1
00:00:06,640 --> 00:00:12,399
Speaker 1: No matter what time of day or night, the er

2
00:00:12,560 --> 00:00:16,000
Speaker 1: is always awake, providing much needed support to patients with

3
00:00:16,160 --> 00:00:20,040
Speaker 1: any and every kind of ailment or injury. Doctor George

4
00:00:20,120 --> 00:00:23,320
Speaker 1: Russo works in a New York hospital emergency room. The

5
00:00:23,360 --> 00:00:26,520
Speaker 1: margin for error in this line of work is razor thin,

6
00:00:26,920 --> 00:00:30,280
Speaker 1: and since the er never closes, finding time to sleep

7
00:00:30,560 --> 00:00:33,600
Speaker 1: and sleep properly is a daunting challenge for George and

8
00:00:33,640 --> 00:00:34,279
Speaker 1: his colleagues.

9
00:00:35,760 --> 00:00:39,960
Speaker 2: There's no plans, appointments. It's whatever comes in comes in.

10
00:00:40,080 --> 00:00:42,440
Speaker 2: Sometimes you're lucky enough to get a notification over the

11
00:00:42,479 --> 00:00:45,360
Speaker 2: phone from the EMS, but that doesn't happen every time,

12
00:00:45,400 --> 00:00:47,480
Speaker 2: so you always got to be ready to jump to it.

13
00:00:47,479 --> 00:00:50,519
Speaker 2: It's a fast paced environment, so you could be seeing

14
00:00:51,520 --> 00:00:55,240
Speaker 2: somebody that's having a heart attack or that is extremely

15
00:00:55,280 --> 00:00:57,960
Speaker 2: sick with something, and then you get a trauma notification

16
00:00:58,080 --> 00:01:00,920
Speaker 2: and something's coming in, and now the doors never closed.

17
00:01:02,120 --> 00:01:05,440
Speaker 1: I wondered, with all of the chaos and urgency of

18
00:01:05,480 --> 00:01:08,520
Speaker 1: the er, how someone like George is thinking about sleep

19
00:01:08,840 --> 00:01:11,360
Speaker 1: and how it impacts his performance. So I asked him

20
00:01:11,360 --> 00:01:13,760
Speaker 1: to recall one of his more hectic shifts and what

21
00:01:13,959 --> 00:01:16,880
Speaker 1: role sleep played in its success or obstacles.

22
00:01:18,000 --> 00:01:21,760
Speaker 2: All right, so it was a Monday. It was Mayhem

23
00:01:21,840 --> 00:01:24,440
Speaker 2: walked into a lot of sign outs from the night

24
00:01:24,480 --> 00:01:27,280
Speaker 2: prior because it was a busy Sunday night already had

25
00:01:27,280 --> 00:01:29,600
Speaker 2: to handle those, but we also had new patients coming

26
00:01:29,600 --> 00:01:34,160
Speaker 2: in for seven am sharp, and then patients were coming

27
00:01:34,240 --> 00:01:36,440
Speaker 2: in from the clinics as well, because sometimes they have

28
00:01:36,560 --> 00:01:39,000
Speaker 2: extremely high blood pressure, they get dizzy and faint when

29
00:01:39,000 --> 00:01:41,480
Speaker 2: they're getting blood taken, and I'm dealing with all of

30
00:01:41,520 --> 00:01:45,360
Speaker 2: those people. And then a stroke alert comes in with EMS,

31
00:01:45,400 --> 00:01:48,160
Speaker 2: so you have to do all the protocol for that

32
00:01:48,320 --> 00:01:50,160
Speaker 2: because time is brain, as they say.

33
00:01:50,840 --> 00:01:51,760
Speaker 3: And then we had.

34
00:01:51,640 --> 00:01:54,600
Speaker 2: A stab wound to the chest come in shortly after,

35
00:01:54,760 --> 00:01:58,200
Speaker 2: so there is a lot of things happening. And then

36
00:01:58,240 --> 00:02:02,200
Speaker 2: there was also COVID patient's coming in, so they're taking

37
00:02:02,280 --> 00:02:05,120
Speaker 2: up the isolation rooms so you don't have exam rooms

38
00:02:05,160 --> 00:02:07,960
Speaker 2: for the other patients, and there was there was just

39
00:02:08,200 --> 00:02:10,560
Speaker 2: a tremendous amount of things going on, and we had

40
00:02:10,560 --> 00:02:14,360
Speaker 2: to transfer patients for some emergencies that our hospital didn't

41
00:02:14,360 --> 00:02:17,440
Speaker 2: have the specialists, so you're on the phones as well,

42
00:02:18,480 --> 00:02:23,639
Speaker 2: and it was it was a day, and I think

43
00:02:23,680 --> 00:02:26,360
Speaker 2: I was lucky enough that I had had like a

44
00:02:26,360 --> 00:02:28,720
Speaker 2: good eight hour to sleep the night prior, like I

45
00:02:28,760 --> 00:02:32,200
Speaker 2: went to bed, I don't know, probably ten pm. And

46
00:02:32,240 --> 00:02:34,120
Speaker 2: since I was there at seven, I woke up at

47
00:02:34,120 --> 00:02:36,919
Speaker 2: six and I felt pretty refreshed. And it wasn't one

48
00:02:36,919 --> 00:02:39,560
Speaker 2: of those nights where I had to split up my

49
00:02:39,720 --> 00:02:42,760
Speaker 2: sleep or I wasn't switching back and forth from days

50
00:02:42,760 --> 00:02:46,440
Speaker 2: to nights. And I think it really helped me get

51
00:02:46,440 --> 00:02:48,160
Speaker 2: through the day. And let me tell you that night,

52
00:02:48,280 --> 00:02:51,600
Speaker 2: I certainly slept well again because I was in bed

53
00:02:51,680 --> 00:02:54,200
Speaker 2: I think at nine point thirty and I didn't wake

54
00:02:54,240 --> 00:02:55,600
Speaker 2: up till the next day at six.

55
00:02:55,720 --> 00:02:56,320
Speaker 3: It was great.

56
00:02:59,320 --> 00:03:02,519
Speaker 1: What role does our sleep play in our long term health?

57
00:03:03,000 --> 00:03:06,440
Speaker 1: How deep does healthy sleep go into our biology? And

58
00:03:06,520 --> 00:03:09,680
Speaker 1: how do you get consistent rest and healthy sleep when

59
00:03:09,720 --> 00:03:13,560
Speaker 1: your bedtime is constantly in flux? Find out on this

60
00:03:13,639 --> 00:03:24,600
Speaker 1: episode of Chasing Sleep Urgent Rest. Hi, I'm Anahad O'Connor,

61
00:03:24,800 --> 00:03:29,320
Speaker 1: and this is Chasing Sleep and iHeartRadio production and partnership

62
00:03:29,320 --> 00:03:37,440
Speaker 1: with Mattress Firm.

63
00:03:37,520 --> 00:03:41,840
Speaker 2: So there's definitely a stress that comes with the high

64
00:03:41,880 --> 00:03:44,680
Speaker 2: stress environment that's very difficult to wind down or to

65
00:03:45,000 --> 00:03:47,800
Speaker 2: just leave at work. Everyone says, don't take it home,

66
00:03:47,840 --> 00:03:52,000
Speaker 2: but sometimes it's not possible. I mean, when things are

67
00:03:52,080 --> 00:03:54,400
Speaker 2: life and death, and when maybe there's a bad outcome

68
00:03:54,400 --> 00:03:56,280
Speaker 2: of something, it's gonna stay with you.

69
00:03:56,320 --> 00:03:57,680
Speaker 3: It just doesn't go away.

70
00:03:58,040 --> 00:04:01,200
Speaker 1: With the intensity. There must be some payoff when things

71
00:04:01,200 --> 00:04:03,640
Speaker 1: are life and death. The downside is that when something

72
00:04:03,640 --> 00:04:07,320
Speaker 1: goes wrong it can be very grim, but when things

73
00:04:07,360 --> 00:04:09,640
Speaker 1: go right, it must feel pretty rewarding.

74
00:04:10,240 --> 00:04:14,160
Speaker 2: The most rewarding part of what I do is when

75
00:04:14,880 --> 00:04:19,680
Speaker 2: family members or a patient feel better in front of you,

76
00:04:19,720 --> 00:04:22,920
Speaker 2: whether it's you give them antibiotics or you give them

77
00:04:22,920 --> 00:04:26,479
Speaker 2: something that helps bust a clot that is causing a

78
00:04:26,480 --> 00:04:28,680
Speaker 2: stroke in their brain, and you can see them go

79
00:04:28,839 --> 00:04:31,360
Speaker 2: from not being able to move one side of their

80
00:04:31,400 --> 00:04:34,400
Speaker 2: body to them being able to move it within hours

81
00:04:34,800 --> 00:04:36,880
Speaker 2: of them being in front of you, and family members

82
00:04:36,920 --> 00:04:39,599
Speaker 2: are crying so happy, the patient's able to talk to

83
00:04:39,640 --> 00:04:43,000
Speaker 2: you afterwards. That's happened a couple times, and it's extremely

84
00:04:43,080 --> 00:04:47,680
Speaker 2: rewarding when you can actually change somebody's life in a

85
00:04:47,720 --> 00:04:49,080
Speaker 2: matter of minutes to hours.

86
00:04:49,600 --> 00:04:54,200
Speaker 1: From bustling cities to sparsely populated rural areas. Emergency medical

87
00:04:54,240 --> 00:04:57,560
Speaker 1: care is a NonStop job. Hospital staff are on their

88
00:04:57,560 --> 00:05:01,400
Speaker 1: feet hour after hour without respite because accidents and injuries

89
00:05:01,440 --> 00:05:02,520
Speaker 1: don't follow a schedule.

90
00:05:03,120 --> 00:05:05,960
Speaker 2: Yeah, the physical aspect of the job, especially after a

91
00:05:05,960 --> 00:05:09,160
Speaker 2: twelve hour shift, wear and tear is absolutely there. I

92
00:05:09,240 --> 00:05:12,599
Speaker 2: mean there's muscle aches that felt like I was back

93
00:05:12,600 --> 00:05:16,840
Speaker 2: playing sports. It's very difficult to find time to work

94
00:05:16,880 --> 00:05:19,640
Speaker 2: out after a twelve hour shift, especially if you have

95
00:05:19,640 --> 00:05:22,080
Speaker 2: a commute, and sometimes these twelve hour shifts go to

96
00:05:22,120 --> 00:05:25,039
Speaker 2: thirteen fourteen hours if something terrible comes in rank before

97
00:05:25,080 --> 00:05:28,919
Speaker 2: the end of it, and it was just it was exhausting.

98
00:05:28,960 --> 00:05:31,080
Speaker 2: I mean, it was very difficult to get in a

99
00:05:31,120 --> 00:05:34,400
Speaker 2: good rhythm of things as things were changing so often

100
00:05:34,560 --> 00:05:38,839
Speaker 2: throughout the pandemic, and also just to get a good

101
00:05:39,120 --> 00:05:41,800
Speaker 2: routine at home, to get to bed at a normal hour,

102
00:05:41,960 --> 00:05:44,480
Speaker 2: to also find a way to eat in there and

103
00:05:44,520 --> 00:05:47,440
Speaker 2: watch a show with your loved one, or if you

104
00:05:47,440 --> 00:05:49,760
Speaker 2: have kids, to find time to be with them because

105
00:05:49,760 --> 00:05:53,719
Speaker 2: they were home all day too. It's hard, it's grueling,

106
00:05:53,920 --> 00:05:57,039
Speaker 2: it's fast paced, it's long days, long nights, and the

107
00:05:57,080 --> 00:06:01,560
Speaker 2: schedule is constantly changing. All of that does a number

108
00:06:01,640 --> 00:06:05,840
Speaker 2: on our mental functions. It's difficult enough working when you're exhausted.

109
00:06:06,320 --> 00:06:08,880
Speaker 2: It becomes even more challenging when the stakes are as

110
00:06:08,960 --> 00:06:14,039
Speaker 2: high as they are in emergency medicine. I wanted to

111
00:06:14,080 --> 00:06:16,800
Speaker 2: learn more about what's happening inside our bodies when our

112
00:06:16,800 --> 00:06:20,400
Speaker 2: sleep schedules change, and what the impact is on medical professionals.

113
00:06:20,839 --> 00:06:23,600
Speaker 2: So I called up doctor Sema Cosla.

114
00:06:23,800 --> 00:06:25,120
Speaker 4: I'm doctor Sema Cosla.

115
00:06:25,160 --> 00:06:28,080
Speaker 5: I'm a sleep medicine physician and the medical director of

116
00:06:28,120 --> 00:06:30,200
Speaker 5: the North Dakota Center for Sleep and Fargo.

117
00:06:31,760 --> 00:06:35,040
Speaker 1: So you have a really extensive background in sleep, and

118
00:06:35,560 --> 00:06:37,760
Speaker 1: first off, I think sleep is really challenging for a

119
00:06:37,800 --> 00:06:40,320
Speaker 1: lot of people. So I wanted to get your thoughts

120
00:06:40,360 --> 00:06:44,440
Speaker 1: on what do you think actually constitutes healthy sleep.

121
00:06:45,040 --> 00:06:48,159
Speaker 5: So there's you know, when we think about healthy sleep,

122
00:06:48,800 --> 00:06:54,919
Speaker 5: we have to consider quality, quantity, and timing, and so

123
00:06:54,960 --> 00:06:57,960
Speaker 5: we want to make sure that we're getting enough good

124
00:06:58,040 --> 00:07:00,200
Speaker 5: quality sleep at the right time time.

125
00:07:01,240 --> 00:07:05,080
Speaker 1: Seema emphasizes the importance of consistent schedules for shift workers,

126
00:07:05,360 --> 00:07:08,039
Speaker 1: and she's even gone as far as to petition hospitals

127
00:07:08,320 --> 00:07:13,480
Speaker 1: to provide consistent shift schedules for their employees. There are

128
00:07:13,480 --> 00:07:15,560
Speaker 1: so many people who have no choice but to have

129
00:07:15,600 --> 00:07:20,160
Speaker 1: these unusual sleep schedules, you know, like our study subject today, George,

130
00:07:20,280 --> 00:07:22,920
Speaker 1: who's an er doctor, and he and others like him

131
00:07:23,240 --> 00:07:26,520
Speaker 1: have no choice but to work the night shift at times?

132
00:07:26,760 --> 00:07:29,640
Speaker 1: How common is this And do you see a lot

133
00:07:29,640 --> 00:07:32,440
Speaker 1: of patients who have to work these unusual sleep schedules

134
00:07:32,560 --> 00:07:34,520
Speaker 1: and what are some of the common complaints that you

135
00:07:34,560 --> 00:07:35,520
Speaker 1: get from these patients?

136
00:07:36,000 --> 00:07:37,200
Speaker 4: Yeah, so you're right.

137
00:07:37,240 --> 00:07:40,480
Speaker 5: In the medical field, also manufacturing, you know, we see

138
00:07:40,520 --> 00:07:43,840
Speaker 5: a lot of overnight workers. I think the challenge about

139
00:07:43,840 --> 00:07:47,000
Speaker 5: an er shift is that it's not consistent. You know,

140
00:07:47,080 --> 00:07:49,720
Speaker 5: sometimes they'll be kind enough to give you, you know,

141
00:07:49,760 --> 00:07:52,080
Speaker 5: a week of days and then a week of nights,

142
00:07:52,240 --> 00:07:56,920
Speaker 5: but oftentimes it isn't like that, so you're constantly switching.

143
00:07:57,440 --> 00:08:00,800
Speaker 5: And so a consistent shift, even if it is night shift,

144
00:08:01,040 --> 00:08:04,280
Speaker 5: is better than a variable shift, right, because at least

145
00:08:04,320 --> 00:08:08,320
Speaker 5: you can give your body some semblance of a circadian rhythm, right.

146
00:08:08,600 --> 00:08:09,600
Speaker 3: I was wondering about that.

147
00:08:09,760 --> 00:08:12,960
Speaker 5: Yeah, yeah, And so I've written letters before just asking

148
00:08:13,040 --> 00:08:15,480
Speaker 5: can you please, like, pick a shift. We don't care

149
00:08:15,520 --> 00:08:18,600
Speaker 5: what the shift is, just make it consistent, please.

150
00:08:19,360 --> 00:08:22,760
Speaker 1: But picking a shift is easier said than done, especially

151
00:08:22,760 --> 00:08:25,000
Speaker 1: in a field to where your day changes wildly with

152
00:08:25,120 --> 00:08:27,800
Speaker 1: no control over what might walk through the hospital doors.

153
00:08:28,520 --> 00:08:32,760
Speaker 2: So the schedule of an er doctor is not the

154
00:08:32,880 --> 00:08:35,679
Speaker 2: average schedule. It is not a Monday through Friday, it

155
00:08:35,720 --> 00:08:38,440
Speaker 2: is not a nine to five, So the average r

156
00:08:38,520 --> 00:08:43,440
Speaker 2: doctor does about twelve to fifteen shifts a month, and

157
00:08:43,480 --> 00:08:46,040
Speaker 2: they can be anywhere from eight to twelve hour shifts.

158
00:08:46,400 --> 00:08:49,400
Speaker 2: Some in rural places do twenty four hour shifts and

159
00:08:49,440 --> 00:08:53,040
Speaker 2: even thirty hour shifts, depending on the amount of patients

160
00:08:53,600 --> 00:08:54,800
Speaker 2: that the hospital sees.

161
00:08:55,640 --> 00:08:57,400
Speaker 3: And these shifts can.

162
00:08:57,240 --> 00:09:00,200
Speaker 2: Be the morning the swing shift, or they can be

163
00:09:00,240 --> 00:09:03,840
Speaker 2: the overnight shift, night to day shift. It's one becomes

164
00:09:03,840 --> 00:09:06,360
Speaker 2: more difficult to get to bed in a normal hour

165
00:09:07,240 --> 00:09:09,280
Speaker 2: because if you go to bed at the same hour

166
00:09:09,320 --> 00:09:10,800
Speaker 2: that you did when you had to wake up at

167
00:09:10,800 --> 00:09:13,040
Speaker 2: seven am, you'll wake up around seven and then you

168
00:09:13,040 --> 00:09:16,880
Speaker 2: don't work again until seven pm. So I would find

169
00:09:16,880 --> 00:09:19,400
Speaker 2: myself trying to push myself and stay up a little later,

170
00:09:19,480 --> 00:09:21,520
Speaker 2: maybe till midnight two in the morning, as if it

171
00:09:21,559 --> 00:09:22,360
Speaker 2: was a Saturday night.

172
00:09:23,040 --> 00:09:26,520
Speaker 1: Frequently changing schedules, while necessary in fields like this one,

173
00:09:26,840 --> 00:09:31,040
Speaker 1: makes for challenging sleep. So the switch back and forth

174
00:09:31,080 --> 00:09:35,840
Speaker 1: from day to night is never easy with sleep and sleep.

175
00:09:36,280 --> 00:09:39,400
Speaker 1: Especially in the emergency medicine world. We tend to be

176
00:09:39,480 --> 00:09:42,920
Speaker 1: the most sleep deprived or have the most issues with

177
00:09:43,000 --> 00:09:45,440
Speaker 1: sleep because of the shift work and jumping around in

178
00:09:45,480 --> 00:09:49,320
Speaker 1: the schedule with twelve hour shifts. Found that it was

179
00:09:49,440 --> 00:09:54,959
Speaker 1: difficult sometimes to keep a nice sleep routine because my

180
00:09:55,040 --> 00:09:57,800
Speaker 1: significant other, she would get home later and I would

181
00:09:57,840 --> 00:09:59,319
Speaker 1: want to stay up to see her, But then that

182
00:09:59,360 --> 00:10:02,560
Speaker 1: would affect my work or my sleep pattern because I

183
00:10:02,559 --> 00:10:04,079
Speaker 1: would be up till midnight and then have to wake

184
00:10:04,120 --> 00:10:06,400
Speaker 1: up again the next day at six am. I found

185
00:10:06,440 --> 00:10:09,760
Speaker 1: out pretty quickly that that wasn't sustainable. And then switching

186
00:10:09,800 --> 00:10:10,800
Speaker 1: over to nights.

187
00:10:11,240 --> 00:10:14,400
Speaker 2: We all have our different ways of trying to normalize it,

188
00:10:14,440 --> 00:10:17,040
Speaker 2: but you're always going to feel kind of awful when

189
00:10:17,040 --> 00:10:19,199
Speaker 2: you're switched over to nights or when you switch back today.

190
00:10:19,240 --> 00:10:20,800
Speaker 3: It's because it's just like jet lag.

191
00:10:20,840 --> 00:10:22,319
Speaker 2: It's like we flew, but you didn't even get the

192
00:10:22,400 --> 00:10:23,800
Speaker 2: nice francifaication out of it.

193
00:10:25,240 --> 00:10:28,880
Speaker 1: Nurses and doctors are so vulnerable to life threatening mistakes

194
00:10:29,080 --> 00:10:32,480
Speaker 1: when their sleep is jeopardized. A tired doctor in an

195
00:10:32,760 --> 00:10:36,079
Speaker 1: er or an operating room becomes a danger to a patient.

196
00:10:36,600 --> 00:10:39,920
Speaker 1: My sister in law is a doctor in London, and

197
00:10:39,960 --> 00:10:42,560
Speaker 1: I was quizzing her about, you know, how she gets

198
00:10:42,600 --> 00:10:44,959
Speaker 1: through this, working these night shifts and going back to

199
00:10:44,960 --> 00:10:48,199
Speaker 1: a regular shift, and she mentioned that at her hospital

200
00:10:48,400 --> 00:10:52,559
Speaker 1: they actually won't let the doctors perform any complex procedures

201
00:10:52,960 --> 00:10:56,400
Speaker 1: or surgeries overnight unless it's an emergency. If someone comes

202
00:10:56,400 --> 00:10:58,760
Speaker 1: in with the gunshot or you know, a stab wound,

203
00:10:58,920 --> 00:11:01,240
Speaker 1: then they have to do something thing. But if it's

204
00:11:01,280 --> 00:11:03,760
Speaker 1: a surgery that they can push off till the morning

205
00:11:04,320 --> 00:11:06,520
Speaker 1: or daytime, you know, they will try to do that

206
00:11:06,600 --> 00:11:09,320
Speaker 1: rather than operate on someone in the middle of the night,

207
00:11:09,440 --> 00:11:11,320
Speaker 1: just because of the risks involved.

208
00:11:11,640 --> 00:11:14,959
Speaker 5: So I think it's important to recognize that some people

209
00:11:15,000 --> 00:11:17,520
Speaker 5: do great at night. That's sort of where they really

210
00:11:17,559 --> 00:11:20,640
Speaker 5: perform well, and they're just naturally better at night, and

211
00:11:20,720 --> 00:11:24,640
Speaker 5: some people don't. So my background is pulmonary and critical care.

212
00:11:25,320 --> 00:11:27,040
Speaker 5: And so then when I would go into the ICU

213
00:11:27,360 --> 00:11:29,600
Speaker 5: in the middle of the night, you write a little

214
00:11:29,600 --> 00:11:35,400
Speaker 5: adrenaline so that to kind of combat the sleepiness that occurs,

215
00:11:35,440 --> 00:11:37,240
Speaker 5: and you have to be sharp, and I think you

216
00:11:37,840 --> 00:11:41,520
Speaker 5: push yourself to be sharp, if that makes sense. You know,

217
00:11:41,679 --> 00:11:45,480
Speaker 5: people in these fields are usually high achievers, high performers,

218
00:11:45,480 --> 00:11:47,360
Speaker 5: and they put a lot of demands, like I'm sure

219
00:11:47,760 --> 00:11:51,240
Speaker 5: you know in the er that adrenaline also helps.

220
00:11:50,960 --> 00:11:54,520
Speaker 1: You, right, And there's been a lot of research on

221
00:11:54,760 --> 00:11:59,120
Speaker 1: this topic of sleep deprivation among healthcare workers. So, for example,

222
00:11:59,440 --> 00:12:02,400
Speaker 1: I saw that the British Journal of Anesthesia published a

223
00:12:02,440 --> 00:12:05,800
Speaker 1: study that found more than ten percent increase in life

224
00:12:05,840 --> 00:12:08,959
Speaker 1: threatening events that happened in surgeries that were performed at night.

225
00:12:09,400 --> 00:12:09,640
Speaker 3: Yeah.

226
00:12:09,679 --> 00:12:13,520
Speaker 5: Well, and it's risk of operator error, but also support

227
00:12:13,600 --> 00:12:16,680
Speaker 5: in a hospital if something goes bad, you're minimally staffed

228
00:12:16,720 --> 00:12:20,160
Speaker 5: at night. And so we used to have this lore

229
00:12:20,360 --> 00:12:23,640
Speaker 5: in the world of pulmonary that if you have fluid

230
00:12:23,679 --> 00:12:27,680
Speaker 5: around your lungs, it needs to be taken out before

231
00:12:27,920 --> 00:12:29,000
Speaker 5: the sun sets.

232
00:12:29,120 --> 00:12:30,800
Speaker 4: Was kind of what we were always taught.

233
00:12:31,440 --> 00:12:33,360
Speaker 5: And then it turns out if you start doing these

234
00:12:33,360 --> 00:12:35,840
Speaker 5: things at nine o'clock at night or ten o'clock at night,

235
00:12:36,200 --> 00:12:39,200
Speaker 5: when no one else is in the hospital, that's not

236
00:12:39,240 --> 00:12:42,880
Speaker 5: great for patients. Yeah, because then you may convert it

237
00:12:42,920 --> 00:12:45,880
Speaker 5: into an emergency procedure or something like that, and calling

238
00:12:45,880 --> 00:12:49,800
Speaker 5: people in from sleep, right, calling people in from their

239
00:12:49,800 --> 00:12:53,200
Speaker 5: beds to help you. And so I applaud where your

240
00:12:53,240 --> 00:12:55,360
Speaker 5: sister works that they recognized this.

241
00:12:59,320 --> 00:13:01,280
Speaker 1: We'll be right back after a brief message from our

242
00:13:01,320 --> 00:13:11,920
Speaker 1: partners at Mattress Firm, and now back to Chasing Sleep.

243
00:13:15,600 --> 00:13:18,520
Speaker 1: Throughout our series so far, I've learned a lot about

244
00:13:18,559 --> 00:13:23,120
Speaker 1: how sleep impacts our physical and mental performance and our endurance.

245
00:13:23,640 --> 00:13:26,840
Speaker 1: I've deepened my understanding of how stress and anxiety can

246
00:13:26,880 --> 00:13:30,280
Speaker 1: adversely impact our sleep as well. But speaking with George

247
00:13:30,280 --> 00:13:33,720
Speaker 1: and Seema gave me a completely new perspective on just

248
00:13:33,720 --> 00:13:36,559
Speaker 1: how much sleep impacts our overall and long term health.

249
00:13:39,320 --> 00:13:40,200
Speaker 4: You know, it's so funny.

250
00:13:40,280 --> 00:13:42,520
Speaker 5: We talk a good game in our world of sleep.

251
00:13:42,600 --> 00:13:43,679
Speaker 5: Right we're saying, yep.

252
00:13:43,520 --> 00:13:45,240
Speaker 4: You should be in bed at the same time every

253
00:13:45,320 --> 00:13:46,040
Speaker 4: night and get.

254
00:13:45,960 --> 00:13:49,280
Speaker 5: Seven to nine hours of good restorative sleep. And so

255
00:13:50,000 --> 00:13:52,600
Speaker 5: what we've seen over the years is sometimes people who

256
00:13:53,040 --> 00:13:57,040
Speaker 5: are night owls, we call them delayed sleep phase coronotype,

257
00:13:57,080 --> 00:13:59,719
Speaker 5: So just meaning that you're just biologically right, you like

258
00:13:59,760 --> 00:14:01,319
Speaker 5: to say up late and you like to sleep in.

259
00:14:02,200 --> 00:14:05,400
Speaker 5: Sometimes they will find themselves in a night shift position

260
00:14:05,559 --> 00:14:08,880
Speaker 5: just because it sort of fits with their circadian rhythm.

261
00:14:09,400 --> 00:14:12,520
Speaker 5: But not always. We do see that there is a

262
00:14:12,640 --> 00:14:16,400
Speaker 5: higher risk of cancer in night shift workers. They did

263
00:14:16,400 --> 00:14:19,680
Speaker 5: a study of nurses, for example, and they had a

264
00:14:19,720 --> 00:14:23,480
Speaker 5: higher incidence of breast cancer. And so it's really it's

265
00:14:23,600 --> 00:14:26,040
Speaker 5: kind of amazing. I remember years ago we were giving

266
00:14:26,040 --> 00:14:29,840
Speaker 5: this conference and I reached out to a cancer researcher

267
00:14:30,240 --> 00:14:32,040
Speaker 5: and I wanted to talk to her about, you know,

268
00:14:32,080 --> 00:14:34,720
Speaker 5: how we think sleep is super important, you know, for

269
00:14:34,840 --> 00:14:37,200
Speaker 5: cancer and that sort of thing, and she kind of

270
00:14:37,240 --> 00:14:39,840
Speaker 5: laughed at me. She was very kind, but I thought

271
00:14:40,040 --> 00:14:43,160
Speaker 5: we were so smart thinking about this, and she's like, oh, yeah,

272
00:14:43,240 --> 00:14:46,000
Speaker 5: we've considered poor sleep a carcinogen for decades.

273
00:14:47,040 --> 00:14:50,200
Speaker 4: So yeah, they were way ahead of us.

274
00:14:53,720 --> 00:14:58,160
Speaker 1: As Sema says, poor sleep is a carcinogen, a mood destabilizer,

275
00:14:58,400 --> 00:15:01,960
Speaker 1: and it causes many other issues and diseases. I wanted

276
00:15:01,960 --> 00:15:05,200
Speaker 1: to learn more about the ways sleep is constantly affecting

277
00:15:05,200 --> 00:15:08,640
Speaker 1: our health, so I asked Sema to explain the biology

278
00:15:08,640 --> 00:15:13,640
Speaker 1: of sleep and everything that's happening inside us as we snooze.

279
00:15:14,400 --> 00:15:18,960
Speaker 5: So rem is important for mood regulation, right, slow wave

280
00:15:19,000 --> 00:15:23,280
Speaker 5: sleep or delta sleep. This is this lovely slow wave sleep.

281
00:15:23,360 --> 00:15:25,560
Speaker 5: Kids get tons of this. This is where they where

282
00:15:25,560 --> 00:15:29,320
Speaker 5: they grow, and where they you know, sleepwalk, do all

283
00:15:29,320 --> 00:15:33,080
Speaker 5: of those things. That's probably important for us to download

284
00:15:33,080 --> 00:15:36,120
Speaker 5: short term memory into long term memory. And then rem

285
00:15:36,200 --> 00:15:40,640
Speaker 5: is important for us to organize and edit those memories

286
00:15:41,480 --> 00:15:46,720
Speaker 5: that's just in the mind. And so if you can imagine,

287
00:15:46,760 --> 00:15:48,960
Speaker 5: the brain has right all those little ups and downs

288
00:15:48,960 --> 00:15:51,920
Speaker 5: and on a cellular level if you imagine it, and

289
00:15:51,960 --> 00:15:53,360
Speaker 5: I'm going to borrow this from one of my.

290
00:15:53,320 --> 00:15:54,720
Speaker 4: Colleagues, doctor Chuck Seisler.

291
00:15:55,040 --> 00:15:58,280
Speaker 5: He was the the expert witness at the Michael Jackson trial,

292
00:15:58,520 --> 00:16:00,680
Speaker 5: and this is how he described it. So if you

293
00:16:00,720 --> 00:16:03,240
Speaker 5: picture it like a big city like New York City, right,

294
00:16:03,240 --> 00:16:06,240
Speaker 5: You've got these big, huge, tall buildings, and then you've

295
00:16:06,280 --> 00:16:09,240
Speaker 5: got these alleys, and all day long, the garbage truck is,

296
00:16:09,520 --> 00:16:11,920
Speaker 5: you know, cleaning debris out of the alleys, right, and

297
00:16:12,040 --> 00:16:15,120
Speaker 5: people are tossing stuff out of the windows. And so

298
00:16:16,120 --> 00:16:21,360
Speaker 5: when you sleep, the buildings shrink and the alleys get

299
00:16:21,400 --> 00:16:25,680
Speaker 5: really wide, and so all of that debris gets swept

300
00:16:25,720 --> 00:16:29,880
Speaker 5: away much more efficiently. And when you analyze that debris,

301
00:16:30,440 --> 00:16:33,400
Speaker 5: it is beta amyloid, which is one of the things

302
00:16:33,400 --> 00:16:36,560
Speaker 5: that builds up in Alzheimer's right, And so sleep is

303
00:16:36,800 --> 00:16:39,960
Speaker 5: really really important to that, you know, for all of that.

304
00:16:40,080 --> 00:16:43,200
Speaker 5: So to your point about you know, why does sleep

305
00:16:43,320 --> 00:16:46,640
Speaker 5: impact cancer growth and why does it impact ourselves? You know,

306
00:16:46,680 --> 00:16:49,800
Speaker 5: we know it's important for immunity. We learned a lot

307
00:16:49,840 --> 00:16:51,800
Speaker 5: with a pandemic, right. We know that if you were

308
00:16:51,840 --> 00:16:54,760
Speaker 5: well rested the night before your your vaccine and the

309
00:16:54,840 --> 00:16:59,200
Speaker 5: day before that you had better vaccine responsiveness, and probably

310
00:16:59,280 --> 00:17:01,240
Speaker 5: just because needs to recover.

311
00:17:02,480 --> 00:17:04,680
Speaker 1: Wow, So it's not just the long term, it's these

312
00:17:04,680 --> 00:17:08,320
Speaker 1: immediate effects have an impact on your response to a vaccine.

313
00:17:09,560 --> 00:17:12,880
Speaker 1: Fascinating analogy. So when we sleep and we have our

314
00:17:13,000 --> 00:17:16,320
Speaker 1: very own sanitation department clearing the streets in our brains,

315
00:17:16,760 --> 00:17:21,439
Speaker 1: think about what that debris entails. It's imperative that George

316
00:17:21,440 --> 00:17:24,080
Speaker 1: has time to clear out those beta amyloid proteins in

317
00:17:24,080 --> 00:17:26,240
Speaker 1: his brain so that he can get back to work

318
00:17:26,440 --> 00:17:28,840
Speaker 1: and be on top of his game, saving lives and

319
00:17:28,920 --> 00:17:36,600
Speaker 1: helping people when they need it the most. With so

320
00:17:36,720 --> 00:17:39,359
Speaker 1: much of our health writing on sleep, I was curious

321
00:17:39,400 --> 00:17:42,720
Speaker 1: about the unique obstacles that er workers like George face

322
00:17:42,880 --> 00:17:45,760
Speaker 1: when they're trying to get adequate sleep. Battling this news

323
00:17:45,760 --> 00:17:48,879
Speaker 1: button for an early morning shift is one thing, coming

324
00:17:48,880 --> 00:17:51,320
Speaker 1: home when the sun rises, and trying to get healthy

325
00:17:51,320 --> 00:17:53,880
Speaker 1: sleep in the middle of the day is an entirely

326
00:17:53,920 --> 00:17:54,919
Speaker 1: different challenge.

327
00:17:55,400 --> 00:17:57,800
Speaker 3: So it's actually easier to get more sleep during the winter.

328
00:17:58,320 --> 00:18:00,480
Speaker 2: During the summer is when it's said it's artists and

329
00:18:00,520 --> 00:18:04,560
Speaker 2: I have to keep the sunglasses on after an overnight shift. Actually,

330
00:18:04,560 --> 00:18:06,720
Speaker 2: that's one of the big things on the way home.

331
00:18:06,760 --> 00:18:08,879
Speaker 2: If I forget my sunglasses, I get really messed up

332
00:18:08,920 --> 00:18:10,639
Speaker 2: because my circadian rhythm wants to be awake.

333
00:18:11,400 --> 00:18:12,560
Speaker 3: So you got to keep it dark.

334
00:18:13,240 --> 00:18:15,920
Speaker 2: And if you can get out at a time where

335
00:18:15,960 --> 00:18:17,520
Speaker 2: the sun still hasn't come up, I try and like

336
00:18:17,600 --> 00:18:20,320
Speaker 2: rush home as if I'm a vampire or something like.

337
00:18:20,359 --> 00:18:22,159
Speaker 2: I have to get there before the sun comes up,

338
00:18:22,200 --> 00:18:24,040
Speaker 2: because it can absolutely throw you for a loop once

339
00:18:24,040 --> 00:18:24,800
Speaker 2: the sun comes up.

340
00:18:26,000 --> 00:18:28,600
Speaker 5: You know, our impetus to sleep is driven by a

341
00:18:28,680 --> 00:18:31,800
Speaker 5: couple of things. So one is that circadian rhythm right

342
00:18:31,920 --> 00:18:35,680
Speaker 5: when we're biologically programmed to be awake and to fall asleep.

343
00:18:36,240 --> 00:18:39,480
Speaker 5: But the other is what's called sleep pressure. So sleep

344
00:18:39,520 --> 00:18:42,520
Speaker 5: pressure builds up from the minute you wake up until

345
00:18:42,520 --> 00:18:44,960
Speaker 5: you go to bed. So if you are at your

346
00:18:45,119 --> 00:18:49,720
Speaker 5: typical sleep schedule, they both peak to push you to sleep.

347
00:18:50,480 --> 00:18:53,240
Speaker 5: But now when we're asking people to work night shift,

348
00:18:54,520 --> 00:18:57,919
Speaker 5: these work against each other, right, and so then we

349
00:18:58,000 --> 00:19:01,000
Speaker 5: have to accommodate. We need to drill just say, okay, well,

350
00:19:01,000 --> 00:19:03,320
Speaker 5: how can we make sure that the sleep you're getting

351
00:19:04,359 --> 00:19:07,480
Speaker 5: is as good as we can make it. And so

352
00:19:07,600 --> 00:19:11,119
Speaker 5: we really focus on the sleep environment. Make sure the

353
00:19:11,200 --> 00:19:15,240
Speaker 5: room is cool and dark, especially and quiet.

354
00:19:17,400 --> 00:19:21,080
Speaker 1: So especially with these ever changing shift schedules and the

355
00:19:21,520 --> 00:19:23,480
Speaker 1: on the job stresses that are the norm and the

356
00:19:23,760 --> 00:19:28,600
Speaker 1: er George, what other tools are there besides caffeine? Can

357
00:19:29,000 --> 00:19:31,560
Speaker 1: strategic napping, for example, help to bridge the gap to

358
00:19:31,600 --> 00:19:32,160
Speaker 1: getting rest?

359
00:19:32,960 --> 00:19:34,879
Speaker 3: Went on twenty four hour shifts.

360
00:19:34,880 --> 00:19:38,600
Speaker 2: Now, we don't necessarily do this in the ers everywhere,

361
00:19:38,640 --> 00:19:41,119
Speaker 2: but some more rural places do have to do twenty

362
00:19:41,160 --> 00:19:44,480
Speaker 2: four hour plus shifts. During residency, I had to do

363
00:19:45,760 --> 00:19:49,160
Speaker 2: ICU rotations that did have twenty four to twenty seven

364
00:19:49,200 --> 00:19:53,040
Speaker 2: hour shifts. Doesn't sound possible and I didn't think it was,

365
00:19:53,119 --> 00:19:54,479
Speaker 2: but somehow you make it through it.

366
00:19:54,560 --> 00:19:56,240
Speaker 3: Now, one of the.

367
00:19:55,880 --> 00:19:58,360
Speaker 2: Main ways was after the whole day to day was done,

368
00:19:58,400 --> 00:20:01,320
Speaker 2: when everyone else had left you and somebody else and

369
00:20:01,359 --> 00:20:03,320
Speaker 2: you would try and take shifts where you could get

370
00:20:03,320 --> 00:20:05,439
Speaker 2: to nap or sometimes even get.

371
00:20:05,320 --> 00:20:08,639
Speaker 3: To sleep like four hours, and it really helped.

372
00:20:08,400 --> 00:20:11,000
Speaker 2: Because you had already been up since six am, and

373
00:20:11,040 --> 00:20:14,000
Speaker 2: then it was about whether it was eight pm ten pm.

374
00:20:14,040 --> 00:20:15,560
Speaker 3: You got to even sleep for two hours.

375
00:20:15,600 --> 00:20:18,760
Speaker 2: It was lovely because at that time bed feels the

376
00:20:18,760 --> 00:20:21,560
Speaker 2: best and you just want to lay down. Sometimes it's

377
00:20:21,560 --> 00:20:24,280
Speaker 2: a little more difficult to kind of wind down and

378
00:20:24,320 --> 00:20:26,800
Speaker 2: then you end up staring at the ceiling for a while.

379
00:20:26,840 --> 00:20:29,760
Speaker 2: But to get that rest and again step away from everything,

380
00:20:29,800 --> 00:20:32,800
Speaker 2: it was so necessary. I don't I'm sure there was

381
00:20:32,880 --> 00:20:35,280
Speaker 2: sometimes that people couldn't do it because it's just too

382
00:20:35,280 --> 00:20:39,080
Speaker 2: busy for those twenty four hours. But the exhaustion really

383
00:20:39,160 --> 00:20:39,760
Speaker 2: takes a toll.

384
00:20:43,359 --> 00:20:45,639
Speaker 1: And so now let's say, for like a healthcare professional

385
00:20:46,080 --> 00:20:48,320
Speaker 1: who you know, maybe works in a rural area and

386
00:20:48,480 --> 00:20:53,480
Speaker 1: is working overnight shift pretty consistently, what can napping do

387
00:20:54,000 --> 00:20:54,440
Speaker 1: for them?

388
00:20:55,000 --> 00:20:58,479
Speaker 5: Oh, so this is a really important strategy. You know,

389
00:20:58,520 --> 00:21:01,199
Speaker 5: if they are on call twenty four hours a day,

390
00:21:01,040 --> 00:21:03,400
Speaker 5: they can't count on being able to sleep at night,

391
00:21:03,440 --> 00:21:06,719
Speaker 5: can they. And so it's important to have a strategy

392
00:21:07,040 --> 00:21:11,480
Speaker 5: where if they do have some downtime, perhaps they will

393
00:21:11,520 --> 00:21:16,000
Speaker 5: be able to nap. Now, normally a shorter nap is better,

394
00:21:16,480 --> 00:21:19,840
Speaker 5: meaning twenty to thirty minutes, just because you don't go

395
00:21:20,000 --> 00:21:25,040
Speaker 5: into all of the sleep stages. Right, But that's for

396
00:21:25,240 --> 00:21:29,560
Speaker 5: people who are able to sleep at night, right. But

397
00:21:29,840 --> 00:21:33,920
Speaker 5: for our er colleagues that work those twenty four hour shifts,

398
00:21:34,320 --> 00:21:37,320
Speaker 5: probably the single most important thing is that they have

399
00:21:37,440 --> 00:21:42,040
Speaker 5: a place where they can sleep that is away from

400
00:21:42,119 --> 00:21:45,040
Speaker 5: the er, not far enough away that they can't jump

401
00:21:45,160 --> 00:21:51,560
Speaker 5: up and help. But it is dark and cool and quiet, right,

402
00:21:51,640 --> 00:21:53,879
Speaker 5: Like when I would leave the ICU, I'd be like, Okay,

403
00:21:54,000 --> 00:21:55,320
Speaker 5: I'm gonna go and try and sleep.

404
00:21:55,760 --> 00:21:59,200
Speaker 4: Please let me know what you need now you know,

405
00:21:59,400 --> 00:21:59,879
Speaker 4: I'm gonna go.

406
00:22:00,240 --> 00:22:02,640
Speaker 5: I'll be back in ten minutes, like, don't page me, right,

407
00:22:03,800 --> 00:22:06,320
Speaker 5: And a lot of the time the nursing staff was

408
00:22:06,320 --> 00:22:09,280
Speaker 5: really protective of that time. You know, they wouldn't wake

409
00:22:09,359 --> 00:22:11,840
Speaker 5: the dock up unless they needed something. And so twenty

410
00:22:11,840 --> 00:22:14,040
Speaker 5: four hours of duty is a long time, and so

411
00:22:14,080 --> 00:22:16,480
Speaker 5: it has to be protected as much as you can absolutely,

412
00:22:16,640 --> 00:22:19,120
Speaker 5: you know, with parameters of only wake me up if

413
00:22:19,200 --> 00:22:21,520
Speaker 5: you know X, Y and Z occur, and then that

414
00:22:21,600 --> 00:22:24,080
Speaker 5: is devoted time, okay.

415
00:22:23,840 --> 00:22:26,040
Speaker 1: And so you want to set your alarm potentially to

416
00:22:26,080 --> 00:22:28,240
Speaker 1: make sure you're not going past thirty minutes.

417
00:22:28,280 --> 00:22:31,080
Speaker 5: It sounds like, well, the thirty minutes isn't necessarily for

418
00:22:31,160 --> 00:22:33,800
Speaker 5: this scenario. This would be we wanted to sleep whenever

419
00:22:33,840 --> 00:22:36,199
Speaker 5: you can capture as much sleep as you can, right

420
00:22:36,280 --> 00:22:38,879
Speaker 5: because ideally if we can get seven hours in that

421
00:22:38,920 --> 00:22:41,280
Speaker 5: twenty four period, that would be amazing. Okay, you know

422
00:22:41,359 --> 00:22:43,840
Speaker 5: the realities that you may not Okay, and so then

423
00:22:43,960 --> 00:22:45,520
Speaker 5: a lot of the time they just they truly go

424
00:22:45,560 --> 00:22:48,479
Speaker 5: without sleep for twenty four hours. And so if you have,

425
00:22:48,800 --> 00:22:51,360
Speaker 5: it's a little bit like the advice we give new parents,

426
00:22:51,880 --> 00:22:53,040
Speaker 5: right sleep when you can.

427
00:23:00,200 --> 00:23:03,080
Speaker 1: That's all for this episode. Join me again next week

428
00:23:03,240 --> 00:23:06,280
Speaker 1: when we learn about the global stage of professional video gaming,

429
00:23:06,520 --> 00:23:10,119
Speaker 1: where round the clock gameplay fuels high stakes tournaments and

430
00:23:10,200 --> 00:23:12,280
Speaker 1: gaming content on streaming services.

431
00:23:12,880 --> 00:23:15,879
Speaker 6: To our brains, these developers and these games are so

432
00:23:16,119 --> 00:23:20,160
Speaker 6: good that they create real experience.

433
00:23:20,760 --> 00:23:21,800
Speaker 3: You feel like you.

434
00:23:21,760 --> 00:23:27,240
Speaker 6: Were in the deserted compound, surrounded by zombies trying to

435
00:23:27,280 --> 00:23:29,399
Speaker 6: figure out how to kill them and get to this

436
00:23:29,560 --> 00:23:32,880
Speaker 6: next place where all the other players are like when

437
00:23:32,920 --> 00:23:35,479
Speaker 6: in fact, no, you're just sitting in a chair in

438
00:23:35,520 --> 00:23:38,000
Speaker 6: your bedroom looking at a box of light.

439
00:23:39,119 --> 00:23:41,359
Speaker 1: We want to hear from you. Leave a rating a

440
00:23:41,400 --> 00:23:44,480
Speaker 1: review for our show on your podcast player of choice.

441
00:23:44,640 --> 00:23:48,560
Speaker 1: You can find me on Twitter at Anahad O'Connor. Until

442
00:23:48,600 --> 00:23:52,040
Speaker 1: next time, hoping you're living your best while sleeping your best.

443
00:23:52,920 --> 00:23:56,600
Speaker 1: Chasing Sleep is a production of iHeartRadio in partnership with

444
00:23:56,640 --> 00:24:00,800
Speaker 1: Mattress Firm. Our executive producer is Molly Sosha. Our EP

445
00:24:00,920 --> 00:24:05,040
Speaker 1: of post is James Foster. Our supervising producer is Keia Swinton.

446
00:24:05,400 --> 00:24:08,919
Speaker 1: Our producer is Sierra Kaiser. This episode was written and

447
00:24:08,960 --> 00:24:12,960
Speaker 1: researched by Eric Lejia and Jess Kapadia. Our show was

448
00:24:13,000 --> 00:24:14,960
Speaker 1: hosted by me Annahad O'Connor