Michael Farquhar Profile picture
Consultant in Sleep Medicine @EvelinaLondon @GSTTnhs Kids' sleep #FightFatigue @RainbowNHSBadge 🏳️‍🌈 He/Him 🏴󠁧󠁢󠁳󠁣󠁴󠁿
11 Jun 20
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
20 May 20
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
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
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
26 May 19
“You get to exhale now?

Growing up LGBT+ in the UK today”

This is a @TwitterUK version of the talk I gave @RCPCHtweets Conference this month

#LGBTMoment
I grew up in Scotland in the 80s and early 90s.

The social and media attitude towards gay people, and LGBT+ people in general, was actively hostile and toxic.

Stories like this were the norm. The way people talked about gay people around me was generally negative
In 1987, 75% of the UK population agreed with the statement:

“Homosexual activity is always or mostly wrong”

Think about that for a second

It’s only 32 years ago - 3/4 of UK population thought there was something fundamentally wrong just with being gay
Read 41 tweets
21 Mar 19
Right ... it’s been 7+ years since I last put on a pair of a scrubs to do a nightshift in a hospital

This is a slightly odd night shift though ...
Welcome to Snow Leopard Ward @EvelinaLondon!

Phase 1 of Snow Leopard, opened in 2016, is our Transitional Care Unit, supporting patients who need Long Term Ventilation as they head from our acute wards to home
We’re just about to open Phase 2 of Snow Leopard ... which will include three new dedicated bedrooms as part of our Children’s Sleep Centre
Read 82 tweets
15 Mar 19
It’s #WorldSleepDay

Sleep is absolutely essential to your physical and mental health

Sleep’s rhythms underpin everything you do, ensuring your brain and body are working at their best: an MoT every night!

We’re often bad at recognising that, and prioritising sleep in our lives
If you’ve had the right amount of good quality sleep, you should be waking physically and mentally ready to tackle the day ahead

#WorldSleepDay
... many of us don’t feel that way though, especially on a weekday!

Most adults in the UK get about an hour’s less sleep than they need each night ... the equivalent of missing an entire night of sleep every week!

rsph.org.uk/about-us/news/…

#WorldSleepDay
Read 163 tweets
3 Feb 19
It isn’t just @nhs where we need to emphasise rest/breaks are essential for people to be able to safely and effectively do the jobs we need them to

Air traffic controllers have mandatory break after 2 hrs work

Why don’t we see importance of regular rest in other professions?
Especially for shiftworkers, we need to think about this better - and be clear with the message around it that we send to the general public

A rested, fed and watered police officer is one who can do their job better

@bmj_latest blogs.bmj.com/bmj/2017/10/06…
Read 2 tweets
3 Nov 18
This story about melatonin use in children is in the Guardian today

A few key points:

@EvelinaLondon @maxdavie @RCPCHtweets

theguardian.com/society/2018/n…
As we better understand the importance of good quality sleep in childhood to short and long term health and development outcomes, more attention is being paid to sleep problems in children

Assessing, and deciding if/when intervention is needed, is therefore happening more often
Most childhood sleep issues can be managed without needing to use medications.

Medication for most sleep problems, as in adults, is only appropriate after thorough assessment and where non-medication options have been unsuccessful

@TheSleepCharity

thechildrenssleepcharity.org.uk/parents.php
Read 20 tweets
24 Oct 18
Adolescents often get a hard time about how - and when - they sleep.

Some basic misunderstandings about adolescent sleep physiology often lie at the heart of it.

Here’s what you need to know:
First of all, adolescence may not be what you think it is.

Adolescence is the period where body, brain and mind are transitioning from child to adult.

Physical changes in the brain continue into the early 20s, with frontal “executive” functions the last to fully mature
We all have an internal body clock, our circadian rhythm, that keeps us awake in the day and asleep at night.

When your body clock is out of sync - like when you’re jet lagged - it can be difficult to sleep at the right time
Read 32 tweets
16 Mar 18
It’s #WorldSleepDay

Sleep is absolutely essential to your physical and mental health.

Sleep’s rhythms underpin everything you do, ensuring your brain and body are working at their best.

But we’re often bad at recognising that, and prioritising sleep in our lives
If you’ve had the right amount of good quality sleep, you should be waking physically and mentally ready to tackle the day ahead

#WorldSleepDay
... many of us don’t feel that way though, especially on a weekday!

Most adults in the UK get about an hour’s less sleep than they need ... the equivalent of missing an entire night of sleep every week!

rsph.org.uk/about-us/news/…

#WorldSleepDay
Read 136 tweets
26 Oct 17
Ensuring you get enough sleep, and REM sleep in particular, makes you better able to cope with emotional stress.
Most REM tends to be found at the end of the night so, if you’re getting an hour less sleep than you need, it’s likely REM you’re losing
People working at night likely to end up even more acutely REM-deprived

Makes you more irritable, less empathic, less emotionally tolerant
Read 4 tweets