The nationwide survey was sponsored by the Committee of Interns and Residents, which is the largest union of resident physicians in the US and is affiliated with the Service Employees International Union, by Public Citizen, a national non-profit consumer advocacy organization, and by the American Medical Student Association (AMSA), a student-governed, national organization committed to representing the concerns of physicians in training in the US. The Committee of Interns and Residents contracted with an independent public opinion survey firm, Lake Research Partners, to design and analyze the survey, and did not impose any limitations on the publication of the study's results. All authors have completed the Unified Competing Interest form at
http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author). ABB is an employee of Mount Sinai School of Medicine and a paid consultant to the Committee of Interns and Residents of the Service Employees International Union (CIR/SEIU). FR is an employee of Montefiore Medical Center and is President of CIR/SEIU. SS is an employee of CIR/SEIU. DM is an employee of Lake Research Partners, an independent public opinion research firm that was provided a contract for services provided in designing, conducting and analyzing the nationwide survey reported herein. PL was previously an employee of Public Citizen. CPL is an employee of Children's Hospital Boston and of Brigham and Women's Hospital, a subsidiary of Partners HealthCare, and is on the faculty of Harvard Medical School. CPL also reports serving as a paid consultant to the District Health Boards of New Zealand, providing recommendation on how to improve the scheduling and working conditions for junior doctors in New Zealand; Vital Issues in Medicine, developing an educational course for physicians on Shift Work Disorder (supported by an unrestricted educational grant from Cephalon Inc. to Vital Issues in Medicine); and AXDev, to assist in the development of a study of Shift Work Disorder (supported by an unrestricted research grant from Cephalon Inc. to AXDev). In addition, CPL reports receiving monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for delivering lectures on sleep deprivation and safety. CAC is an employee of Brigham and Women's Hospital, a subsidiary of Partners HealthCare, which employs more than 1,000 resident physicians, and is on the faculty of Harvard Medical School. CAC has received consulting fees from or served as a paid member of scientific advisory boards for: Actelion, Ltd; Bombardier, Inc.; Boston Celtics; Cephalon, Inc.; Columbia River Bar Pilots, Delta Airlines; Eli Lilly and Co.; Fedex Kinko's; Federal Motor Carrier Safety Administration (FMCSA), US Department of Transportation; Fusion Medical Education, LLC; Garda Síochána Inspectorate (Dublin, Ireland); Hypnion, Inc. (acquired by Eli Lilly and Co. in April 2007); Global Ground Support; Johnson & Johnson; Koninklijke Philips Electronics, NV; Minnesota Timberwolves; Morgan Stanley; Philips Respironics, Inc.; Portland Trail Blazers; Sanofi-Aventis Group; Sepracor, Inc.; Sleep Multimedia, Inc.; Sleep Research Society (for which CAC served as president); Somnus Therapeutics, Inc.; Takeda Pharmaceuticals; Vanda Pharmaceuticals, Inc.; Vital Issues in Medicine; Warburg-Pincus and Zeo Inc. CAC owns an equity interest in Lifetrac, Inc.; Somnus Therapeutics, Inc.; Vanda Pharmaceuticals, Inc., and Zeo Inc., and received royalties from McGraw Hill, the New York Times and Penguin Press. CAC has received lecture fees from the Accreditation Council of Graduate Medical Education; Alfresa; the American Academy of Allergy, Asthma and Immunology Program Directors; American Physiological Society; Association of University Anesthesiologists; Baylor College of Medicine; Beth-Israel Deaconess Medical Center; Brown Medical School/Rhode Island Hospital; Cephalon, Inc.; Clinical Excellence Commission (Australia); Dalhousie University; Duke University Medical Center; Harvard School of Public Health, Harvard University; Institute of Sleep Health Promotion (NPO); London Deanery; Morehouse School of Medicine; Mount Sinai School of Medicine; National Emergency Training Center; National Institutes of Health; North East Sleep Society; Osaka University School of Medicine; Partners HealthCare, Inc.; Sanofi-Aventis, Inc.; St Lukes Roosevelt Hospital; Takeda; Tanabe Seiyaku Co., Ltd; Tokyo Electric Power Company (TEPCO); University of Michigan; University of Pennsylvania; University of Pittsburgh; University of Tsukuba; University of Virginia Medical School; University of Washington Medical Center; University of Wisconsin Medical School; World Federation of Sleep Research and Sleep Medicine Societies. CAC has also received research prizes with monetary awards from the American Academy of Sleep Medicine; American Clinical and Climatological Association; Association for Patient-Oriented Research; National Institute for Occupational Safety and Health; National Sleep Foundation; and Sleep Research Society; clinical trial research contracts from Cephalon, Inc., Merck & Co., Inc., and Pfizer, Inc.; an investigator-initiated research grant from Cephalon, Inc.; and his research laboratory at the Brigham and Women's Hospital has received unrestricted research and education funds and/or support for research expenses from Cephalon, Inc., Koninklijke Philips Electronics, NV, ResMed, and the Brigham and Women's Hospital. The Harvard Medical School Division of Sleep Medicine (HMS/DSM), which CAC directs, has received unrestricted research and educational gifts and endowment funds from: Boehringer Ingelheim Pharmaceuticals, Inc., Cephalon, Inc., George H Kidder, Gerald McGinnis, GlaxoSmithKline, Herbert Lee, Hypnion, Jazz Pharmaceuticals, Jordan's Furniture, Merck & Co., Inc., Peter C Farrell, Pfizer, ResMed, Respironics, Inc., Sanofi-Aventis, Inc., Sealy, Inc., Sepracor, Inc., Simmons, Sleep Health Centers LLC, Spring Aire, Takeda Pharmaceuticals and Tempur-Pedic. The HMS/DSM has received gifts from many outside organizations and individuals including: Axon Sleep Research Laboratories, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Catalyst Group, Cephalon, Inc., Clarus Ventures, Eli Lilly and Co., Farrell Family Foundation, Fisher & Paykel Healthcare Corporation, George H Kidder, GlaxoSmithKline, Hypnion, Inc., Jordan's Furniture, Merck Research Laboratories, Park Place Corporation, Respironics, Inc., Sanofi-Aventis, Inc., Select Comfort Corporation, Sepracor, Inc., Sleep Health Centers LLC, Takeda Pharmaceuticals, Tempur-Pedic Medical Division, Total Sleep Holdings, Vanda Pharmaceuticals, Inc. The HMS/DSM Sleep and Health Education Program has received Educational Grant funding from Cephalon, Inc., Takeda Pharmaceuticals, Sanofi-Aventis, Inc. and Sepracor, Inc. CAC is the incumbent of an endowed professorship provided to Harvard University by Cephalon, Inc. and holds a number of process patents in the field of sleep/circadian rhythms (for example, photic resetting of the human circadian pacemaker). Since 1985, CAC has also served as an expert witness on various legal cases related to sleep and/or circadian rhythms.