Is this what I really want?”
Walking through the connecting bridge from the wards to the university hospital with a glass slide in my hands and accidentally witnessing the sunrise, this question kept reverberating in my head.
It was just the first day of clerkship and this was to be the reality in the next couple of years of training, to expect to be always sleep deprived.
While I did survive as most doctors do, remembering never fails to bring feelings of disbelief on how it was possible to go on a 48-hour duty, doze off under the shower and while standing, endure edema-inducing rounds, prepare for presentations, and the funniest of all, drift into la la land without drooling and falling off the chair on a date with a then crush, who was decent enough to wait for me to wake up. Being young does enable one to perform magic tricks.
“Doctor, he woke up at 5 a.m. so it’s his nap time.” I motioned the parents to stop from waking their 1-year-old son for two selfish purposes: first, it would be easier to perform a medical examination and, second, it would increase the chances of him having a happier disposition in the face of an impending vaccination. True enough, he recovered pretty quickly after being momentarily surprised by the sting received.
“My son has trouble sleeping.” This is not an unusual complaint from mothers who have teenagers. To extract needed information, I would usually resort to using a battery of questions to come close to a conclusion. Are you married to your cellphone? What is causing you stress lately? Do you have a habit of drinking caffeine-laden drinks? Do you wake up in the middle of the night? Do you feel tired even after having slept for eight hours?
“I just feel so washed out and hopeless.” One friend, whom we marvel at for being able to sail through difficult situations, had this sage advice, “Get a good night’s sleep. Things will always look better in the morning.”
“I will have to decline your invite. Nine o’clock is bedtime and I would be needing eight hours at the minimum to be functional the next day. At my age, it would take a minimum of two days to recover and get back on track.” This had come from a senior colleague.
While everyone knows the value of sleep and its benefits and that there have been studies on possible associations between chronic insufficient sleep and an increased risk for cardiovascular and metabolic conditions, immunosuppression, overall mortality, and renal function, further research is still needed on its impact on health outcomes and overall well-being.
In the Journal of the National Sleep Foundation, a nonprofit organization whose mission is to promote sleep health, poor sleep was even mentioned as a public health concern, and rightly so. One would have to agree that it greatly affects productivity. Chronic sleep insufficiency, as a result of a variety of factors such as sleep disorders, medical conditions such as obstructive sleep apnea, and demands from work, family, and school, singularly or combined will eventually take its toll on an individual’s physical and mental health.
How many hours are needed? There is still insufficient evidence as to the exact number and duration is not the only factor to be considered. The quality of sleep one gets is also a major determinant. You may have heard of individuals who wake up refreshed after having less than six hours of sleep, while some require 10 hours or more. The American Academy of Sleep Medicine and the Sleep Research Society recommend that “for optimal health, adults would be needing, on a regular basis, an average seven to eight hours per night.” The recommendation from the National Sleep Foundation for children varies according to age, with neonates and infants needing twice as much.
Prescription: While some of these may require a change in lifestyle, it wouldn’t hurt to make the effort. Let me share some of what I have read and learning to practice. Foremost, try to stick to a regular schedule for sleeping and waking up on a daily basis. Limit intake of caffeine-containing food or drink in the morning. Avoid exposure to blue light before you go to bed. The bedroom is a place to relax and not an extension of your workspace. Free yourself of thoughts that cause stress or anxiety. For people who are energized by short naps during the day, keep it to 20 minutes.
The benefits of good quality sleep are immeasurable. Not only does it result in better cognition and judgment but affects mood as well. While you may have the means to buy a bed, one can never buy sleep. Take that needed beauty rest.
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