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Sleep is more important than food

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Re: Sleep is more important than food

#151

Post by Poiesis »

silverlake wrote: post #121
mjfern wrote: post #35

Earlier quoted context omitted.

Even more disconcerting is the sleeping culture/routine throughout medical residency and fellowship; arguably, the most important stages of medical education, where doctors in training learn the hands-on skills to practice medicine. Despite the importance of learning during this stage, individuals are routinely sleep-deprived: "20% of all residents reported sleeping an average of 5 hours or less per night, with 66% a…

I've asked many doctors about this. They insist that they are not effected by sleep deprivation. They claim it is safer to have the same doctor for 24-48 hours rather than hand off a patient to a new, fresh doctor.

I don't doubt that the handoff is a risky part of the process. But that doesn't mean that we can't do a better job at figuring out how to make the handoff process better.

Re: Sleep is more important than food

#152

Post by jpr »

dexen wrote: post #62
kscaldef wrote: post #14

Earlier quoted context omitted.

No, those schools have cultures that promote such behavior. I was a grad student and TA at Caltech and observed that the undergrads had horrible time management skills. Procrastination and heroic effort at the last minute were the norm. (I'm not specifically picking on Caltech undergrads, BTW. I'm fairly sure this is typical at most schools.)

Scheduling Algorithms for Procrastinators: http://www.cs.sunysb.edu/~bender/pub/JoS07-procrastinate.pdf ``We are writing this sentence two days before the deadline. Unfortunately that sentence (and this one) are among the first that we have written. How could we have delayed so much when we have known about this deadline for months? (...)''

That looks like an interesting paper. I'll save it so I can read it later.

Re: Sleep is more important than food

#153

Post by RK »

philwelch wrote: post #56
pyre wrote: post #49

Earlier quoted context omitted.

To some extent the sleep deprivation is a weeding process/learning experience in and of itself. Being able to perform under stress/lack of sleep is a good quality in a doctor.

How many doctors are actually weeded out after they get to their residency, though? First year of med school, absolutely. Residency is a bit late.

By the time you hit residency, you are so far into debt that not having a job that pays $100k+ (eventually) is suicidal. That being said, some people do drop out.

I know one person who dropped out, but was at married to another resident, so has a safety net. Another resident dropped out due to a medical condition that prevented him from standing for hours a day and landed a job at McKinsey. Another friend dropped out and became a receptionist! Eventually she went into a residency for a lower stress specialty (surgery -> psychiatry).

Re: Sleep is more important than food

#154

Post by mattm »

kylek wrote: post #46
mjfern wrote: post #35

Earlier quoted context omitted.

Even more disconcerting is the sleeping culture/routine throughout medical residency and fellowship; arguably, the most important stages of medical education, where doctors in training learn the hands-on skills to practice medicine. Despite the importance of learning during this stage, individuals are routinely sleep-deprived: "20% of all residents reported sleeping an average of 5 hours or less per night, with 66% a…

One thing that I wanted to try (but never had the schedule to support) is polyphasic sleep ( http://en.wikipedia.org/wiki/Polyphasic_sleep ). The idea that sleeping 15 minutes every 4 hours (on a very strict schedule) to keep your mind close to a waking-REM-type sleep. Granted, every few weeks you would have to crash HARD (20+ hour rest).

From what I've read about polyphasic sleep, it doesn't seem to be best for humans. A lot of people have difficulty with it. I've come to the conclusion that people are biphasic. I think people perform their best with a long night's sleep and then a short nap around 2pm. I've noticed this works for me. YMMV.

Re: Sleep is more important than food

#155

Post by Silhouette »

silverlake wrote: post #121
mjfern wrote: post #35

Earlier quoted context omitted.

Even more disconcerting is the sleeping culture/routine throughout medical residency and fellowship; arguably, the most important stages of medical education, where doctors in training learn the hands-on skills to practice medicine. Despite the importance of learning during this stage, individuals are routinely sleep-deprived: "20% of all residents reported sleeping an average of 5 hours or less per night, with 66% a…

I've asked many doctors about this. They insist that they are not effected by sleep deprivation. They claim it is safer to have the same doctor for 24-48 hours rather than hand off a patient to a new, fresh doctor.

That level of delusion is actually more scary than the sleep deprivation itself.

It's like a guy who's driving home after a 20 hour day that ended with a couple of drinks at the bar, calling home from the car to tell the wife that he's on his way and his driving is perfectly safe. In reality, he is so impaired by the tiredness, the alcohol, and the distraction of the call that he can no longer even understand how far off his game he must be, nor judge the horrific risk he must be taking by driving in that way.

Re: Sleep is more important than food

#156

Post by plastics »

silverlake wrote: post #121
mjfern wrote: post #35

Earlier quoted context omitted.

Even more disconcerting is the sleeping culture/routine throughout medical residency and fellowship; arguably, the most important stages of medical education, where doctors in training learn the hands-on skills to practice medicine. Despite the importance of learning during this stage, individuals are routinely sleep-deprived: "20% of all residents reported sleeping an average of 5 hours or less per night, with 66% a…

I've asked many doctors about this. They insist that they are not effected by sleep deprivation. They claim it is safer to have the same doctor for 24-48 hours rather than hand off a patient to a new, fresh doctor.

The problem with sleep deprivation is that unless you have an objective way of measuring your (mental) performance you're usually not able to realize when it declines, because your're self monitoring capabilities decline as well.

A simple test, that worked very well for me, was testing my reading speed (I know it is only a weak indicator for mental acuity, but it is easy and fast to test).

Under perfect conditions (well rested, optimal nutrition, completely silent room, no visual distractions, after mediation and a good cup of green tea) I am able to read about 800 WPM (which is not to bad) of the kind of text I usually need to read with good retention. For me this declines rapidly to less than 200 WPM (which is quite bad for a "knowledge worker") with sleep deprivation and/or a noisy environment, even though I believe I am doing fine.

That being said, even though I would say that doctors are handicapped "mental performance" is handicapped by their working conditions, I fully agree that it is better for patient safety to not hand off a patient to a new doctor say every 8 or 12 hours due to the amount implicit knowledge that a doctor gathers during a >24h time period about his patients that can't be transferred in a handoff.

Software Developers, imagine what a screw up it would be if you'd have to hand off your code every 8h to another developer, who'd have to continue right were you left... add to this not having a version control system, spotty test coverage and highly ambiguous specifications

Re: Sleep is more important than food

#157

Post by dexen »

jpr wrote: post #152
dexen wrote: post #62

Earlier quoted context omitted.

Scheduling Algorithms for Procrastinators: http://www.cs.sunysb.edu/~bender/pub/JoS07-procrastinate.pdf ``We are writing this sentence two days before the deadline. Unfortunately that sentence (and this one) are among the first that we have written. How could we have delayed so much when we have known about this deadline for months? (...)''

That looks like an interesting paper. I'll save it so I can read it later.

It's ``ha ha only serious'', actually. Whimsical style and solid analysis of algorithms you can actually use to schedule your procrastination & work better.

Re: Sleep is more important than food

#158

Post by forensic »

hoag wrote: post #145

Preparing for the California Bar Exam was a fascinating experience for me. Not only was it the most mentally challenging endeavor I had ever undertaken, it proved to be the most psychologically challenging as well. Fortunately, our two bar prep professors were not only licensed attorneys, but also Ph.D.s in neuropsychology. Part of our rigorous training therefore was not simply learning the law, but actually learning…

You're assigning your success to disciplined sleeping habits which seems very strange.

I would ascribe your success to proper nutrition, proper mnemonics, adequate sleep, and lots of studying.

Getting enough sleep (and not too much) is important but what is the advantage of keeping it within those tight boundaries? The natural human sleep cycle is often running on non-24 hour cycles and the science I've seen indicates that if you CAN work on these cycles it enhances memory, cognition and creativity.

I don't understand why you give so much credit to your rigid sleep schedule, especially because all the science I've seen indicates that what is important is getting adequate sleep and then studying properly, not sleeping at particular times.

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