Skimping on Sleep Can Impact Health

Short on sleep? Join the crowd. Many of us have too much to do and not nearly enough time to do it – and often sleep pays the price.

Health care workers can face exceptional challenges, especially medical residents, who can log up to 80 hours a week. While the number of hours can seem grueling, a few years ago the number was much higher. But six years ago, the Accreditation Council for Graduate Medical Education (ACGME) instituted a new policy that limited residents to working a maximum of 80 hours a week, explains Charles Albrecht, M.D., the program director for the Johns Hopkins/Sinai Hospital Residency Program in Internal Medicine and interim chief for Sinai Department of Medicine. Hospitals realize the importance of physicians getting enough rest, he says.

"We are mandated to inform and teach about fatigue," Dr. Albrecht says. "We discuss with our physicians how to recognize the effects of a lack of sleep.

One point made is that residents should recognize whether their sleepiness stems from overwork or from a medical condition, such as hypothyroidism, or a psychological disorder, such as depression. That's true for everyone – ask your physician if you're getting more than eight to nine hours of sleep, but are still tired.

It's a common fallacy for people to think they can get by on four, five or six hours. The increasing recognition of sleep being critical to successful patient outcomes is a big improvement, Dr. Albrecht says. Nine years ago, when he was a resident, he remembers struggling to stay awake on the drive home after logging a long hospital shift. Since that's a danger for both the doctor and other drivers, Sinai started a transportation fund. If a resident feels sleepy before driving home, the transportation fund is available for use of a taxi.

Recommendations for getting a good night's sleep include making the room very dark, using earplugs, staying away from coffee or trying a cup of herbal tea. Experts also agree that nutritional and fitness routines are key components in a good night's sleep. Stick to a regular breakfast, lunch and dinner schedule, and don't work out too close to bedtime.

Al Kafrouni, M.D., who runs the Sleep Disorders Center at Northwest Hospital, says problems falling or staying asleep are among the symptoms of a sleep disorder.

"There are different modalities for treatment including pharmacotherapy, cognitive and behavioral techniques or a combination of these modalities," he says.

Another common sleep disorder is obstructive sleep apnea, which causes people to be excessively sleepy during the day and experience disruptive sleep during the night. It's also treatable, Dr. Kafrouni says.

In addition to cutting back on caffeine, exercise and good nutrition, Dr. Kafrouni advises:

• Avoid steady use of sleeping pills.
• Use your bedroom as a place to sleep, not as an office or place to watch television.
• Stop smoking.
• Avoid alcohol before bed.

To learn more about the Sleep Disorders Centers at LifeBridge Health, call 410-601-WELL (9355) or visit us at www.lifebridgehealth.org.