When it comes to sleep health, do you practice what you preach?

By: David A. Schulman | March 26, 2013

Research and surveys indicate health- care providers get less sleep than the average American and use caffeine as a way to “keep awake.” So are you practicing what you preach when it comes to sleep health? Here are three things clinicians should do to improve sleep.

• Shut off the electronics before bed. We are a society that has become increasingly focused on technology, often using electronic devices moments before bed to read, check e-mail, or to just get one last game in before going to sleep. Unfortunately, the light being emitted from these devices is not your friend; light can have a profound effect on our ability to fall asleep and stay asleep, to the degree that we use it proactively to treat certain sleep disorders. And the worst offenders are those light-emitting devices that we hold close to our faces; smartphones and tablets provide a high intensity of light into the retina (compared with televisions, which we view from farther away). Consider going back to print media and giving your body a 30-minute electronics-free period before bed to help you fall and stay asleep more easily.
• Get more sleep. The average health-care provider sleeps less than the average American and, as a fairly intelligent group, we may be better at compensating for the normal impairment that comes from sleep deprivation. But we are not superhuman! Studies show that partial chronic sleep deprivation (less than six hours per night) can lead to functional impairment equivalent to a full 24 hours of total sleep deprivation. We’re all busy, juggling careers, family and recreational time, but I promise that you’ll be far more efficient at managing your multiple commitments with at least seven hours of sleep under your belt. I find many colleagues relish bragging about their ability to fall asleep without difficulty at night even after a cup of coffee. My friend—if you can do that, then you are probably so sleep-deprived that the caffeine in that coffee is just looking at you, hanging its head, and nodding knowingly! And remember that catching up on sleep whenever you can is helpful, so sleeping in (or napping) on the weekend is great if you can’t give up those nighttime activities.
• Clinician, heal thyself! We are certainly not immune to the sleep pathologies that plague our patients; given the high stresses of our careers, it is not unusual to have occasional nights with difficulty falling asleep. Occasional insomnia is not uncommon and may not, on its own, be dangerous. Regular insomnia is a bit more problematic, in part due to the growing data demonstrating adverse outcomes associated with chronic use of hypnotic medications used to shorten sleep latency. While intermittent use of over-the-counter or prescription sleep aids is probably not dangerous in otherwise healthy individuals, there is strong evidence that chronic medication use for insomnia is inferior to a regimen of cognitive behavioral therapy for insomnia (CBT-I). This is typically delivered by a specially trained psychologist, though there is ample information about frequently used techniques available in publications and on the Internet in the case of busy professionals who may not have the time to see a dedicated specialist.

Dr. Schulman is an Associate Professor of Medicine at Emory University in Atlanta, where he also serves as the Director of the Pulmonary and Critical Care Medicine Fellowship Program. He is the current Chair of the Sleep NetWork Steering Committee for the ACCP, the President-Elect of the Association of Pulmonary and Critical Care Medicine Program Directors, and the President of the Southeast Thoracic Association.