Sleep: Your life depends on it

ByJohn D. Kelly IV, MD

Orthopedic surgeons are accustomed to getting by on less sleep. We were pummeled into submission during residency, and years of trauma call makes us somewhat accustomed to being tired. But in order to navigate a successful career in the most challenging but rewarding of professions, we need regular and restful sleep.

Lack of sleep will ultimately come back to bite you. Even though we think we may feel OK, sleep deficits have a cumulative toll on our bodies and psyches. Millions of years of evolution dictate that adults need, with rare exception, at least 7 hours of restful sleep per evening. Obviously, a night on-call make this impossible, but accrued sleep debts must be repaid. The toll of inadequate rest includes increased risk of hypertension, diabetes, memory deficits, Alzheimer’s disease, depression and diminished growth hormone secretion. In addition, sleep deprivation whacks our immune system.

The epiphany

Several years ago, I fell victim to chronic sleep deprivation. In addition to being a good husband and dad to young twin daughters, I was trying to grow my practice. I thought I had learned to be accustomed to ‘burning a candle at both ends’ and was reasonably functional. I slowly developed a serious infection in my right eye (a periorbital cellulitis) with cultures revealing a nocardia asteroides infection – a fungal like organism that favors immunocompromised hosts. This pathogen can slowly invade and enmesh soft tissues with its tentacle-like appendages.

In my case, the bug was encroaching upon my optic nerve. My ophthalmologist told me he saw this infectious agent almost exclusively in HIV-infected and immunocompromised patients. At one point my doctor asked, “Are you getting enough rest, John?" I knew the answer. The wake-up call had arrived. Thankfully, my eye responded to an extensive irrigation and debridement and several weeks of antibiotics.

The lesson

Since my encounter with near blindness, I have become more mindful of rest in my life. When I get adequate, sleep I am more alert, retain information better and get fewer colds and flu. In essence, I am more effective. In an effort to get more done, sleep gets subordinated to work. In reality, we will accomplish more, retain more, be well more and enjoy more if we get adequate rest.

The following are some suggestions:

decide today to make sleep a priority. Your ability to minister to your families and patients will be enhanced;
try to adhere to regular bedtimes. Folks who comply to regular schedules (as best they can) tend to live longer and happier lives;
avoid caffeine alter 3:00 PM, if at all possible. It is simply not worth it;
attempt to exercise regularly and in the morning, if at all possible. Afternoon and evening workouts are less conducive to deep sleep;
avoid medical reading in the bedroom. We must not subconsciously associate our bedrooms and work;
be mindful of any sleep debt you have accrued (post-call) and recognize that it is OK to sleep in on weekends.
avoid alcohol near bedtime. Alcohol affects the ability to obtain true regenerative sleep.

Remember, we cannot give what we do not have. Nothing else can recharge your batteries like a good night’s rest. Get more sleep and watch your life awaken.