january 2008 | Welcome to Finding Balance eNews.

Catch Some Zs
Some of you may be familiar with the expression to catch a couple of Zs. This is derived from the use of the letter Z in comic strips to indicate sleeping. Apparently we docs are not catching enough Zs!

In a randomized, internet-based questionnaire, the American College of Chest Physicians Sleep Institute (ACCP-SI) surveyed 5,000 US physician members about current sleep habits and how sleep affected work and day-to-day performance (1). Of the 581 respondents, 70 percent reported needing at least 7 hours of sleep to function at their best during the day, yet physicians reported sleeping an average of 6.5 hours on a workday.

Physicians reported "making up" for lost sleep on the weekends or days off by sleeping an average of 7.5 hours a night. Furthermore, 43.1 percent of physicians indicated their current work schedule did not allow for adequate sleep. Physicians rarely reported insomnia or difficulty initiating or maintaining sleep. However, 21.8 percent reported not feeling refreshed upon waking at least a few nights a week.

Most physicians indicated that sleep issues did not significantly impact work performance or other daily activities. However, 18 percent of physicians reported missing at least one family or leisure activity due to sleep issues.

In an earlier article, reported in Internal Medicine News, it was stated that 52 percent of 500 primary care physicians randomly surveyed by telephone reported have sleep difficulties, averaging 15.8 nights of sleep difficulty/month. When you further analyze the difficulties: 20 percent took an average of 26 minutes to fall asleep, 19 percent dozed off while driving and 20 percent used sleep agents at least twice per month.

This is concerning for our long and short term health. The short term concern is falling asleep while driving. While you may consider this a rare event, I suspect that you can remember at least one time arriving home or to the hospital and not remembering how you got there. It is also likely that you caught yourself dozing off while driving, awaking quickly to catch yourself.

The long term ramifications are also concerning. Too little sleep may raise the risk of developing heart disease. In the nurse’s health study, women who averaged five hours or less of sleep a night were 39 percent more likely to develop heart disease than women who got eight hours. Those sleeping six hours a night had an 18 percent higher risk of developing CAD than the eight-hour sleepers (3).

Lack of sleep is associated with hypertension, elevated cortisol and catecholamines, lower glucose intolerance and lower heart rate variability, all of which are associated with increased CAD risk.

In summary, we tend to under-value and under-estimate the importance of sleep – please catch some Zs!

• American College of Chest Physicians (2008, March 5). Most Physicians Sleep Fewer Hours Than Needed For Peak Performance, Report Says. ScienceDaily. Retrieved March 6, 2008, from http://www.sciencedaily.com/releases/2008/03/080304075723.htm
• Dr. Thomas Roth, Ph.D., Chief of the Division of Sleep Disorders Medicine at the Henry Ford Hospital in Detroit (Internal Medicine News, 12-1-96, pg. 1).
• A Prospective Study of Sleep Duration and Coronary Heart Disease in Women Najib T. Ayas, MD; David P. White, MD; JoAnn E. Manson, MD, DrPH; Meir J. Stampfer, MD, DrPH; Frank E. Speizer, MD; Atul Malhotra, MD; Frank B. Hu, MD, PhD, Arch Intern Med. 2003;163:205-209.

Just for fun
I’ve been listening to a lot of Joshua Radin recently. I first heard him on the sound track of the movie, The Last Kiss as well as on the Scrubs soundtrack. His voice is very reminiscent of Art Garfunkel’s (of Simon and Garfunkel), sweet, whispery and soft. For a great sample check out the song Star Mile on the album We Were Here. Highly recommended!