Before you dismiss this article on sleep as irrelevant to or not possible for you, just give it a go. I used to be a terrible insomniac, and have completely turned that around. I used to live on coffee and sugar, to keep me going through the day, and then drink alcohol at night to try and settle my racy self down enough to sleep, which it did, temporarily, but my sleep was short-lived and of poor quality. I was exhausted, overweight and miserable. The single most important change I have made in life to become the happy, healthy, vital person I am today is to gradually bring forward the time I went to sleep. Of course, to do this, I had to change everything else about my life too! But it has made a huge difference to the way I feel and the way I live… and it may just help you too…
Doctors are usually chronically tired, if not exhausted. We think that this is just the way it is, and there is nothing we can do about it. We also think that it doesn’t matter much, that we are trained to deal with it and it does not really affect our performance.
Fatigue is as dangerous as being drunk
But studies have shown that fatigue causes symptoms similar to alcohol impairment, including forgetfulness, errors in judgment and reduced reaction time…which is not so great for us as doctors, or for our patients!
Being awake for 18 hours straight is the equivalent of having a blood alcohol level of 0.05% and being awake for just 20 hours straight is the equivalent of being 0.10%. These are pretty sobering statistics!(1)
Many of us have direct experience of this, of falling asleep or nearly so at the wheel of the car on our way to or from work…or of knowing we were impaired at work just because of sheer exhaustion.
So if we know that trying to function when tired is as dangerous as being drunk, what can we do about it?
We need to sleep
We need to sleep – we can go without food and drink for longer than we can go without sleep – and it is not just the amount of sleep that matters, but the quality and timing of that sleep.
It is not always possible for us to choose when we go to bed, because of our work hours and on-call commitments, but when we can, it is great to choose to go to bed early.
The hours of sleep between 9 pm and 1 am are those that rest and restore us the most, and if we miss out on these hours, no amount of sleep will ever feel enough!
Do you wake feeling refreshed, vital, alive and full of energy, as you used to feel when you were a child?
Or do you wake feeling as if you could sleep for a week, no matter how much sleep you may have had?
Could this be something to do with when we choose to go to sleep?
I have too much to do to go to sleep
We often stay up late thinking we need to finish tasks, or trying to have some ‘me’ time at the end of the day, particularly if we have young kids and just want some peace and quiet when they are asleep, or just because our day does not feel enough if we don’t spend some time doing whatever we feel like doing before the day’s end.
But you are more refreshed and alert in the early hours of the morning, so if you need to read or study or catch up on paperwork, going to bed early makes even more sense if you are super busy. It takes longer to do a task at the end of the day, and you are more likely to make mistakes when you are tired. And you may find that the earlier you go to bed, the less sleep you need, so you end up with more working hours in the day!
If you spend the first waking hours of your day doing what you love to do before you go to work, then you feel more full in yourself. You have taken care of yourself and are then more willing and able to dedicate the rest of the day to the care of others. You already feel complete, so you are not waiting to get the day over and done with so that you can have time for you, and at the end of the day you are ready to rest when you are tired, rather than feeling like you need something more to complete your day.
The quality of your sleep affects the quality of your day
As you go to bed earlier, the quality of your sleep increases, and so you feel more rested and refreshed the next day. Burnout, fatigue, exhaustion, and the need to eat and drink sweet things, drink coffee, and generally find energy from external sources decreases. You have more energy and are more able to exercise. And we actually need energy to go to sleep, so that if we go to bed when we are pleasantly tired, rather than waiting till we are exhausted, we sleep more soundly. With all of this, the quality of our diet, health and wellbeing can improve tremendously, as can our mood and our outlook on life.
All great reasons to make sleep a priority, no matter what else needs to be done. There are never enough hours in the day to do everything and there is never nothing to do, so we have to choose to stop sometime…why not stop when your body is tired instead of over-riding it and eating or drinking or doing something stimulating, that makes it harder to go to sleep when you finally decide it is time.
If you listen to your body and stop when you are tired and go to bed early, you may just find that you sleep soundly and wake feeling rested, refreshed and ready for the day in a way you have not felt for a very long time!
This article was first published on 11 November 2017 on To Medicine with Love