didn't measure how many days recovery takes; in a lab study, one long night in bed didn't undo 5 nights of short sleep (Banks and colleagues, 2010).

The rules on 24-hour call

At most 24 hours of continuous scheduled work, plus up to 4 hours for handoffs and education, with no new patients (6.22).
At least 14 hours free after 24 hours of in-house call (6.21.a).
In-house call no more often than every third night, averaged over 4 weeks (6.27).

Common questions

How much do residents sleep on 24-hour call?: In one study, interns slept about 2.2 hours on call nights, and about 1 in 6 (17.5%) didn't sleep at all.
Is it riskier to drive home after 24-hour call?: Yes. In a study of 2,737 interns, crashes and near misses were more likely after shifts of 24 hours or more, and each extended shift in a month raised the risk of a crash on the drive home by 16.2%.
How long is the break after 24-hour call?: Residents need at least 14 hours free of clinical work and education after 24 hours of in-house call.

Check your own schedule against these rules.

Use the free duty-hour check with your calendar link, the subscribe link your scheduling app gives you, or a calendar file. Our server reads a link once, sends back only the shift times and keeps nothing; a file never leaves your device. No account needed (what the checks see).

Open the duty-hour check