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