Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Sleep isn’t a luxury. It’s a medical necessity.

Drew Kotler
Conditions
August 24, 2014
Share
Tweet
Share

Most hospitals are strapped with a massive amount of debt.  Not monetary debt, but sleep debt.   Amongst both the staff and patients, sleep is severely lacking.  In our busy society, we associate sleep with leisure and relaxation; a reward at the end of a long day.  But sleep isn’t a luxury.  Rather, it’s a medical necessity.

Sleep deprivation has widespread consequences, causing cognitive dysfunction, weakened immune system, impaired healing, increased blood pressure, increased insulin resistance, increased cortisol levels, increased risk of mental illness, and even increased mortality.  Although some of these sequelae come from long-term sleep debt, the ones that are most germane to the inpatient setting, such as decreased immunity and healing, begin the moment sleep quality deteriorates.  Our circadian rhythm, the 24-hour internal clock that dictates a myriad of cyclical biological functions, is exquisitely sensitive to a lack of sleep.  When it is running smoothly, it’s like a world-class orchestra performing a Beethoven masterpiece.   When it is out of sync, it turns into a room full of unruly kindergartners during music class.

Unfortunately, we don’t facilitate good sleep in the hospital.  There is the incessant beeping and chirping of various devices and voices throughout the hospital, which can prevent patients from even beginning to drift to sleep.  Additionally, patients are routinely awakened throughout the night and early in the morning.  If a patient had surgery, they’re likely getting their vitals checked repeatedly overnight.  If they didn’t have surgery, they’re still likely being awakened late at night for a blood draw.   Then, as early as 4 a.m., a disjointed parade of medical staff begins to enter and exit their room.

Even if we don’t notice, we hold the notion that patients are our subjects that should wake up when we want them to, but this is problematic.  Sleep is an important aspect of medical treatment.  Thus, waking a patient is a health risk that should always be weighed against its benefits.  For instance, consider the multiple post-operative overnight vital sign checks.  Awakening a post-operative patient to check vital signs can certainly save a patient’s life (hence the term vital signs).

However, saving a life by checking overnight vitals is much more likely to be in a high-risk patient with multiple comorbidities.  To avoid unnecessarily awakening low-risk patients, an evidence-based risk stratification system could decide the frequency of checks a patient actually needs.  An even better solution is to monitor vitals without walking into the room.  Costly but effective, wearable wireless monitors can retrieve vital signs without disturbing the patient’s sleep.

Even without extra costs, we can easily promote good sleep hygiene. Patients should be advised to avoid late night television, avoid taking multiple naps, and get out of bed during the day if possible.  Patients should also be exposed to sunlight during the day and darkness at night to calibrate their circadian rhythm.  Ultimately, we as health care providers have to acknowledge the medical value of sleep.  Maybe once we do, we’ll allow ourselves to sleep too.

Drew Kotler is a medical student. 

Prev

MKSAP: 59-year-old man with intermittent itching

August 24, 2014 Kevin 0
…
Next

Direct primary care and concierge medicine: They're not the same

August 24, 2014 Kevin 5
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
MKSAP: 59-year-old man with intermittent itching
Next Post >
Direct primary care and concierge medicine: They're not the same

ADVERTISEMENT

More by Drew Kotler

  • a desk with keyboard and ipad with the kevinmd logo

    Dissecting a cadaver cannot be replaced by technology

    Drew Kotler

More in Conditions

  • Medicaid lags behind on Alzheimer’s blood test coverage

    Amanda Matter
  • Why transgender health care needs urgent reform and inclusive practices

    Angela Rodriguez, MD
  • Why the Sean Combs trial is a wake-up call for HIV prevention

    Catherine Diamond, MD
  • New surge in misleading ads about diabetes on social media poses a serious health risk

    Laura Syron
  • mRNA post vaccination syndrome: Is it real?

    Harry Oken, MD
  • The critical role of nurse practitioners in colorectal cancer screening

    Elisabeth Evans, FNP
  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • How federal actions threaten vaccine policy and trust

      American College of Physicians | Conditions
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • An addiction physician’s warning about America’s next public health crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Gen Z’s DIY approach to health care

      Amanda Heidemann, MD | Education
    • What street medicine taught me about healing

      Alina Kang | Education
    • Smart asset protection strategies every doctor needs

      Paul Morton, CFP | Finance
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • How IMGs can find purpose in clinical research [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • How federal actions threaten vaccine policy and trust

      American College of Physicians | Conditions
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • An addiction physician’s warning about America’s next public health crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Gen Z’s DIY approach to health care

      Amanda Heidemann, MD | Education
    • What street medicine taught me about healing

      Alina Kang | Education
    • Smart asset protection strategies every doctor needs

      Paul Morton, CFP | Finance
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • How IMGs can find purpose in clinical research [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Sleep isn’t a luxury. It’s a medical necessity.
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...