(usual caveat that, because this was published in the BMJ, “healthcare professionals” was changed to “doctors” in the headline but, clearly, this isn’t just about doctors)
And this, more than ever:
“When the pandemic is over, and we return to some sense of “normal” again, we will need an even more vigorous discussion about what safe staffing, safe resources, and a safe model of care really mean in the modern NHS.”
Excellent thread from @DrShreeUnadkat explaining why # many of us are feeling the way we are as the second COVID19 wave continues to strengthen, and practical suggestions to help
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
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?
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)
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
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!)
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?
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
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