Sleep is necessary for optimal health, cognitive functioning, and emotional health; however, in Western culture, sleep is often undervalued, resulting in significant sleep deprivation for many different populations.
In medicine, sleep deprivation is a normative part of training and practice across many subspecialties as patients have medical concerns that span all 24 hours in a day (i.e., night call situations). Additionally, the multiple demands of medical training often leads to chronic sleep deprivation, or receiving two hours less per night of sleep for at least two weeks.
Below, you will find multiple sleep wellness topics for consideration.
Catherine Loomis, PhD, CBSM is a licensed psychologist who is trained and certified in Behavioral Sleep Medicine. She has expertise in the effect of sleep disturbance on one's health as well as empirically validated treatment methods for disrupted sleep.
In the following Podcast, Dr. Loomis discusses brief tips for medical trainees to cope with the stressors of sleep deprivation in order to maintain one's optimal health.
Stress and Sleep
When under acute stress, sleep can be negatively affected, which can have both biological and cognitive mechanisms (i.e., adrenalin and worry, respectively).
Caring for your Sleep: Sleep Hygiene
Sleep hygiene involves using behavioral principles and techniques to ensure optimal sleep. Like other behaviors, sleep (and wakefulness for that matter) can be trained and affected by stimuli in the environment. Much like one would use a consistent routine (i.e., read a book, bath, put on pajamas, brush teeth starting at 6:45 pm and ending at 7:30 pm) to ensure a smooth bedtime for a young child, a similar approach can be used for adults. This approach works primarily because one's body is being conditioned (although out of awareness) to start calming down with the multiple environmental stimuli. Below are some simple principles one can use to maximize sleep quality when able:
Ritual: Making a bedtime routine
- Set a normal time to go to bed and wake up (to the extent possible)
- Go through a 15-20 minute routine where you provide your body with a "cool down" period prior to going to bed (Example: 10:00 pm put on pajamas, make warm cup of decaffeinated tea, read enjoyable book in dim area in house for 15 minutes, get in bed at 10:30 pm)
- Use bed for sleeping and other night-time activities (i.e., do not read, eat, watch television, talk on the telephone, or spend time in bed when in a wakeful state)
Environment: Setting the Stage
- Sleep in a cool, quiet environment with warm bedding available
- Use white noise machines as necessary
Physiological Arousal: Calming the Body
- Avoid exercise (physiological arousal) in the evenings prior to bed
- Avoid eating a large or heavy meal close to bedtime
- Limit caffeine or stimulant intake in the evenings
Coping with Sleep Difficulties: Minimizing Sleep-Related Anxiety
- If you find yourself in bed in a wakeful state worrying about sleeping (i.e., "oh no, it is going to take forever to fall asleep and I have to be up at 5:30 am!")
Turning your Brain Off: Sleep and Rumination
Initiating or maintaining sleep can be challenging in the context of busy schedules and lives as when people get in bed to try to sleep, many of the things that one should have done, didn't do, or needs to do in the future runs through one's head. Unfortunately, worry and thinking in bed can significantly interfere with sleep. Please see strategies below on how to deal with worry when trying to sleep.
- Thought stopping techniques
- Relaxation exercises
Sleep and Medical Training: Coping with Acute Sleep Deprivation
Medical training often involves being on call, requiring medical trainees to work through the night for up to 30 hours. The ACGME has new duties hours that are in place for medical residents, which were created to hopefully ensure patient and resident safety related to excessive fatigue. Additionally, the ACGME has training resources available for coping with sleep deprivation and excessive fatigue. MCW resources are below:
- Strategies to cope with sleep deprivation
- Strategic naps
- Use of caffeine
- Preparing for on-call
Insomnia: When to Seek Help
If you are experiencing sleep problems that are lasting a significant period of time (i.e., two weeks or longer), consider seeking consultation to discuss sleep management treatment.