For years is has been understood that doctors take call and could have been up the night before you have an elective surgery the next day. During training I would go days in a row with minimal sleep and I just considered it the norm. I knew it affected my work, but as a resident we just pushed through. Now there are increasing guidelines for training programs making sure that residents have enough sleep.

The real problem is that there are no regulations for surgeons in private practice. Most surgeons are required to cover the ER call on a rotation basis. There is a good chance that a surgeon could be up most of the night and still have a full day of elective surgery the next day. The question is….. “Does being sleep deprived affect the surgeon’s performance?”

This is the question you should be asking as either you or family members come in the morning of surgery for an elective procedure. A recent study in the American Journal of Surgery (http://www.americanjournalofsurgery.com/article/S0002-9610(11)00616-7/abstract) showed that surgeons who don’t get enough sleep can still do the learned tasks as well as rested surgeons. However, their brains had to work much harder to accomplish the same task. What this means is that as long as the procedure went as planned everything was the same between rested and sleepy surgeons. But when an unexpected problem arose, then the tired surgeons had an increased difficulty adapting to the changing circumstances.

Likewise in a recent JAMA article(http://jama.ama-assn.org/content/302/14/1565), is was shown that there are actually more complication when surgeons have less than 6 hours of sleep the night before. This is in line with studies showing that pilots, truck drivers and train conductors also have impaired reaction times when tired.

So what are we to do. Surgeons are still required to take call. Patients want their procedures at the scheduled time as they have made multiple arrangements to adjust their lives for that day and the post op period. Moreover, the surgeon doesn’t want to constantly reschedule his practice when he has to unexpectedly work the night before.

It’s a real problem!! I think as the patient, you have the right to ask your surgeon if he/she had a good night’s rest. If not, remember the procedure is often elective and you can reschedule for another day. It is also the surgeon’s responsibility to have the patient’s best interest at heart. If he/she is too tired to work at their best, they can also make the decision to postpone the procedure to another day.

Even though working with fatigue has been part of the culture of medicine for many years, it’s time to take a long look at what we can do to ensure that surgeons have enough rest prior to performing elective cases. The more we learn about the effects of lack of sleep, the more we can hopefully prevent unnecessary complications. Once again we see how important sleep is and how much it can affect every aspect of our daily lives!!

Learn more about our minimally invasive treatments for snoring and sleep apnea.

Here are the main points the survey uncovered:

Hard Day’s Night. About 40 percent of Chicagoans surveyed experience problems at work due to lack of sleep.

Everyone does it (almost). Nearly 70 percent of people say that there is at least one person in their household who snores.

Disrupted slumber. More than 60 percent of respondents report being awakened by their partner’s snoring. More than a third of Chicagoans surveyed have been awakened by their own snoring!

Snorers keep out! About a third of survey respondents have slept apart to get away from a snoring partner.   (One in every three respondents)

Snoring tests relationships.  Nearly 30% of people surveyed say snoring causes problems in their relationships.

Snoring takes a toll on your sex life. Nearly 20% of respondents who snore say if they didn’t snore they would possibly have more sex with their partner.

Snoring Breakups. Nearly 46% of respondents say they would consider dumping a dating relationship if his or her snoring kept them from getting a good night’s sleep.

Take care of your snore! More than 60 percent of Chicagoans surveyed believe that snoring warrants treatment.

Additionally:

*More than half of the survey respondents reported suffering from seasonal allergies, 49% of which treat them with over the counter medication.

**When asked which professional athlete they think snore the most, most respondents guessed the Chicago Bears, specifically Brian Urlacher!

Learn more about our minimally invasive treatments for snoring and sleep apnea.

Even more surprising was that people who only “snorted or stopped breathing” on average 5 nights a week, but didn’t have sleep apnea, showed an increased risk of depression as well. Men with these symptoms had 5 times the risk, while women were twice as likely to develop depression. The study doesn’t go into why, but this is one more example of how sleep affects all aspects of our lives.

So, if you or your partner snore or have developed sleep apnea, consult your doctor. This could be a reason you have been more depressed lately. Improving your sleep could make all the difference. Call us today at The Snoring Center and let’s get you sleeping better. Good sleep is essential to good mental health!!

Sleep article abstract: http://www.journalsleep.org/ViewAbstract.aspx?pid=28460

My 10 year old daughter Bianca is presenting this to her language arts class today, as part of their “speech competition”. I hope she wins!

Sleep Your Way Smarter

By Bianca Schwimmer

I can tell you how to improve your grades, without doing any extra work, really! If you simply sleep longer, your grades may get considerably better. Many kids think that the person who stays up the latest is the coolest, but really, the more you sleep, the better your grades, and the happier your parents.

Children from ages five to twelve need ten to twelve hours of sleep per night. Poor sleep can result in mood swings, behavioral problems, and cognitive problems that can impact their ability to learn in school. The quantity and quality of sleep have an impact on learning and memory. A sleep-deprived person cannot focus his/her attention on something for a long period of time, and therefore cannot remember or learn the material as well as they could have if they have had enough sleep. Sleep, memory, and learning are all interrelated. If a person lacks sleep, it causes focus and memory loss, which affects his/her ability to learn, whether it be in school, at work, in a meeting, or just listening to a teacher or a friend.

“What behaviors interfere with a good night’s sleep?”

When children eat or drink caffeine, play video games, watch television, or go on the computer before going to bed, some symptoms are lack of sleep and having nightmares. Watching television before bed has been said to cause bedtime resistance, having trouble falling asleep, anxiety around sleep, nightmares, and fewer overall hours of sleep. Keeping televisions, computers, and video games out of a child’s bedroom can help discourage the temptation to engage in these activities before going to sleep.

School-aged children should be taught to exercise healthy sleeping habits and tips, especially those kids who do multiple extra- curricular activities, such as sports or playing an instrument. Those kids need to rest their bodies for multiple reasons: 1) They also have to have 10-12 hours of sleep 2) They need to be rested at school 3) They have to be energized for their activities and anything else that they have to do the next day. It takes more time management and effort to accomplish this, but it’s well worth it in the long run.

“ What can you do to get a better night’s sleep?”

Keeping your bedroom cool, dark, and quiet increases the quantity and quality of your sleep, so you will be refreshed and ready to learn for the next day’s work. Keeping a constant sleep schedule (for example, going to bed at the same time every day) and a bedtime routine (such as taking a warm shower before going to sleep) also helps to improve your sleep. It gets your body used to going to bed at that time, so you will be able to fall asleep faster and deeper, for increased quality. For increased quality and quantity of your sleep, avoid caffeine and sweets before bed. Some people find that the smell of lavender and listening to music before bed helps you fall asleep faster. Studies show that magnesium rich food, such as green vegetables, helps you fall asleep more easily. A glass of warm milk might help, as well!

After hearing all of this, you are probably thinking that the “cool kid” lack of sleep is over and done with. The next time your parents ask you to go to bed, I wouldn’t think twice about resisting!

Disturbed sleep widely impacts our day-to-day mood and behaviors.  Below is a series of questions and answers looking at the effect poor sleep may have on our health—specifically our stress hormone levels, appetite, metabolism, and mood.

• Poor sleeping habits affect the production of cortisol and adrenaline in what way?  What are the consequences of that? 

Poor sleep can lead to an increase in the production of cortisol and adrenaline, which are also referred to as the “stress hormones.”  Generally speaking, having a chronic higher level of stress hormones can increase the risk of high blood pressure, heart disease, heart attack, and stroke.

• Does lack of sleep affect your hunger levels and the type of foods you crave?

Yes, it can, particularly an acute lack of sleep.  Research has found that subjects who had a limited night of sleep had more cravings for high-calorie, carbohydrate-rich foods, and in fact did eat on average over 500 calories more in a day without increasing their activity level.

• What about the effect on metabolism? Does lack of sleep slow down your metabolism? Does it affect how your body processes and stores fat?

Over the long term, certainly metabolism can be affected, but it’s a more complicated picture.  Let’s go back to cortisol–which is one of the stress hormones that is critical for health, when in proper balance.

The increased levels of cortisol that can occur with poor sleep may lead to complications such as high blood pressure, glucose intolerance and diabetes, osteoporosis, hair loss, cold intolerance, acne, and low libido.

In terms of fat storage, when in a high cortisol state, the body tends to deposit fat around the middle—leading to abdominal weight gain.

• Comment on this statement: “One of the common symptoms of sleep debt is that inability to wind down come evening time.” 

Well, again referring to the increased levels of stress hormones present, these higher levels of cortisol and adrenaline may cause you to feel like you’re in ‘overdrive.’  You may feel tired, yet wired; you may have a higher sense of anxiety; you may have scattered or racing thoughts and not be able to focus; you may have a shorter fuse.

• Does poor sleeping affect how easy your body heals (for example, from illness or from an intense workout)? Are you more likely to suffer from pains and aches if you don’t sleep well or enough?

Poor sleep definitely affects how well the body heals.  We know that sleep loss impairs immune function, and sleep architecture is altered during infection to improve the body’s defenses.

It also appears that poor sleep, or sleep deprivation, can increase the likelihood you will suffer from aches and pains.  For example, one study looked at a healthy group of middle-aged women and deprived a portion of that group of slow wave sleep (the deepest stage of sleep) for a period of three days.  In response, those women showed a decreased tolerance for pain and increased levels of discomfort and fatigue.

Overall, despite a significant amount of research into sleep and sleep disorders, there are still large gaps in terms of our current knowledge—not the least of which is exactly why we require sleep.

Learn more about our minimally invasive treatments for snoring and sleep apnea.

Learn more about our minimally invasive treatments for snoring and sleep apnea.

Learn more about our minimally invasive treatments for snoring and sleep apnea.