Quality sleep is a necessary aspect of mental and physical well-being. It has been linked to improved brain performance, increased mood, and better health outcomes. It is during sleep that our cells undergo repair and growth and our brain forms vital synaptic connections, consolidating the information learned during the previous day. When accommodating a busy schedule, many people are first to sacrifice their sleep. Doctors, nurses, and other healthcare professionals often have some of the busiest schedules, working shifts between twelve and twenty-four hours long. Moreover, physicians, especially, spend many nights on-call and lose out on essential sleep, resulting in devastating consequences for both physicians and their patients.
A 2020 research article looks at the consequences of on-call shifts, poor sleep habits, and their impact on healthcare workers and patients. An “Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors” reveals that poor sleep was associated with higher rates of burnout and lower professional fulfillment in physicians. Moreover, this correlated to an increase in patient complaints and an increase in preventable medical errors. Likely related to an increase in medical errors, sleep-deprived physicians show hyperactivity in their amygdala, potentially leading to increased reactivity and impulsivity, especially since medicine is already an emotionally taxing field. In addition to previously listed side effects of sleep deprivation, long-term memory is also likely to suffer as a result of poor sleep habits.
Dr. Cavanaugh’s article entitled “Developmental emergence of sleep rhythms enables long-term memory capabilities in Drosophila” determines that deep sleep stages are essential to long-term memory facilitation. This is dependent on the regulation of our circadian clock. Tim0 and clkJRK mutant drosophila, genes that are known to regulate the circadian clock, showed significant deficits in both long-term memory consolidation and retrieval in comparison to wild-type Drosophila. Moreover, L3 Dh44>CCHa1-R RNAi larvae, an experimental condition that impacted the larvae’s ability to partake in deep sleep, impaired long-term memory. This suggests that both regular sleep patterns and deep sleep are necessary for consolidation and retrieval of long-term.
While Dr. Cavanaugh’s article focuses on Drosophila, it has real-world human implications. Physicians on-call are frequently experiencing disruption in their sleeping patterns, impacting both their circadian clock and their ability to enter deep sleep. These disruptions, evident in Drosophila, will likely impact their long-term memory. This is crucial to physicians as they frequently rely on the retrieval of their long-term memory to make life-saving medical decisions. Information learned during medical school and medical training that has successfully been consolidated may not be retrieved successfully during high-stakes periods. This disruption in long-term memory could influence the propensity of sleep-deprived physicians to make more medical errors. This implies that medical students who also tend to suffer from sleep deprivation will struggle to consolidate vital information learned in medical school. The Trockel et al paper presents a correlation between sleep-deprived physicians and mental wellness. Could this be a direct result of the neurological expression of clock genes or melatonin levels? The constant shift of one's circadian period due to changing hours at work has devastating consequences for burnout, physical and mental health, decision-making processes, and the ability to utilize one’s long-term memory.
References:
Poe AR, Zhu L, Szuperak M, McClanahan PD, Anafi RC, Scholl B, Thum AS, Cavanaugh DJ, Kayser MS. Developmental emergence of sleep rhythms enables long-term memory in Drosophila. Sci Adv. 2023 Sep 8;9(36):eadh2301. doi: 10.1126/sciadv.adh2301. Epub 2023 Sep 8. PMID: 37683005; PMCID: PMC10491288.
Trockel MT, Menon NK, Rowe SG, et al. Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Netw Open. 2020;3(12):e2028111. doi:10.1001/jamanetworkopen.2020.28111
No comments:
Post a Comment