Prioritizing Sleep for High-Performance Teams in the Emergency Department
SAEM PULSE | MAY-JUNE 2022
By Amanda J. Deutsch, MD, and Al’ai Alvarez, MD, on behalf of the SAEM Wellness Committee
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Like our mobile phones and other handheld devices, our energy depletes over time and needs to be recharged. Likewise, when it comes to our energy at work, we are recharged and our performance is optimized by a few critical things: food, exercise, and rest — especially a good night’s sleep. Not only is lack of sleep not good for your long-term health, in the short term, it can impact performance and put you at risk for mistakes and accidents. The long-term effects of sleep impairment are astounding. Briefly, lack of sleep shortens our lives. Adults who sleep fewer than six hours a night have a 200% increased likelihood of a heart attack or stroke in their lifetime and a 40% increased risk of developing cancer. Short sleep time leads to a 45% increase in developing coronary heart disease. In one study, restricted sleep for one week (<6 hr) caused an
individual’s cells to be insulin resistant, and in another, sleep-deprived mice showed a 200% increase in speed and size of cancer growth. If that is not enough, sleeping less impacts our DNA by physically damaging telomeres. While long-term complications of sleep disruptions are well established, it is essential to consider the impact of impairment in sleep on our performance. Emergency physicians are not unlike elite athletes and other highperformance teams — the moment we step into the emergency department, we are on the go and performing at a high level until we leave. EKGs are handed to us to gauge whether to quickly activate the Cath lab. We are constantly assessing the board for patients who need expedited rooming and acute interventions, serially taskswitching our focus on various highpriority decisions, all while taking time to
convey treatment plans to patients and families in a compassionate manner. Imagine going through medical school with people telling you, “You need to go home and get some sleep to better learn the skills you’re being taught.” Studies have shown the importance of sleep on motor skills to the extent that the International Olympic Committee released a consensus statement highlighting the need for sleep across all sports and genders. Performance, specifically with elite athletes, has been studied to see what happens when athletes get fewer than eight hours of sleep. In his book, Why We Sleep, Matthew Walker shared statistics of Golden State Warrior Andre Iguodala’s performance based on his sleep habits. When he had more than eight hours of sleep, he had a 12% increase in minutes played, 29% increase in points per minute, 2% increase in three-point
