09 September 2005

The Importance of Sleeping

Sleep is very important. Most busy people take it for granted, and probably would settle only for a sleep time of 3 - 4 hours daily. Anything over that would make them describe it as oversleeping or being lazy already. But is it, really?

The current issue of JAMA carries a study revealing that the effects of lack of sleep are comparable with neurobehavioral impairments associated after imbibing 3 or 4 cocktails or around 0.04 to 0.05 g percent blood alcohol concentration.

The study involved young medical doctors, who we all know are subjected to long hours of work and little or no hours of sleep. The researchers also found out that these sleep-deprived doctors had a 7 percent slower reaction time, 40 percent higher commission errors, and had more errors in driving as evidenced by the results of their use of a driving simulator.

Hah! Beware of a post-duty doctor driving on the streets, then? How do these doctors deal with crucial decision-making when confronted with life-and-death situations?

Now, I think when we talk of doctors, and those of the health profession, we talk more of the extreme aspect of sleep deprivation. How about those people who have a choice to have 8 or more hours of sleep but would rather choose to stay out late, doing any of the ff:
partying with friends, chatting on the Net, talking endlessly on the phone, playing online computer games, doing work overtime in the office, or cramming for an exam?

I know, I know. 'Been there, done that. Guilty as charged. No need to rub it in.

But you know, looking back, if I can turn back time, I would have slept. And we know now I'm right. More and more scientific studies are coming out proving that lack of sleep does indeed cause neurobehavioral impairments --- much like drinking alcohol.

The bad part comes when we feel exhausted and dizzy while, say.....operating a machine, driving, thinking what the right answer is in a multiple-choice test, and yes, making a crucial decision about an ICU patient. We invite more accidents to happen as we go on.

Rygel, a young doctor-blogger friend of mine, asked me weeks ago in the tagboard: "Dr E, any advise for those of us taking the medical boards?"

I replied, "Get enough sleep."

He said, "Too late. I hardly slept."

Now, would it have made a difference? Would medboard takers have higher grades if they had a restful sleep the previous night? I leave the answer to future sleep researchers.

If it were up to me, I would put sleep stations everywhere, in the mall, in the office, in hospitals, etc. People need to recharge so they can think more clearly. I think I can even say that clear thinking and sleeping are two sides of the same coin.

More useful SLEEP links here:





17 reactions:

beajerry said...

Why do you think the culture of doctor-in-training promotes the harried duty with little rest?
Is it to help doctors ingrain their craft as instinct, or is it some strange evolution of MD training from now-useless roots?

joyce said...

oh dear...i sleep an average of 4-5 hours on weekdays and 12 hours on weekends...i suppose there's no such thing as catching up on sleep...ang hirap naman kasing matulog during daytime! buti pala wala na ako'ng sasakyan =( more likely, i'd be a statistic in no time!

Rygel said...

This is a bitter subject for me! (",)

something similar to beajerry - why is it that our iternship and residency programs promote those inhumane duty hours despite the medical evidence of the bad effects of rest deprivation?

Sometimes it's ironic (and sad) that those who promore proper healthcare are the one's subjected to unhealthy working conditions

antifaust said...

I think a lot of residents have campaigned for fewer duty hours. I think there are two main problems why the system doesn't change: 1) we simply don't have enough doctors, nurses and med students to rotate in that many shifts, 2) hospitals have grown accustomed to the 24 hour (at times, 48 hour) shifts.
I told my parents not to buy me a car when I graduated, knowing that I would be subjected to sleep deprivation. I commute home, and usually I fall asleep in the bus.

Dr. Emer said...

Hello, Beajerry. I think being a doctor is one of the most critical jobs out there. You decide on life-and-death situations in an instant, and I think that really requires clear thinking. Why are we subjected to inhuman schedules? I don't know. In retrospect, I see no logic in it. I'm sure you can cultivate passion and commitment in a profession without sleep deprivation as a stimuli.

Be careful, Joyce. See to it that you get enough sleep when you can. I think sleep is like a currency. If you owe too much, repayment means not only the principal but the interest, too.

Hello, Rygel. The "evidence" of sleep deprivation among doctors has only surfaced in the recent years. While many of us realized that ourselves beeing woozy and seeing double while seeing our patients, we all took it in stride and ignored it. The conventional wisdom then (and now?) was that if the seniors were able to handle it, why can't we? Looking back, I think it remains to be one of the biggest fallacies in the medical world. I think a simple solution lies in constructing intelligent working shifts. Nurses have 8-hour shifts, why can't we have that? Make overstaying optional, or as the need requires. Wouldn't that be more logical? Wouldn't we make our patients happier and secure that we are seeing them with a clearer mind?

I agree with you, Mic. Here in the Philippines, there is the factor of lack of health personnel. Not so many doctors and nurses around so that means more working hours. But I think your second reason needs some change. Hospitals should be desensitized into thinking that 48hr shifts are normal. Well, it probably is, if we are robots. But we aren't, so they have to come up with working shifts in which both doctors and patients feel safe and secure with what we are doing. Hey, good idea on the car option. Just get one when you're a consultant already.

Rygel said...

I think the only solution to this is to have a law (well... politics here... this is useless) that protects the health of employees, including doctors. In the US i think there's a law that allows one to work only a certain # of hours each week and gives a day off after 24 hrs of work.

If such a law exists in the Philippines, i think somebody claimed that doctors are above the law and therefore exempted from it.

Rygel said...

i can't stop commenting! hahaha
Even 12 hours shifts would be acceptable. or mandatory day offs after a 24hour duty.

Anonymous said...

Hi Doc E. Hay Im guilty of this. I only have couple of hours of sleep. Then I go to bed very late pa. Hirap kc talaga ako matulog ng maaga eh. My usual sleep is at 2am, the earliest pa . Hay... :(

Btw, I've moved na po. Kindly update your link. Thanks :D


jeanny said...

opppsss...mali..sorry for that it's at


persh said...

would u mind if i linked you up? i hope not :) got here through ate mec :)

celia kusinera said...

Thanks for this post Doc Emer. For me, sleep deprivation has a more degenerative physical effect - my myasthenia becomes worse. My slurring and muscle weakness becomes worse, my eyesight becomes fuzzy and my eyelids droop considerably. I try my best though a lot of times it's hard to get enough sleep when you're a working mom. :-|

Dr. Emer said...

We hope it happens here, Rygel.

Hello, Jeanny. Well, you can try some of the tips at HOW TO SLEEP WELL. I've updated my links. Thanks!

No problem, Persh. Link away!

Working moms and getting enough sleep don't seem like a good combination, right Celia? Maybe time management might do the trick. Especially in your case.

bugsybee said...

Hi Doc - came here thru Bayi's recommendation. And what timing! I am one really sleep-deprived person (averaging only a little over 4 hours of sleep) and I've been like this since grade school. I can still function normally but there are times, especially in the recent years, when I feel woozy. I wanted to start making up for all my sleep-deprivation but it's so hard for old dogs to learn new tricks.

Dr. Emer said...

Hello, Bugsybee! 'Great to see you here, you are most welcome.

Have you tried seeing a doctor about it? You might want to try that option if you want. If not, then, don't despair. You're in great company --- some famous people also had problems sleeping. But do get some sleep when you can. Even catnaps may be helpful in your case. Ingat!

Toni said...

Ah! Sleep stations! I wish they had that here in the office. What a great idea.

Toni said...

By the way, check this out. It's one of my favorite photoblogs:


Then click on the Siesta category. :) I remembered the blog when I read this post!

Abster said...

Hello Doc Emer! Another very education post.

Ah, sleep stations...I'd be one of the mainstays in that. Question though... Can we make up for lost sleep? Like if we only have two hours of sleep last night, then can we sleep for about 10 hours tonight?