By Brandon Peters, MD
Sleep is a pillar of health and well-being—but not just for patients. Physicians who sacrifice sleep are just as likely to experience the effects of sleep deprivation. In fact, there may be an added unique risk: poor sleep may exacerbate the risk of burnout in healthcare providers. Fortunately, there are a few changes that might help to optimize sleep among physicians.
Although residents may be supported with duty hour restrictions, no such protection is extended to attending physicians. Interminable service needs, disruptive shift work and call schedules, a professional culture that values work at the expense of rest, family and social demands, and individuals driven to excel at all costs can quickly overwhelm the desire to obtain adequate sleep. No one acclimates to sleep deprivation. Even the bare minimum amount of recommended sleep—at least 7 hours per night for adults—may seem like a distant dream.
Though this may be where many physicians find themselves, there are rumblings of change within healthcare. After being ignored for decades, sleep may finally be slowly gaining the recognition that it deserves. In order for this to occur, there must be a shift in priorities at both organizational and individual levels.
As a member of the American Academy of Sleep Medicine’s Public Safety Committee this past year, I was fortunate to participate in the drafting of an academy position statement on sleep, fatigue, and burnout among physicians. It is estimated that nearly 50% of physicians report symptoms of clinical burnout, as defined according to the Maslach Burnout Index. This affects the quality of care delivered, medical errors and malpractice risk, interpersonal relationships, and both patient and physician satisfaction.
There is no substitute for sleep that is sufficient, consistent, and of good quality. Beyond harmonizing a work-life balance, this is about meeting basic physiological needs for optimal function. Consider following these basic guidelines:
Make sleep a priority: meet your basic needs of 7 to 9 hours on a nightly basis and do not sacrifice sleep for other activities, including work.
Keep a consistent sleep-wake schedule. Go to bed feeling sleepy and wake at the same time daily, including weekends.
Try to get 15-30 minutes of natural light upon awakening (or use a light box) to help entrain the circadian rhythm.
Reduce caffeine and alcohol consumption to optimize sleep quality.
Exercise regularly to improve sleep.
Spend 1 hour before your anticipated bedtime relaxing; put aside work and read, watch TV or a movie, listen to music, or take a bath.
Reduce stress and anxiety with relaxation techniques, mindfulness, or other interventions.
Remember that additional help is available for those who continue to struggle. Chronic insomnia may be improved with cognitive behavioral therapy for insomnia (CBTI). Other sleep disorders, including sleep apnea, may require testing and treatment. It is possible to sleep well and feel and function better. Give sleep the priority that it warrants, and yield the benefits to your health and life.
Brandon Peters, MD, is the writer on sleep for Verywell.com, a neurology-trained sleep medicine specialist at Virginia Mason Medical Center in Seattle, and adjunct lecturer at the Stanford Center for Sleep Sciences and Medicine.