The Dangers of Sleep-deprived Physicians

The American Academy of Sleep Medicine (AASM) recommends that most adults get at least seven hours of sleep each night.

And yes, that means you, too.

“This recommendation applies to the medical community as well,” said Fariha Abbasi-Feinberg, MD, who is board-certified in both sleep medicine and neurology and serves as a board member of the AASM. In fact, physicians and other clinicians may need healthy sleep more than the general public.

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How lack of sleep can affect physicians 

Believe it or not, physicians are not superhuman. They’re not immune to the wear and tear that life and work can put on their bodies. A lack of sufficient sleep can hurt their ability to function, which can ultimately affect patient outcomes.

“Physicians overall are known for pushing themselves, but we need to realize that a well-rested physician is a better physician. Sleep deprivation can affect our focus, mood and productivity,” said Christopher Drumm, MD, a family practice physician with Einstein Medical Center Montgomery in East Norriton, Pennsylvania.

“If you are sleep-deprived, your motor and cognitive impairment is almost as much as if you were drinking alcohol,” said Abbasi-Feinberg.

A 2000 study on sleep deprivation, published in the journal BMJ, found that just 28 hours of sleep deprivation can impair a person’s function to the same degree as if their blood alcohol content (BAC) level was .10%, which is above the federal standard of a .08% BAC for intoxication.

“And you wouldn’t go to work with a blood alcohol level at the legal limit,” Abbasi-Feinberg said.

Not getting enough sleep can negatively impact a physician’s health, as well. Research shows that sleep deprivation is a risk factor for Type 2 diabetes, obesity, cardiovascular disease, and other health problems. Sleep-deprived physicians are also more likely to become involved in accidents driving home after working extended shifts, according to a 2008 study in BCMJ.

Why don’t doctors get enough sleep? 

What are the most common obstacles that impede physicians from getting enough sleep?

For many, it’s working long hours, with changing schedules and on-call shifts. A 2013 study in the Annals of Thoracic Medicine pointed to periods of acute sleep deprivation that can occur during on-call shifts that affect physicians’ mood and alertness, which inhibits their performance on the job and can put patient safety at risk. Similar studies involving nurses and other healthcare workers have also found that sleep deprivation has an impact on their job performance.

Sometimes, the lack of sleep just can’t be helped. Your specialty may require that you work at night, or respond to patients’ needs after “regular hours.” For example, if you’re an obstetrician, you may be called to deliver a baby in the wee hours of the night.

“And heart attacks happen in the middle of the night. Lots of things happen in the middle of the night,” said Abbasi-Feinberg. “And we have to be alert and able to handle what we need to. So, it’s extremely important for physicians to take care of themselves and stay as healthy as they can, and sleep is an important aspect of that.”

That means taking pains to prepare for a night on call in advance. Get extra sleep the night before and prepare to sleep more afterward, too. Some practices are even giving physicians an extra half-day off (or more) to make up for sleep loss, noted Abbasi-Feinberg.

You also have to be careful not to self-sabotage your sleep. Do you come home after a long day’s work and find yourself binge-watching a favorite show when you should be sleeping? Or scroll through your Facebook or Twitter feed when you should be putting your devices aside and getting some shut eye?

Drumm agreed that physicians must make time for this important kind of self-care, and the start of 2020 can be a great time to set that kind of goal.

“I am going to turn off my computer earlier and make sure I get to sleep at a good time,” said Drumm.

Ask for help 

You might be able to skate by if you don’t get enough sleep one or two nights in a row.

“After that, it really catches up with you,” said Abbasi-Feinberg.

The important thing is to not let the practice become a habit.

The bottom line: if you suspect you’re not getting enough sleep, or the sleep that you’re getting isn’t sufficient, talk to your own physician. You may suffer from a sleep disorder like obstructive sleep apnea or another condition that could warrant medical or surgical treatment. Or your doctor could just talk to you about how to improve your sleep hygiene, if that’s the major issue for you.

“Because help is out there,” said Abbasi-Feinberg.

Related:
The Pros and Cons of Working as a Nocturnist 

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