As we’re all very aware at this point in the semester, sleep quality and its duration will impact your performance in academia; unless you’re one of those people that function on 2 hours of sleep which is something that I will never understand. For the rest of you, if you need a minimum of 6 hours stay tuned for my unraveled thoughts on this topic.
Multiple studies in the article of Lukowski cited the sleep patterns of college students compared to those of high school students. Some noting the lack of sleep at night on a college student’s “leisure days” or their nighttime mid-sleep being later on during school days. Others studying the percentage of students with poor sleep compared to “normal” Finnish adults. All of this to say that at a molecular level, our biological factors such as sleep architecture and circadian rhythms are affected. And of course, the basis of this blog being how it effects our academia while trying to balance a social life (is that still a thing in grad school?).
I’m sure some of you can relate to how lack of proper sleep can affect a myriad of things on a personal level: your mood, temperament, ability to focus, motor skills, etc. Let’s dive into a little bit of physiology and explore the effects that lead us to these sleep deprivation symptoms. I thought it was interesting that a study by Dawson and Reid used alcohol to compare sleep deprivation symptoms. They found that being awake for 17 hours was comparable to a blood alcohol concentration of 0.05% and 24 hours was comparable to 0.10%. That went from legal driving limit to you should definitely NOT be behind the wheel of a moving vehicle. And to think that we can relate this to how it affects us in class?! Are you rethinking your sleeping habits yet?
Research has found correlations of sleep deprivation with decreases in glucose metabolism. Highly impacted areas of the brain in this regard are cortical and subcortical structures. Didn’t Dr. Campisi just tell us something about The Queen’s Gambit and extremely intelligent chess players having a metabolic rate of 6000kcal/day or something? I know I don’t have that kind of metabolic rate happening in my brain reserves but regardless, I still want a decent amount of glucose to be able to even be metabolized.
In addition to our concern about glucose metabolism, another factor to think about is our cortisol levels. Don’t you think you’re more stressed with a lack of sleep? Yeah, that has to do with our cortisol levels being turned upside down. This is a major hormone that’s affected by changes in our sleep habits (Bhatti et al. 2019). Lack of sleep equals decreases in cortisol levels. Decreases in cortisol levels equals increases the probability of us not being nice to our colleagues.
Moral of the story, please cognizant the amount of sleep you’re getting every night and don’t forget that quality matters! I believe we can incorporate non-malfeasance into this blog as we think about the ways we might be harming ourselves, others, and our potential patients as we look at our future selves as physicians, dentists, and PAs. Of course, you’d never treat a patient while being inebriated, so why would you treat a patient while under the effects of sleep deprivation? I know this sounds easier said than done, as we all need to live a little and the reality of life often gets in the way. I get it, try telling all of this to graduate, professional students, and those working in the ER during the wee hours of the night/morning.
I hope this gets you to think about the damaging effects of sleep deprivation and entices you to do your own additional research on the long-term effects of sleep deprivation and our well-being. Long-term chronic stress from lecture at the beginning of the semester ring a bell to anyone here? Just me? Ok…
As I write this blog post at 2 a.m. on a Saturday night/Sunday morning (technicalities), I realize how ironic this sounds. But don’t fret, I’ll be sure to shut the blinds and make sure I get at least six hours of sleep clocked in tonight for an optimal “study day” tomorrow. Remove the quotes, of course I’ll be using my Sunday to study… I am in grad school after all.
Dawson D, Reid K. Fatigue, alcohol and perfor- mance impairment. Nature. 1997;388:235. (Reference found in Short & Banks research)
2. Short, M. A., & Banks, S. (2014). The Functional Impact of Sleep Deprivation, Sleep Restriction, and Sleep Fragmentation. In M. T. Bianchi (Ed.), Sleep Deprivation and Disease (pp. 13–26). Springer New York. https://doi.org/10.1007/978-1-4614-9087-6_2
3. Lukowski, A. F., & Milojevich, H. M. (2015). Sleep Quality and Temperament Among University Students: Differential Associations With Nighttime Sleep Duration and Sleep Disruptions. Behavioral Sleep Medicine, 13(3), 217–230. https://doi.org/10.1080/15402002.2013.855214
4. Bhatti AA, Qureshi ZA, Jawaria, Umar N, Nasir R, Khan UA. Correlation of serum cortisol with sleep habits and daytime sleepiness of young adults. Isra Med J. 2019; 11(4): 208-212.
Hi Diem!
ReplyDeleteThanks for sharing, I am definitely reevaluating my sleeping schedule after reading your blog post! The most interesting thing about your posts is the comparison between sleep deprivation and alcohol toxicity, it truly does put a different perspective on the importance of getting an adequate amount of quality sleep each night. As I read your post I was thinking about if the routine of sleep played any role in the quality and quantity of sleep of an individual. As a kid my parents would have me on a regulated schedule in which it did not matter if it was the weekend, holidays, or vacation we always woke up at the same time. As a teenager I remember my friends would find it funny that I would wake up so early on a weekend. I came across this article that delves into my question and it turns out that having a set sleep schedule does in fact promote memory function and overall academic performance (Curcio & Degennaro, 2006). The study found that students that reported higher levels of academic performance and increased focus had a higher sleeping total than those who were not performing as well in their academics. This group of students also reported they would go to bed early and wake up at the same time on school days as well as weekends, which the team termed as “hygienic sleep” (Curcio & Degennaro, 2006). I am looking forward to those extra couple hours of sleep in return for some added focus and concentration for my study days.
Reference:
CURCIO, G., FERRARA, M., & DEGENNARO, L. (2006). Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews, 10(5), 323–337. https://doi.org/10.1016/j.smrv.2005.11.001
Thank you for sharing your experience! It's obvious that your parents knew what they were doing and set you up for success right from the start! I think it's so interesting that the small habits you carry out consistently can contribute to something so much bigger before you know it; in this case healthy sleeping habits and your grades. I really like that term "hygienic sleep" because it puts your health, by means of sleep, in a very interesting perspective. We always think of other things as part of our hygiene like showering or brushing our teeth, but to think that you can have a hygienic sleep as well even more so entices me to achieve proper sleep. I looked into another article that correlated sleep timing, quality, and duration with academic scores. The study touch on what you talked about in the sense of having healthy sleep habits positively affecting high school students' grades in Italy (Lorenzo et al. 2015). It's interesting that even after taking other external factors into account, the student's sleep efficiency had the greatest effects on their academic scores. I feel like it's so important to be cognizant of this when we want to push ourselves at 2 in the morning trying to squeeze in a little extra study time. Sometimes, we just need to be kinder to ourselves and remember that sleep is just as important as that extra hour of studying!
DeleteTonetti, L., Fabbri, M., Filardi, M., Martoni, M., & Natale, V. (2015). Effects of sleep timing, sleep quality and sleep duration on school achievement in adolescents. Sleep medicine, 16(8), 936–940. https://doi-org.dml.regis.edu/10.1016/j.sleep.2015.03.026
Diem,
ReplyDeleteI know we all can relate to lack of sleep or pulling all-nighters at one point in our academic careers. But I never thought that it would be equivalent to being inebriated. In high school, I definitely had some close calls while driving back from a two-a-day practice schedule (morning practice, school, then a second practice afterwards). Sometimes, I only remember being at practice and then laying in my bed after a late dinner. Very scary to think that I was basically driving drunk.
I’m also worried about how lack of sleep will affect our memories, especially in our future professional schooling. Anecdotally, my med school friends have complained about their sleep decreasing and the amount that they have to study. In a study with 314 med students, Brick et al. (2010) found 148 of the sample qualified for poor sleep quality as indicated by their Pittsburgh Sleep Quality Index score. In a review of fMRI memory studies, Chee & Chuah (2008) found working memory was impaired as well as attention which often leads to increased errors. This has strong implications while in professional school. Imagine being on call as a med student and having to perform a surgery. Both your cognitive and motor functions are significantly impaired.
Looking at my sleep stats from last night, my Garmin only recorded 6 hours of sleep. Sleep has always been an issue for me, but I’m going to start working on it tonight!!
Brick, C. A., Seely, D. L., & Palermo, T. M. (2010). Association between sleep hygiene and sleep quality in medical students. Behavioral sleep medicine, 8(2), 113–121. https://doi.org/10.1080/15402001003622925
Chee, M. W. L., & Chuah, L. Y. M. (2008). Functional neuroimaging insights into how sleep and sleep deprivation affect memory and cognition. Current Opinion in Neurology, 21(4), 417–423. Retrieved October 3, 2021, from http://cogneuro-lab.org/userfiles/publication/cheechuah_functionalneuroimaginginsightsintohowsleepandsleepdeprivationaffectmemoryandcognition_curropinneuro_2008.pdf.
Thank you for your contribution to this post! You've brought up some really good points about sleep deprivation with those going through medical school. You would think that when grooming future physicians that our society would take into consideration the detrimental effects of sleep deprivation. Instead, I feel like our society still promotes and even emboldens those in healthcare to function on minimum amounts of sleep and still expect optimal results. That's ridiculous because people's lives are literally in our hands and you want the minimum amount of errors possible..!
DeleteI looked into your Brick et al. 2010 reference and appreciate the fact that they took other demographics into consideration as well as drugs like caffeine, tobacco, and alcohol. It's a bit comforting to me that they found that those students had similar sleep qualities of those their age outside of their profession. Still it doesn't meant that those sleep qualities were great.. Disheartening to read that half of those participants met the clinical cutoff for poor sleep quality.
I will always be an advocate for better structures to be put into place for those in professional schools to have healthier environments for better sleep, and subsequently produce healthier professionals because of it. It will always be ironic to me that we as professionals will advocate for better overall health habits among our patients, when we are sometimes the ones contributing to the hypocrisy of it all.
This study reminds of an episode of Mythbusters when they compared driving drunk and driving sleep deprived. I believe they found that driving sleep deprived can actually be worse than driving drunk and being high, following the conclusion of the study mentioned.
ReplyDeleteDiving deeper into the effect sleep deprivation can have on students, specifically graduate students like ourselves, I found that it may also be the cause for burnout. Like you mentioned in your article, sleep deprivation can cause increased amounts of stress, something graduate students already experience regularly. The study I found also mentioned that this increased amount of stress due to sleep deprivation may also be the main cause of burnout in graduate students. By increasing the amount and quality of sleep the students experienced, the less stressed they became with a decrease in the risk of burnout. I don't think sleep deprivation is the only cause of burnout, but it is nice to know that maybe good sleep will help stave it off.
Allen, H. K., Barrall, A. L., Vincent, K. B., & Arria, A. M. (2020). Stress and burnout among graduate students: Moderation by sleep duration and quality. International Journal of Behavioral Medicine, 28(1), 21–28. https://doi.org/10.1007/s12529-020-09867-8