What Happens When Doctors Don’t Get Enough Sleep

It seems obvious that those tasked with saving lives should be in the best possible physical and mental state to do so. Sadly, this is not the case for physicians who find themselves working 24+ hour shifts, past the point of reasonable fatigue. According to information gathered from a CDC National Health Survey, physicians are the fourth most sleep-deprived professionals in America.[1] As one doctor explains, after getting pulled over while driving home after a 36-hour shift, “I was not fit to use my driver’s license, but I had just been using my MEDICAL license for over a day non-stop!”[2] The lack of sleep many physicians suffer from can have serious consequences for both their own health and the health of their patients. However, the Accreditation Council for Graduate Medical Education recently made the decision to increase work hours from 16- to 28-hour shifts for new doctors, showing a disregard for health, safety, and the legal consequences of overworking doctors.[3] In the following article, we’ll explain the top concerns associated with this trend:

 

Dangers Posed to Doctors

One of the greatest risks exhaustion poses to doctors is in regards to driving; getting five or six hours of sleep leaves drivers impaired to a degree comparable to drunkenness, yet doctors coming off a 24- or 30-hour shift haven’t even had that.[4] Doctors have given numerous testimonials about falling asleep at the wheel, running off the road, and injuring themselves and others driving home after work because of sleep deprivation.[5] Long term, sleep deprivation, as mentioned in our blog post on nurse shift work, can also lead to a weakened immune response, weight gain, high blood pressure, depression, greater risk of cancer, and respiratory and cardiovascular problems.[6]

 

Dangers Posed to Professionalism

The quality of a doctor is often judged not only by their care, but by their interactions with patients and families, and sleep deprivation keeps physicians from being their best selves during crucial exchanges. Many doctors report falling asleep on or next to patients, not remembering the questions they’ve just asked patients, and losing their balance and falling on patients.[7] One physician recalls of her residency, “I was so sleep deprived that I’d fall asleep while writing patient notes and write my dreams into the notes.”[8] Not only is this behavior unprofessional, it can cause patients and family members to suffer a serious lack of trust for a doctor’s judgment and abilities.

 

Dangers Posed to Patients

Fatigue causes lapses in memory, poorer motor skills, and impaired judgment, all things that can lead to lethal mistakes.[9] A 2009 study found that complications increased during operations when the surgeon has slept less than six hours, and a 2006 study found that extended hours awake cause a 300% increase in preventable mistakes that led to a patient’s death.[10] Additionally, the quality of handovers from one doctor to another are jeopardized when a doctor is exhausted; a doctor is often rushed and forgetful when informing the next doctor about important details regarding the patients they will be caring for.[11] Errors in treatment, administration, and charting, along with a general lack of attention and awareness, are entirely preventable and entirely unacceptable.

 

Pilots and truck drivers have mandatory restricted hours; why should the situation be different for doctors, whose sleep deprivation can similarly put lives at stake?[12] In order to see progress, our advocacy needs to be for those affected by doctor sleep deprivation as well as those who have little control over the hours they work.

[1] Tuttle, Brad, “Top 10 Most (Yawn) Sleep-Deprived Jobs,” Time.com, Feb. 24, 2012, http://business.time.com/2012/02/24/top-10-most-yawn-sleep-deprived-jobs/

[2] Wible, Pamela, “The secret horrors of sleep-deprived doctors,” KevinMD.com, March 12, 2017,  http://www.kevinmd.com/blog/2017/03/secret-horrors-sleep-deprived-doctors.html

[3] Ibid

[4] Hamblin, James, “No Doctor Should Work 30 Straight Hours Without Sleep,” TheAtlantic.com, Dec. 15, 2016, https://www.theatlantic.com/health/archive/2016/12/no-doctor-should-work-30-straight-hours/510395/

[5] Wible, “The secret horrors”

[6] Pietrangelo, Ann, “The Effects of Sleep Deprivation on the Body,” Healthline.com, Aug. 19, 2014, http://www.healthline.com/health/sleep-deprivation/effects-on-body

[7] Wible, “The secret horrors”

[8] Ibid

[9] Hamblin, “No Doctor Should Work”

[10] Goldman, Brian, “It’s time for doctors to admit that our lack of sleep is killing patients,” Quartz Media, May 5, 2015, https://qz.com/389958/its-time-for-doctors-to-admit-that-our-lack-of-sleep-is-killing-patients/

[11] Campbell, Denis, “Junior doctors’ sleep deprivation poses threat to patients, says GMC,” TheGuardian.com, Dec. 1, 2016, https://www.theguardian.com/society/2016/dec/01/junior-doctors-sleep-deprivation-poses-threat-to-patients-says-gmc

[12] Goldman, “It’s time for doctors”

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