Sleep – could it be a cure for all ills?

According to the British Medical Journal, the issue of sleep (or lack of it) is back in fashion.

Two recent books, Why We Sleep by neuroscientist Matthew Walker and The Business of Sleep by clinical psychologist Vicki Culpin, warn in the strongest terms that regularly sleeping less than seven hours a night is a disaster for our mental and physical wellbeing.

As a culture, we in rich countries are in the throes of what Culpin calls “an epidemic of sleeplessness”, increasing our risk of depression, anxiety, dementia, stroke, heart disease, obesity, cancer, diabetes, and road traffic crashes.

Walker describes “low level exhaustion” as the accepted norm, with the same dire consequences, especially bad for night owls and for teenagers forced to function against their natural circadian rhythms.

As I well remember sleep deprivation has long been a normal part of life for doctors. It is increasingly recognised as harmful both to doctors and to patients because people are not good at assessing their own levels of fatigue. Doctors are encouraged to look for warning signs in themselves and their colleagues, and organisations should take more responsibility for how much fatigue an employee accumulates.

Hospital trusts may be forced to ensure regular four-hourly breaks if legal action brought by a group of junior doctors is successful.

And calls for better monitoring by medical directors will intensify as more information emerges about the intense unbroken and undersupported 13-hour shift endured by Hadiza Bawa-garba, a doctor recently struck off over the death of Jack Adcock.

What we need is a better understanding of how to minimise sleep debt among those working night shifts. This is why I’m writing about a strategy for dealing with night shifts drawn up by Helen Mckenna and Matt Wilkes. Watch this space.