In A Rush?
Arianna Huffington’s new book, “The Sleep Revolution,” should inspire everyone to get some serious shut-eye, especially doctors. We’re awful at sleeping. Sleep insufficiency is rampant in medicine and a complex solution is needed. I prefer a simple solution so I turned to my pediatric population and learned their secret – nap like you just don’t care.
Lesson One from children: You make errors when you’re tired.
When a toddler is sleepy, they listen to their bodies and nap. This was recently illustrated by a two-year-old patient of mine at Columbia children’s hospital. One minute, she was negotiating a set of colored rings and the next, she was sleeping, rings scattered. I revisited that child, post cat-nap, and she was dominating her colored-ring challenge.
Sleep on this: Medical interns had a 700 percent increase in fatigue-related mistakes in a Harvard study referenced in The Sleep Revolution. Doctors may focus better if we nap as we make errors when we don’t.
Short of throwing our stethoscopes and demanding afternoon siestas, we need to severely review the effects of forgoing sleep. One study showed that residents functioned as if they had a blood alcohol level of 0.05 after a busy night call. Another study went further and showed that residents had impaired driving skills after consecutive night shifts. Push the patient charts aside and nap if you have to.
Lesson Two from children: Ignore the stigma around being sleepy.
Sleep deprivation is a badge of martyrdom for physicians. In the opening chapter of The Sleep Revolution, there’s a section titled: DOCTORS WITHOUT BEDTIMES and Arianna Huffington nails medicine’s stigma on sleepiness perfectly. She cites US Surgeon General, Dr. Vivek Murthy, who recalls training in a culture in which “strong people didn’t need sleep”.
Ever hear a child afraid to tell you he or she is sleepy? Absolutely not. Children aren’t living in physician culture but perhaps we can stop ridiculing each other for needing rest. Go tell a sleepy four-year-old that “strong people don’t need sleep” and see how quickly you get a toy thrown at you.
Lesson Three from children: Preschool rules. You get nap time.
Patients want physicians to continuously learn yet many of us are half-awake during afternoon lectures. In preschools, nap time revitalizes little minds so why can’t we borrow this time-honored tradition? The National Sleep Foundation calls naps a “mini-vacation”, and research shows a 30-minute nap can boost alertness, lower stress, and help physicians be more empathetic. Maybe we should encourage our tired colleagues to duck out for afternoon naps during our coveted snippets of free time. Then maybe we’ll see fewer physicians fast asleep during a Grand Rounds lecture.
Conclusion: Go back to your childhood instincts.
Simply put, doctors need to nap more. Instead, we function like zombies before our morning coffee and get cranky by day’s end. Worse yet, we make mistakes when tired. Sleep insufficiency is directly linked to obesity, diabetes, hypertension, and even various cancers – the same chronic diseases we’re trained to fight. Let’s prescribe ourselves a sleep revolution. Somewhere in between our 60-plus hour work weeks and busy work lives, I’m confident we can tap into our inner child, tune out the world and snooze.
On a recent night shift of mine, I was napping on a desk during some downtime and a nurse teased me:
You look like a baby