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Sensing Savvy

What Surgeons Should Know About Sleep Deprivation

Posted by Thomas Gole, DO, FAAFP on Nov 25, 2015 5:30:00 AM

sleep-deprivation.jpgAs a surgeon, you face a unique set of challenges other professions do not: You’ve got to be on call and you work unpredictable hours, which means the need to work at night is an essential part of the job.

But night work means you’re fighting to stay awake when your body is physiologically programmed to sleep—no matter how much coffee you drink or how much sleep you get during the day. Working at night increases your sleep debt, and working when most people are asleep can have effects on your health and can possibly impact your ability to care for patients.

Ilda Amrian1 discovered that “sleep deprivation subjectively had an impact on the surgeons and that they were aware of the effect fatigue had on their work performance. As a result they applied different mechanisms to cope with fatigue.”

How the United States’ Work Hour “Limit” Can Affect You

In the United States, where it is accepted and expected to “always be on,” the study unsurprisingly found surgeons worked far more hours than those in European countries.

In Scandinavia physicians typically work 37-48 hours per week on average over four weeks; in the UK it is 48 hours per week (the general EU maximum) and in the United States, the work hour restriction is 80 hours per week for [surgical] residents. There is no formal work hour limit for attending surgeons in the US, who typically work 50-60 hours per week.2 In Scandinavia, shift work is 16 to 24 hours, which means that the physicians have the day off after a night shift. Similar to Scandinavia, the UK has a maximum of 16 hours of work in a 24-hour period. In the United States, physicians have been known to work extended shift, meaning that their consecutive work hours can run more than 24 hours, as opposed to the other extreme, Holland has a maximum of eight work hours.3

As you can imagine, this can take a toll on you physically and mentally. These extended work hours, combined with a workload of 50+ hours per week can—and often do, according to Amrian’s research—cause chronic sleep deprivation. Night work combined with these extended hours affected patient safety and physician health through increased risk of percutaneous injury.

Physicians driving home from their night shifts were also more likely to be involved in motor vehicle crashes.4

3 Strategies to Fight Fatigue

Establish a Solid Sleep Routine

This may seem obvious, but an essential part of maintaining health and reducing night-shift fatigue is to establish a solid sleep routine. To do this, make sure your bedroom is a suitable place for sleep. That means trying to avoid watching TV, using mobile devices, or playing videos in your bedroom. When sleeping at home, always try to sleep in your bed and avoid using a couch or chair as a place to sleep.

Take a Nap

Naps are not reserved for young children. Taking an afternoon nap before a night shift or during your shift, can give you an energy boost. If you nap during your shift, try limiting your time asleep to no more than 45 minutes. Anything between 20 and 45 minutes can help counteract fatigue.5

Eat

Try to follow a similar eating pattern during night-shift work that you would during the day. Remember to eat and drink enough so you are not starting your shift hungry or thirsty. It is easy to miss regular meals when working at night because your circadian rhythms can affect appetite, and it is a time when most dining establishments are closed.

When your night shifts are finished, be sure to catch up on your sleep by going to bed as soon as you get home.

1http://www.ncbi.nlm.nih.gov/pubmed/25186549
2http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=10595106.PDF 3http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=10595106.PDF 4http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=10595106.PDF 5https://www.facs.org/education/resources/medical-students/lifestyle
http://www.tsranet.org/wp-content/uploads/2013/01/Fighting_Fatigue.pdf

CABG Flow Interpretation

Topics: Clinical Trends

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