Sleep deprivation: An oft-ignored occupational hazard in health care

NEW ORLEANS — Sleep deprivation in the medical community is not uncommon, but keynote speaker Arianna Huffington urged an audience of interventional health care professionals to be aware of the dangers of a lack of sleep and to break the sleep-deprivation cycle.

Sleep deprivation is “an occupational hazard” for physicians, according to Huffington, founder and editor-in-chief of The Huffington Post and author of The Sleep Revolution: Transforming Your Life, One Night at a Time.

“We are living under this delusion that sleep deprivation is a badge of honor,” she told the audience at the Society for Cardiovascular Angiography and Interventions Annual Meeting. “It started back in the first industrial revolution when we thought that we could treat human beings like machines.”

Rather, she encouraged the audience to be “ambassadors” to patients, staff and colleagues. “As doctors, you have the unique opportunity to educate [yourself] and your patients. ... Letting them know how critical sleep and recharging is to their health and well-being is going to begin to change both practices within your profession and among your patients,” she said.

Huffington’s interest in the sleep cycle started after she collapsed from exhaustion several years ago.

“How much sleep we get is essential to our health,” she said.

However, she noted that the science behind sleep is relatively new. The first scientific sleep center was founded at Stanford University in 1970. Today, there are approximately 3,000 sleep centers in the United States.

Sleep deprivation can affect a multitude of aspects of health, from the immune system to obesity to hypertension. One major focus is research on the connection between sleep deprivation and heart disease. Huffington referenced a study in which 63% of men who had MI also had a sleep disorder. Moreover, the link between sleep and adverse outcomes is particularly pronounced in women, as women process stress differently than men. Women in stressful jobs have a 40% greater risk for heart disease, she said. The connection between stress and sleep deprivation is clear, she said, as stress floods the body with cortisol, thus triggering an inflammatory response.

Health impacts aside, sleep deprivation can also affect decision-making, reaction time, productivity, creativity and other aspects of quality of life.

Sleep deprivation is a concern among health care professionals, who encounter emergency calls in the middle of the night and long shifts, for example. However, “you cannot live in a state of fight or flight without huge health consequences,” Huffington said during the keynote presentation.

Seven to 9 hours of sleep per night is recommended to “operate at full capacity,” she said, although noting that is not always possible for health care professionals. A small portion of the population — about 1.5% — has a genetic mutation by which they can function well on 3 or 4 hours of sleep a night. “But let me remind all of you scientists here that you cannot train yourself to have a genetic mutation,” she said.

She urged the audience to focus on an “everyday plan” for sleep, as opposed to the “emergency plan.”

In The Sleep Revolution, Huffington discusses the latest science behind sleep and provides tools, tips and techniques to avoid sleep deprivation. She said it is important to focus on “micro-steps.”

One micro-step deals with technology, which is a main culprit in widespread sleep deprivation, she said. An estimated 70% of people sleep with their phones by their beds, she said. When she asked how many people in the audience sleep with their phones by their bed, most hands in the room were raised.

“This is the one [micro-step] I want you to leave with today: At the end of your day, at least 5 minutes before you’re going to turn off the lights, please turn off your devices and gently escort them out of your bedroom,” she said.

As physicians encounter emergencies more often than most professions, in which they need to be easily reached by phone, she suggested using a landline or a “dumbphone” without data.

“We are now at an amazing inflection point about our relationship with technology, and that is central to our relationship with sleep,” Huffington said.

Another tip is having a transition to sleep. “Most people think they can just put their phone down and go to sleep; you need a ritual to slow down your brain,” she said. Focusing on another micro-step — adding a small amount of sleep to your schedule; 30 minutes, for example — may also yield noticeable results. Huffington also offers tips on naps and sleep meditation.

“It’s important to have robust conversation about this topic,” she told the audience.

After the keynote address, Kenneth Rosenfield, MD, MHCDS, SCAI 2016-2017 president, section head of vascular medicine and intervention at Massachusetts General Hospital, and a member of the Cardiology Today’s Intervention Editorial Board, acknowledged that “it’s embedded in our medical training that [sleep deprivation] is sort of a badge of courage.

“Of all specialties in the entire medical field, ours is perhaps most on the firing line when it comes to sleeplessness and interrupted sleep. This is a bit of a wake-up call for our community,” he said. “Or, rather, maybe it’s a call to go to sleep.” – by Katie Kalvaitis

Reference:

Huffington A. The Sleep Revolution. Presented at: Society for Cardiovascular Angiography and Interventions Annual Meeting; May 10-13, 2017; New Orleans.

Disclosure: Huffington is author of The Sleep Revolution: Transforming Your Life, One Night at a Time.