| "What do the nuclear accident at Chernobyl, | | | | worker had 50 days in a row. It's no wonder |
| the near meltdown at Three Mile Island, the | | | | these people made mistakes, and failed to |
| disastrous oil spill by the Exxon Valdex, and | | | | notice and react to crucial information that |
| the loss of the space shuttle "Challenger" | | | | would have prevented the shuttle disaster! |
| all have in common? They were all caused by | | | | This type of problem also accounts for the |
| people who were making mistakes because they | | | | Exxon Valdez disaster, and the accidents at |
| had too little sleep." This is how Stanley | | | | the Three-Mile Island and Chernobyl nuclear |
| Coren's book "Sleep Thieves" opens. He then | | | | power plants. |
| goes on to point out that there is an | | | | |
| epidemic of sleep deprivation in our society | | | | The book "Sleep Thieves" was only written |
| (which should be no surprise to anyone). | | | | about a decade ago, yet in it, Coren quotes |
| What is amazing is the cost of this sleep | | | | several doctors (especially residents and |
| deprivation to us, not only individually but | | | | interns) who were too sleepy to treat their |
| to our entire society. | | | | patients effectively due to the intensive and |
| | | | long work schedules imposed on them. They |
| Most of us have probably experienced at least | | | | "get so damned depressed sometimes, |
| one time where we drove somewhere even though | | | | especially when things heat up in the ER, |
| we felt sleepy. We don't realize what this | | | | like on "Welfare Wednesdays"...". One doctor |
| means. A German experiment found that one | | | | talked about "Gomers" which were "a sort of |
| man who was sent out for a drive for just | | | | label we use for patients sometimes. It |
| under 4 hours one night was actually asleep | | | | comes from "get out of my emergency room". |
| for about 20 minutes. Evidently there was a | | | | You really don't want to see another patient |
| something like a built-in autopilot that gave | | | | when you are on call. They take up your |
| him just enough navigation information to | | | | time. They keep you from sleeping. They |
| prevent him from running off the road or | | | | make paperwork... They don't understand that |
| hitting another vehicle. According to | | | | we might have been working for 16 hours or |
| Coren, if we are already sleepy and it is a | | | | even 36 hours with no sleep. Sometimes, when |
| time of day when sleepiness is strongest | | | | that happens, at least for me, my eyes get |
| anyway, and we are driving, the urge to sleep | | | | all blurry and hard to focus. So I try to |
| at least for a few moments at a time becomes | | | | slow down and double check things...But I |
| irresistible. Even if we are only going at | | | | can't tell my Gomer my problems, because if I |
| 30 mph, a 10 second period of sleep will | | | | do he'll think I can't do my job right, and |
| result in you traveling 440 feet, which is | | | | if anything goes wrong we end up with lawyers |
| enough to take you across several lanes of | | | | and lawsuits...". Another commented "All |
| traffic and off the road for a distance | | | | you want to do is get them out of your ward. |
| longer than a football field's length. | | | | You don't want to talk to them...If you treat |
| That's scary. This problem is especially | | | | them like people, you are effectively |
| significant for those truck drivers who have | | | | punished for it. First of all it means that |
| to drive long distances at night, without | | | | you have to spend extra time with them, and |
| enough sleep, and often have got into bad | | | | that means more time in the ward...Maybe when |
| accidents because of it. | | | | I go into private practice, I'll start to |
| | | | take an interest in individual patients, but |
| Interestingly, the Stanford Sleep Disorders | | | | not now. Now, I'd rather sleep..." I hope |
| Clinic has published data which suggests that | | | | the conditions placed on interns and resident |
| up to 45% of patients with sleep apnea, and | | | | doctors have improved by now because I sure |
| 8% of patients with simple insomnia, report | | | | wouldn't want to be a patient of |
| that they have had at least one car accident | | | | sleep-deprived doctors like these. |
| which they attributed to being sleepy while | | | | |
| they were driving. Another study even found | | | | It is clear that there is a tremendous cost |
| that 93% of sleep apnea patients have had car | | | | both individually and to society in general, |
| accidents in which being sleepy or | | | | of not getting enough sleep. If you are |
| inattentive probably contributed to the | | | | sleepy and are driving a vehicle you run a |
| accident! | | | | serious risk of killing not only yourself but |
| | | | your passengers and also the people in the |
| Extended shift work causes mistakes made to | | | | place you crash into. Sleepy doctors run |
| sleepiness. A major factor in causing the | | | | the risk of hurting or even killing their |
| Challenger accident was keeping people on | | | | patients. And people who have been working |
| their shifts for, and ignoring scheduled time | | | | long shifts for many consecutive days can |
| off, for as many days as necessary to get the | | | | cause accidents that affect whole countries, |
| task done. According to Coren, during the | | | | or even the whole world (in environmental |
| year before the launch the average shift | | | | disasters). Make sure you get enough sleep, |
| length was 10 to 12 hours with work periods | | | | and the world will be a safer place! |
| ranging from 10-18 days in a row. One | | | | |