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Michael Farquhar Profile picture
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22 Oct, 4 tweets, 3 min read
Maybe I’m not educated enough either but I genuinely struggle to understand how this Government can’t find money to support this, when so much has been frittered away elsewhere

That Tory MPs, including a consultant paediatrician, can in conscience vote against this amazes me
Also: @RCPCHtweets @RCPCH_and_Us ... I know @MarcusRashford has an MBE now, but surely he deserves recognition from us as well, in view of how determined he is to give voice to children and young people and advocate on their behalf?
Very relevant @bmj_latest article, quoting @maxdavie @RCPCHtweets amongst others, on this, from a few weeks ago

bmj.com/content/370/bm…
“It all plays in together” Image

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More from @DrMikeFarquhar

Michael Farquhar Profile picture
24 Oct
Whether you’re the parent of a toddler (or an adolescent) or, like @WelshGasDoc, an overtired shiftworker, many people know the frustration of trying to get themselves or someone else to sleep but, no matter how tired they seem, they just won’t do it

Sleep has rhythms Image
How sleepy we feel, and how much we *need* to sleep don’t always match up

The simplest example of this is the post-lunch sleepiness many of us feel

Even if we don’t sleep, we usually feel *less* tired a few hours later when we’ve been awake longer

Weird, huh? Image
Sleep is a complex process, but we can simplify how we think about it into what is called the “two process” model of sleep

This describes sleep/wake as the interaction of two elements: Sleep Pressure (S), and Circadian Rhythm (C) Image
Read 39 tweets
Michael Farquhar Profile picture
23 Oct
The @gmcuk annual training survey is out, looking in particular at the impact of COVID19 on medical trainers and trainees

gmc-uk.org/-/media/docume… Image
As always there is lots of granular data in the report but at the high level:

~25% of trainees & ~20% of trainers score “high” or “very high” on Copenhagen Burnout Inventory questions in the survey

40% of both trainees and trainees describe work as emotionally exhausting Image
And almost half report feeling tired/fatigued at the end of the day

(though, as always, I think the phrasing of the question “are you exhausted in the morning at the thought of work” is quite an existential way of asking it!) ImageImage
Read 10 tweets
Michael Farquhar Profile picture
11 Jun
I have two twitter accounts: a professional one (this one), a personal one, and I run a third account for @RainbowNHSBadge

I’ve been trying to decide which account to post this thread from but I think it has to be this one really
My name’s Mike Farquhar. I’m a consultant paediatrician, specialising in sleep medicine

I have a couple of professional side-interests in parallel to my main job

One is the impact of shiftwork and sleep deprivation on NHS staff

The other is around advocating for LGBT+ people
I’ve spoken about what I’m about to speak about here before; much of the content comes from a plenary talk I gave @RCPCHtweets Conference last year

But, for reasons that will hopefully become clear, I think it’s important to restate some of this again

twitter.com/i/events/11327…
Read 25 tweets
Michael Farquhar Profile picture
20 May
I had a wee stint in our adult ICU team as part of COVID19 redeployment and, for some of that time, had an actigraph on

Actigraphy, worn like a watch, uses a number of sensors (mainly motion and light) to give an overall impression of sleep routine and pattern
Shift pattern was 3 long days/3 days off/3 nights/3 off, then repeat cycle

LOTS of caveats about this data:
- on shift, actigraph was in a scrubs pocket, often under PPE
- it isn’t directly measuring sleep
- one day I forgot to put it on at all...
- etc

But...it gives an idea
Some other points/caveats:
- black lines: motion/activity
- coloured lines: light exposure
- blue shading: sleep
- yellow: wake
- red: night shift
- purple: day shift
- I took some time to rest/recover on “off” days, but was generally doing “normal job” work on those days as well
Read 21 tweets
Michael Farquhar Profile picture
28 Oct 19
The joys of the Internet!

Great to be watching @harvardmed sleep medicine legend Chuck Czeisler delivering a celebratory lecture on “A Brief Journey Through Circadian Time” @BrighamWomens, from the comfort of my office 💤 💡
Prof Czeisler talking us through the history of human circadian research, starting with some of the early experiments confirming the tendency of humans to “free-run” if deprived of external cues about day/night, light/dark
The factors regulating sleep are complex, and we *still* don’t understand them all.

Prof Czeisler demonstrating how this early data was already hinting at some of the multiple oscillating processes underlying our circadian rhythms
Read 21 tweets
Michael Farquhar Profile picture
22 Sep 19
Today is #WorldNarcolepsyDay, aiming to raise awareness about a sleep disease which is often misunderstood by both the general public, and many doctors
Narcolepsy often seen as a “funny” illness, the punchline of a joke, or as a “good” thing (“I wish *I* could fall asleep anywhere/time!”)

It absolutely isn’t

Narcolepsy is a serious neurological disease which can cause significant disability and impair quality of life
Narcolepsy is a primary sleep disease, meaning it is sleep itself which is the source of the problems associated with it

Sleep is the foundation of our physical and mental health; when sleep is impaired, the consequences can affect every aspect of health and wellbeing
Read 26 tweets

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