Why you should care
We spend a third of our lives doing it, so how much should doctors study it?
Go ahead and ask medical students how much time they spend in the classroom learning about sleep — wait, that’s a bad idea. They’re busy cramming for an exam and they’re exhausted. Whoa, look at that one’s eyes.
But hypothetically, say you were to nudge awake some slumbering soon-to-be white coats in the library and ask that question. How much are they learning about the topic on everyone’s mind — that running clock, that constant struggle, that reason for a great or horrible day … but too late. They’re back asleep.
Well, the hypothetical students, if they were hypothetically awake, might confess:
U.S. medical students get only three hours of schooling on sleep science, even though sleep is essential to good health.
“We spend a third of our lives sleeping, and we spend just a couple of hours [studying sleep] in so many years of undergraduate medical training,” says Dr. Daniel Goh at the National University Children’s Medical Institute in Singapore. “It sounds appalling, really.”
In 2011 Goh sent surveys to 409 medical schools in 12 countries to see how they compared in their sleep curriculum. The appalling results show the U.S., along with Australia, ahead of the pack, with around three hours spent on the subject in classrooms or in residency. Indonesia, Malaysia and Vietnam reported zero hours.
That’s really not good enough, according to Goh. And because only around a quarter of those contacted responded to the survey, he believes the problem could be much worse. “Far more schools probably have zero hours of sleep education,” he says.
It’s not like the science of sleep is static. The field has been adding new research at a rapid pace. It seems we are only now figuring out what healthy sleep is for a human — just in time for modern living to screw it up. Some recent discoveries have been surprising, and most of them are bummers. For example, a lack of sleep can change your biological clock genes, which in turn may lead to diseases like diabetes.
Want more? There’s a 65 percent higher mortality rate for adults who get only five hours of sleep a night, unless they also sleep in on the weekend. Only one night of sleep deprivation can lead to an increase in a protein associated with Alzheimer’s. And just two glasses of wine in the evening negatively impact sleep quality by almost 40 percent.
Educating young doctors about sleep will help them take better care of their patients.
Dr. Melissa Lipford, sleep specialist, Mayo Clinic
So why isn’t more formal education set aside for this quickly evolving field? For the same reason those hypothetical students were hypothetically snoozing. In Goh’s study, a major reason given was a packed schedule. Plus, sleep education currently is a low priority, perhaps because professors think students will get the knowledge while practicing. Or maybe because they want to stick with a traditional curriculum.
Dr. Melissa Lipford, a sleep specialist at the Mayo Clinic, thinks it would help to give students more formal training in her discipline. If young physicians learn about sleep issues early on, they’re going to be more apt to ask questions and give diagnoses on sleep disorders. After all, most patients with sleep issues don’t mention them to their doctors. “These are things that are not typically within the standard of care models, and we’re not often consistently screening for some of these processes,” Lipford says. “And they’re extremely treatable.” She suggests incorporating more sleep training into current coursework — like case-based specific topics in neurology or cardiovascular courses — might be a way to fit it in.
Meanwhile, the Asia Pacific Pediatric Alliance has been setting up workshops in Vietnam and other places, says Goh, where doctors can learn more about sleep. And a medical professional has developed a module on sleep for her undergraduate class (she’s even written a book to be used as a text).
Lipford notes something exists now that wasn’t around when she was in medical school — duty-hour restrictions. Those are the result of research on the effects of sleep deprivation. “We’re now starting to realize this is a field that inherently is associated with sleep deprivation and affects how physicians care for their patients,” she says.
“Educating young doctors about sleep will help them take better care of their patients in terms of identifying and treating sleep disorders. And it’s going to help physicians take better care of themselves.”