1
00:00:10,039 --> 00:00:12,200
Speaker 1: No matter what time of day or night, the e

2
00:00:12,360 --> 00:00:15,720
Speaker 1: R is always awake, providing much needed support to patients

3
00:00:15,880 --> 00:00:19,599
Speaker 1: with any and every kind of ailment or injury. Dr

4
00:00:19,680 --> 00:00:23,119
Speaker 1: George Russo works in a New York hospital emergency room.

5
00:00:23,160 --> 00:00:25,599
Speaker 1: The margin for error in this line of work is

6
00:00:25,760 --> 00:00:28,640
Speaker 1: raised or thin, and since the e R never closes,

7
00:00:29,080 --> 00:00:32,600
Speaker 1: finding time to sleep and sleep properly is a daunting

8
00:00:32,680 --> 00:00:37,320
Speaker 1: challenge for George and his colleagues. There's no planned appointments.

9
00:00:38,159 --> 00:00:41,080
Speaker 1: It's whatever comes in comes in. Sometimes you're lucky enough

10
00:00:41,120 --> 00:00:43,080
Speaker 1: to get a notification over the phone from the e

11
00:00:43,280 --> 00:00:45,519
Speaker 1: M S, but that doesn't happen every time, so you

12
00:00:45,600 --> 00:00:47,720
Speaker 1: always gotta be ready to jump to it. It's a

13
00:00:47,760 --> 00:00:52,080
Speaker 1: fast paced environment, so you could be seeing somebody that's

14
00:00:52,120 --> 00:00:56,000
Speaker 1: having a heart attack or that is extremely sick with something,

15
00:00:56,040 --> 00:00:58,960
Speaker 1: and then you get a trauma notification and something's coming

16
00:00:59,000 --> 00:01:02,680
Speaker 1: in and now the wars and never closed. I wondered,

17
00:01:03,360 --> 00:01:05,880
Speaker 1: with all of the chaos and urgency of the e R,

18
00:01:06,319 --> 00:01:09,080
Speaker 1: how someone like George is thinking about sleep and how

19
00:01:09,120 --> 00:01:11,720
Speaker 1: it impacts his performance. So I asked him to recall

20
00:01:11,800 --> 00:01:14,480
Speaker 1: one of his more hectic shifts and what roles sleep

21
00:01:14,520 --> 00:01:19,600
Speaker 1: played in its success or obstacles all right. So it

22
00:01:19,720 --> 00:01:23,039
Speaker 1: was a Monday. It was Mayhem walked into a lot

23
00:01:23,080 --> 00:01:25,200
Speaker 1: of sign outs from the night prior because it was

24
00:01:25,240 --> 00:01:28,120
Speaker 1: a busy Sunday night already had to handle those, but

25
00:01:28,160 --> 00:01:31,120
Speaker 1: we also had new patients coming in for seven am sharp,

26
00:01:31,760 --> 00:01:35,399
Speaker 1: and then patients were coming in from the clinics as well,

27
00:01:35,480 --> 00:01:38,200
Speaker 1: because sometimes they have extremely high blood pressure, they get

28
00:01:38,200 --> 00:01:40,760
Speaker 1: dizzy and faint when they're getting blood taken, and I'm

29
00:01:40,760 --> 00:01:43,559
Speaker 1: dealing with all of those people. And then a stroke

30
00:01:43,600 --> 00:01:45,760
Speaker 1: alert comes in with E M S, so you have

31
00:01:45,840 --> 00:01:49,400
Speaker 1: to do the protocol for that because time is brain,

32
00:01:49,520 --> 00:01:52,760
Speaker 1: as they say. And then we had a stab wound

33
00:01:52,800 --> 00:01:55,200
Speaker 1: to the chest come in shortly after, so there was

34
00:01:55,240 --> 00:01:58,840
Speaker 1: a lot of things happening. And then there was also

35
00:01:59,320 --> 00:02:03,480
Speaker 1: COVID patient coming in, so they're taking up the isolation

36
00:02:03,560 --> 00:02:06,120
Speaker 1: rooms so you don't have exam rooms for the other patients,

37
00:02:06,680 --> 00:02:09,400
Speaker 1: and there was there was just a tremendous amount of

38
00:02:09,440 --> 00:02:12,080
Speaker 1: things going on, and we had to transfer patients for

39
00:02:12,400 --> 00:02:15,240
Speaker 1: some emergencies that our hospital didn't have the specialists for,

40
00:02:15,880 --> 00:02:18,960
Speaker 1: so you're on the phones as well, and it was

41
00:02:19,800 --> 00:02:24,280
Speaker 1: it was a day, and I think I was lucky

42
00:02:24,360 --> 00:02:27,200
Speaker 1: enough that I had had like a good eight hours

43
00:02:27,240 --> 00:02:29,280
Speaker 1: to sleep the night prior, Like I went to bed,

44
00:02:30,680 --> 00:02:32,600
Speaker 1: I don't know, probably ten pm. And since I was

45
00:02:32,639 --> 00:02:34,600
Speaker 1: there at seven, I woke up at six and I

46
00:02:34,639 --> 00:02:37,519
Speaker 1: felt pretty refreshed. And it wasn't one of those nights

47
00:02:37,520 --> 00:02:40,840
Speaker 1: where I had to split up my sleep or I

48
00:02:40,880 --> 00:02:45,000
Speaker 1: wasn't switching back and forth from days to nights. And uh,

49
00:02:45,200 --> 00:02:46,919
Speaker 1: I think it really helped me get through the day.

50
00:02:46,960 --> 00:02:49,280
Speaker 1: And then I tell you that night I certainly slept

51
00:02:49,320 --> 00:02:52,080
Speaker 1: well again because I was in bed I think at

52
00:02:52,160 --> 00:02:54,839
Speaker 1: nine thirty and I didn't wake up till the next

53
00:02:54,919 --> 00:03:00,640
Speaker 1: day at six. It was great. What role does our

54
00:03:00,680 --> 00:03:04,079
Speaker 1: sleep play in our long term health? How deep does

55
00:03:04,120 --> 00:03:06,840
Speaker 1: healthy sleep go into our biology? And how do you

56
00:03:06,880 --> 00:03:10,560
Speaker 1: get consistent rest and healthy sleep when your bedtime is

57
00:03:10,680 --> 00:03:14,640
Speaker 1: constantly in flux? Find out on this episode of Chasing

58
00:03:14,639 --> 00:03:24,880
Speaker 1: Sleep Urgent rest. Hi, I'm on a hut O'Connor and

59
00:03:25,000 --> 00:03:28,680
Speaker 1: this is Chasing Sleep and I heart radio production and

60
00:03:28,760 --> 00:03:40,520
Speaker 1: partnership with Mattress Firm. So there's definitely a stress, uh

61
00:03:41,040 --> 00:03:43,560
Speaker 1: that comes with the high stress environment that's very difficult

62
00:03:43,600 --> 00:03:46,880
Speaker 1: to wind down or to just leave at work. Everyone says,

63
00:03:46,920 --> 00:03:51,200
Speaker 1: don't take it home, but sometimes it's not possible. I mean,

64
00:03:51,400 --> 00:03:53,640
Speaker 1: when things are life and death, and when maybe there's

65
00:03:53,640 --> 00:03:56,240
Speaker 1: a bad outcome of something, it's gonna stay with you.

66
00:03:56,280 --> 00:03:59,320
Speaker 1: It just doesn't go away with the intensity. There must

67
00:03:59,320 --> 00:04:02,320
Speaker 1: be some payoff when things are life and death. The

68
00:04:02,400 --> 00:04:05,120
Speaker 1: downside is that when something goes wrong it can be

69
00:04:05,200 --> 00:04:08,880
Speaker 1: very grim, but when things go right, it must feel

70
00:04:08,880 --> 00:04:12,720
Speaker 1: pretty rewarding. The most rewarding part of what I do

71
00:04:13,640 --> 00:04:19,200
Speaker 1: is when family members or a patient feel better in

72
00:04:19,240 --> 00:04:22,359
Speaker 1: front of you, whether it's you give them antibiotics or

73
00:04:22,400 --> 00:04:25,800
Speaker 1: you give them something that helps bust a clot that

74
00:04:25,920 --> 00:04:27,800
Speaker 1: is causing a stroke in their brain, and you can

75
00:04:27,839 --> 00:04:30,800
Speaker 1: see them go from not being able to move one

76
00:04:30,880 --> 00:04:33,120
Speaker 1: side of their body to them being able to move

77
00:04:33,120 --> 00:04:35,880
Speaker 1: it within hours of them being in front of you,

78
00:04:36,000 --> 00:04:39,120
Speaker 1: and family members are crying so happy, the patients able

79
00:04:39,160 --> 00:04:41,679
Speaker 1: to talk to you afterwards. That's happened a couple of times,

80
00:04:41,680 --> 00:04:46,799
Speaker 1: and it's extremely rewarding when you can actually change somebody's

81
00:04:46,880 --> 00:04:50,240
Speaker 1: life in a matter of minutes to hours. From bustling

82
00:04:50,320 --> 00:04:54,640
Speaker 1: cities to sparsely populated rural areas, emergency medical care is

83
00:04:54,680 --> 00:04:58,080
Speaker 1: a NonStop job. Hospital staff are on their feet hour

84
00:04:58,160 --> 00:05:01,920
Speaker 1: after hour without respite because accidents and injuries don't follow

85
00:05:01,920 --> 00:05:05,560
Speaker 1: a schedule. Yeah, the physical aspect of the job, especially

86
00:05:05,600 --> 00:05:09,080
Speaker 1: after a twelve hour shift, wear and tear is absolutely there.

87
00:05:09,120 --> 00:05:12,040
Speaker 1: I mean there was there's muscle aches that felt like

88
00:05:12,040 --> 00:05:15,839
Speaker 1: I was back playing sports. It's very difficult to find

89
00:05:15,920 --> 00:05:19,440
Speaker 1: time to work out after twelve hour shift, especially if

90
00:05:19,440 --> 00:05:21,839
Speaker 1: you have a commute, and sometimes these twelve hour shifts

91
00:05:21,839 --> 00:05:24,680
Speaker 1: go to fourteen hours of something terrible comes in right

92
00:05:24,760 --> 00:05:28,200
Speaker 1: before the end of it, and it was just it

93
00:05:28,279 --> 00:05:30,839
Speaker 1: was exhausting. I mean, it was very difficult to get

94
00:05:30,839 --> 00:05:33,760
Speaker 1: in a good rhythm of things as things were changing

95
00:05:33,800 --> 00:05:38,120
Speaker 1: so often throughout the pandemic, and also just to get

96
00:05:38,360 --> 00:05:41,039
Speaker 1: a good routine at home, to get to bed at

97
00:05:41,040 --> 00:05:43,880
Speaker 1: a normal hour, to also find a way to eat

98
00:05:43,920 --> 00:05:46,279
Speaker 1: in there and watch a show with your your loved one,

99
00:05:46,400 --> 00:05:48,960
Speaker 1: or if you have kids, to find time to be

100
00:05:49,080 --> 00:05:52,080
Speaker 1: with them because they were home all day too. It's hard,

101
00:05:53,000 --> 00:05:56,599
Speaker 1: it's grueling, it's fast paced, it's long days, long nights,

102
00:05:56,800 --> 00:06:00,560
Speaker 1: and the schedule is constantly changing and all of that

103
00:06:00,600 --> 00:06:04,120
Speaker 1: does a number on our mental functions. It's difficult enough

104
00:06:04,200 --> 00:06:08,120
Speaker 1: working when you're exhausted, it becomes even more challenging when

105
00:06:08,120 --> 00:06:11,279
Speaker 1: the stakes are as high as they are an emergency medicine.

106
00:06:13,520 --> 00:06:15,880
Speaker 1: I wanted to learn more about what's happening inside our

107
00:06:15,880 --> 00:06:19,039
Speaker 1: bodies when our sleep schedules change, and what the impact

108
00:06:19,080 --> 00:06:22,760
Speaker 1: is on medical professionals. So I called up Dr Sema Cosla.

109
00:06:23,760 --> 00:06:26,839
Speaker 1: I'm Dr Sema Cosla, and I sleep medicine physician and

110
00:06:26,880 --> 00:06:29,560
Speaker 1: the medical director of the North Dakota Center for Sleep

111
00:06:29,600 --> 00:06:34,680
Speaker 1: and Fargo. So you have a really extensive background in sleep,

112
00:06:34,920 --> 00:06:37,640
Speaker 1: and first off, I think sleep is really challenging for

113
00:06:37,680 --> 00:06:39,920
Speaker 1: a lot of people. So I wanted to get your

114
00:06:39,920 --> 00:06:44,360
Speaker 1: thoughts on what do you think actually constitutes healthy sleep.

115
00:06:45,040 --> 00:06:48,080
Speaker 1: So there's you know, when we think about healthy sleep,

116
00:06:48,760 --> 00:06:54,920
Speaker 1: we have to consider quality, quantity, and timing, and so

117
00:06:54,960 --> 00:06:57,919
Speaker 1: we want to make sure that we're getting enough good

118
00:06:58,000 --> 00:07:02,960
Speaker 1: quality sleep at the right time. Seema emphasizes the importance

119
00:07:02,960 --> 00:07:06,200
Speaker 1: of consistent schedules for shift workers, and she's even gone

120
00:07:06,240 --> 00:07:09,480
Speaker 1: as far as to petition hospitals to provide consistent shift

121
00:07:09,520 --> 00:07:14,280
Speaker 1: schedules for their employees. There are so many people who

122
00:07:14,280 --> 00:07:17,640
Speaker 1: have no choice but to have these unusual sleep schedules.

123
00:07:17,760 --> 00:07:20,520
Speaker 1: You know, like our study subject today, George, who is

124
00:07:20,520 --> 00:07:23,040
Speaker 1: an e R doctor, and he and others like him

125
00:07:23,200 --> 00:07:26,680
Speaker 1: have no choice but to work the night shift at times.

126
00:07:26,680 --> 00:07:29,560
Speaker 1: How common is this And do you see a lot

127
00:07:29,600 --> 00:07:32,440
Speaker 1: of patients who have to work these unusual sleep schedules

128
00:07:32,520 --> 00:07:34,520
Speaker 1: And what are some of the common complaints that you

129
00:07:34,560 --> 00:07:37,400
Speaker 1: get from these patients? Yeah, so you're right. In the

130
00:07:37,400 --> 00:07:40,720
Speaker 1: medical field, also manufacturing, you know, we see a lot

131
00:07:40,760 --> 00:07:43,960
Speaker 1: of overnight workers. I think the challenge about an e

132
00:07:44,120 --> 00:07:47,480
Speaker 1: R shift is that it's not consistent. You know, sometimes

133
00:07:47,520 --> 00:07:49,720
Speaker 1: they'll be kind enough to give you, you know, a

134
00:07:49,800 --> 00:07:52,280
Speaker 1: week of days and then a week of nights, but

135
00:07:52,400 --> 00:07:57,520
Speaker 1: oftentimes it isn't like that, so you're constantly switching. And

136
00:07:57,560 --> 00:08:01,120
Speaker 1: so a consistent shift, even if as night shift, is

137
00:08:01,160 --> 00:08:04,360
Speaker 1: better than a variable shift, right, because at least you

138
00:08:04,400 --> 00:08:08,240
Speaker 1: can give your body some semblance of a circadian rhythm, right.

139
00:08:08,560 --> 00:08:11,360
Speaker 1: I was wondering about that. Yeah, yeah, And so I've

140
00:08:11,400 --> 00:08:14,040
Speaker 1: written letters before just asking can you please, like pick

141
00:08:14,080 --> 00:08:17,040
Speaker 1: a shift. We don't care what the shift is, to

142
00:08:17,280 --> 00:08:21,080
Speaker 1: make it consistent, please, But picking a shift is easier

143
00:08:21,120 --> 00:08:23,760
Speaker 1: said than done, especially in a field where your day

144
00:08:23,840 --> 00:08:26,680
Speaker 1: changes wildly with no control over what might walk through

145
00:08:26,680 --> 00:08:30,000
Speaker 1: the hospital doors. So the schedule of an e R

146
00:08:30,080 --> 00:08:34,560
Speaker 1: doctor is not the average schedule. It is not a

147
00:08:34,600 --> 00:08:36,800
Speaker 1: Monday through Friday, it is not a nine to five.

148
00:08:37,559 --> 00:08:41,479
Speaker 1: So the average gr doctor does about twelve to fifteen

149
00:08:41,559 --> 00:08:44,640
Speaker 1: shifts a month, and they can be anywhere from eight

150
00:08:44,679 --> 00:08:48,520
Speaker 1: to twelve hour shifts. Some in rural places do twenty

151
00:08:48,520 --> 00:08:51,760
Speaker 1: four hour shifts and even thirty hour shifts depending on

152
00:08:51,880 --> 00:08:56,120
Speaker 1: the amount of patients that the hospital sees. And these

153
00:08:56,120 --> 00:09:00,160
Speaker 1: shifts can be the morning swing shift or they be

154
00:09:00,200 --> 00:09:03,439
Speaker 1: the overnight shift. Night to day shift is when it

155
00:09:03,480 --> 00:09:06,280
Speaker 1: becomes more difficult to get to bed and normal hour

156
00:09:07,240 --> 00:09:09,200
Speaker 1: because if you go to bed at the same hour

157
00:09:09,320 --> 00:09:10,760
Speaker 1: that you did when you had to wake up at

158
00:09:10,760 --> 00:09:13,000
Speaker 1: seven am, you wake up around seven and then you

159
00:09:13,000 --> 00:09:16,840
Speaker 1: don't work again until seven pm. So I would find

160
00:09:16,880 --> 00:09:19,319
Speaker 1: myself trying to push myself and stay up a little later,

161
00:09:19,440 --> 00:09:21,480
Speaker 1: maybe until midnight two in the morning, as if it

162
00:09:21,520 --> 00:09:25,559
Speaker 1: was a Saturday night. Frequently, changing schedules, while necessary and

163
00:09:25,640 --> 00:09:29,880
Speaker 1: feels like this one, makes for challenging sleep. So the

164
00:09:29,920 --> 00:09:33,720
Speaker 1: switch back and forth from day to night is never

165
00:09:33,840 --> 00:09:38,640
Speaker 1: easy with sleep and sleep, especially in the emergency medicine world.

166
00:09:38,640 --> 00:09:41,840
Speaker 1: Did we tend to be the most sleep deprived or

167
00:09:41,920 --> 00:09:44,320
Speaker 1: have the most issues with sleep because of the shift

168
00:09:44,320 --> 00:09:47,559
Speaker 1: work and jumping around in the schedule. UH with twelve

169
00:09:47,559 --> 00:09:51,680
Speaker 1: hour shifts, found that it was difficult sometimes to keep

170
00:09:51,720 --> 00:09:56,040
Speaker 1: a nice sleep routine because my significant other, she would

171
00:09:56,040 --> 00:09:58,360
Speaker 1: get home later and I would want to stay up

172
00:09:58,400 --> 00:10:00,600
Speaker 1: to see her. But then that would affect my work

173
00:10:01,120 --> 00:10:03,160
Speaker 1: or my sleep pattern because I would be up till

174
00:10:03,200 --> 00:10:04,679
Speaker 1: midnight and then have to wake up again the next

175
00:10:04,760 --> 00:10:07,360
Speaker 1: day at six am. I found out pretty quickly that

176
00:10:07,360 --> 00:10:11,280
Speaker 1: that wasn't sustainable. And then switching over to nights. We

177
00:10:11,360 --> 00:10:14,360
Speaker 1: all have our different ways of trying to normalize it,

178
00:10:14,400 --> 00:10:17,000
Speaker 1: but you're always going to feel kind of awful when

179
00:10:17,000 --> 00:10:19,200
Speaker 1: you switched over to nights or when you switch back today.

180
00:10:19,200 --> 00:10:21,480
Speaker 1: It's because it's just like jet lag. It's like we flew,

181
00:10:21,520 --> 00:10:23,520
Speaker 1: but you didn't even get the nice Franci vacation out

182
00:10:23,520 --> 00:10:27,959
Speaker 1: of it. Nurses and doctors are so vulnerable to life

183
00:10:28,000 --> 00:10:31,600
Speaker 1: their ning mistakes. When their sleep is jeopardized, a tired

184
00:10:31,640 --> 00:10:34,800
Speaker 1: doctor in an e er or an operating room becomes

185
00:10:34,800 --> 00:10:37,480
Speaker 1: a danger to a patient. My sister in law is

186
00:10:37,520 --> 00:10:41,439
Speaker 1: a doctor in London, and I was quizzing her about,

187
00:10:41,640 --> 00:10:43,720
Speaker 1: you know how she gets through this, you know, working

188
00:10:43,760 --> 00:10:45,800
Speaker 1: these night shifts and go back to regular shift, and

189
00:10:45,840 --> 00:10:49,280
Speaker 1: she mentioned that at her hospital they actually won't let

190
00:10:49,280 --> 00:10:54,920
Speaker 1: the doctors perform any complex procedures or surgeries overnight unless

191
00:10:54,960 --> 00:10:57,280
Speaker 1: it's an emergency. If someone comes in with the gunshot

192
00:10:57,440 --> 00:10:59,720
Speaker 1: or you know, a stab wound, then they have to

193
00:10:59,720 --> 00:11:02,360
Speaker 1: do some thing. But if it's a surgery that they

194
00:11:02,360 --> 00:11:05,480
Speaker 1: can push off until the morning or daytime, you know,

195
00:11:05,520 --> 00:11:08,080
Speaker 1: they will try to do that rather than operate on

196
00:11:08,120 --> 00:11:09,880
Speaker 1: someone in the middle of the night, just because of

197
00:11:09,920 --> 00:11:13,760
Speaker 1: the risks involved. So I think it's important to recognize

198
00:11:13,840 --> 00:11:16,840
Speaker 1: that some people do great at night. That's sort of

199
00:11:16,840 --> 00:11:19,880
Speaker 1: where they really perform well, and they're just naturally better

200
00:11:20,040 --> 00:11:23,199
Speaker 1: at night, and some people don't. So my background is

201
00:11:23,240 --> 00:11:26,160
Speaker 1: pulmonary and critical care, and so that when I would

202
00:11:26,160 --> 00:11:27,880
Speaker 1: go into the i c U in the middle of

203
00:11:27,880 --> 00:11:32,559
Speaker 1: the night, you write a little adrenaline so to kind

204
00:11:32,600 --> 00:11:36,040
Speaker 1: of combat the sleepiness that occurs, and you have to

205
00:11:36,080 --> 00:11:39,320
Speaker 1: be sharp, and I think you push yourself to be sharp,

206
00:11:39,400 --> 00:11:43,040
Speaker 1: if that makes sense. You know, people in these fields

207
00:11:43,040 --> 00:11:45,880
Speaker 1: are usually high achievers, high performers, and they put a

208
00:11:45,920 --> 00:11:48,280
Speaker 1: lot of demands, like I'm sure you know in the

209
00:11:48,320 --> 00:11:53,040
Speaker 1: e er that adrenaline also helps you, right, And there's

210
00:11:53,080 --> 00:11:55,720
Speaker 1: been a lot of research on this topic of sleep

211
00:11:55,720 --> 00:11:59,920
Speaker 1: deprivation among healthcare workers. So, for example, I saw that

212
00:12:00,000 --> 00:12:03,240
Speaker 1: the British Journal of Anesthesia published a study that found

213
00:12:03,400 --> 00:12:07,080
Speaker 1: more than ten increase in life threatening events that happened

214
00:12:07,080 --> 00:12:09,880
Speaker 1: in surgeries that were performed at night. Yeah. Well, and

215
00:12:09,960 --> 00:12:13,480
Speaker 1: it's at its risk of operator error, but also support

216
00:12:13,559 --> 00:12:16,640
Speaker 1: in a hospital if something goes bad, you're minimally staffed

217
00:12:16,679 --> 00:12:20,079
Speaker 1: at night. And so we used to have this lore

218
00:12:20,320 --> 00:12:23,600
Speaker 1: in the world of pulmonary that if you have fluid

219
00:12:23,640 --> 00:12:27,640
Speaker 1: around your lungs, it needs to be taken out before

220
00:12:27,840 --> 00:12:30,800
Speaker 1: the sun sets. Was kind of what we were always taught.

221
00:12:31,400 --> 00:12:33,320
Speaker 1: And then it turns out if you start doing these

222
00:12:33,360 --> 00:12:35,760
Speaker 1: things at nine o'clock at night or ten o'clock at night,

223
00:12:36,160 --> 00:12:39,160
Speaker 1: when no one else is in the hospital, that's not

224
00:12:39,200 --> 00:12:42,840
Speaker 1: great for patients. Yeah, because then you may convert it

225
00:12:42,880 --> 00:12:45,840
Speaker 1: into an emergency procedure or something like that and calling

226
00:12:45,880 --> 00:12:49,760
Speaker 1: people in from sleep, right, calling people in from their

227
00:12:49,800 --> 00:12:53,160
Speaker 1: beds to help you. And so I applaud where your

228
00:12:53,200 --> 00:13:00,120
Speaker 1: sister works that they recognize this. We'll be right back

229
00:13:00,120 --> 00:13:10,520
Speaker 1: after a brief message from our partners at Mattress Firm,

230
00:13:10,559 --> 00:13:17,000
Speaker 1: and now back to chasing sleep throughout our series. So far,

231
00:13:17,440 --> 00:13:20,360
Speaker 1: I've learned a lot about how sleep impacts our physical

232
00:13:20,720 --> 00:13:24,880
Speaker 1: and mental performance and our endurance. I've deepened my understanding

233
00:13:24,920 --> 00:13:28,160
Speaker 1: of how stress and anxiety can adversely impact our sleep

234
00:13:28,200 --> 00:13:31,400
Speaker 1: as well. But speaking with George and Seema gave me

235
00:13:31,480 --> 00:13:34,840
Speaker 1: a completely new perspective on just how much sleep impacts

236
00:13:34,840 --> 00:13:40,120
Speaker 1: our overall and long term health. You know, it's so funny.

237
00:13:40,240 --> 00:13:42,480
Speaker 1: We we talk a good game in our world of sleep,

238
00:13:42,600 --> 00:13:44,320
Speaker 1: right we're saying, yep, you should be in bed at

239
00:13:44,320 --> 00:13:46,600
Speaker 1: the same time every night and get seven to nine

240
00:13:46,640 --> 00:13:50,040
Speaker 1: hours of good restorative sleep. And so what we what

241
00:13:50,160 --> 00:13:53,160
Speaker 1: we've seen over the years is sometimes people who are

242
00:13:53,360 --> 00:13:57,120
Speaker 1: night owls, we call them delayed sleep phase coronotype. So

243
00:13:57,280 --> 00:13:59,720
Speaker 1: just meaning that you're just biologically right. You you like

244
00:13:59,760 --> 00:14:02,080
Speaker 1: to say up late, and you like to sleep in um.

245
00:14:02,160 --> 00:14:05,400
Speaker 1: Sometimes they will find themselves in a night shift position

246
00:14:05,480 --> 00:14:09,360
Speaker 1: just because it sort of fits with their circadian rhythm.

247
00:14:09,360 --> 00:14:12,520
Speaker 1: But not always. We do see that there is a

248
00:14:12,640 --> 00:14:16,360
Speaker 1: higher risk of cancer in night shift workers. They did

249
00:14:16,400 --> 00:14:19,640
Speaker 1: a study of nurses, for example, and they had a

250
00:14:19,680 --> 00:14:23,480
Speaker 1: higher incidence of breast cancer. And so it's really it's

251
00:14:23,560 --> 00:14:26,000
Speaker 1: kind of amazing. I remember years ago we were giving

252
00:14:26,000 --> 00:14:29,800
Speaker 1: this conference, and I reached out to a cancer researcher

253
00:14:30,240 --> 00:14:31,960
Speaker 1: and I wanted to talk to her about, you know,

254
00:14:32,040 --> 00:14:34,560
Speaker 1: how we think sleep is super important for you know,

255
00:14:34,600 --> 00:14:36,920
Speaker 1: for cancer and and that sort of thing, and she

256
00:14:36,960 --> 00:14:39,240
Speaker 1: kind of laughed at me. She was very kind, but

257
00:14:39,360 --> 00:14:41,840
Speaker 1: I thought we were so smart thinking about this, and

258
00:14:41,840 --> 00:14:45,200
Speaker 1: she's like, oh, yeah, we've considered poor sleep a carcinogen

259
00:14:45,280 --> 00:14:50,200
Speaker 1: for decades, So yeah, they were way ahead of us.

260
00:14:53,680 --> 00:14:58,160
Speaker 1: As Seema says, poor sleep is a carcinogen, a mood destabilizer,

261
00:14:58,360 --> 00:15:01,880
Speaker 1: and it causes many other issues and diseases. I wanted

262
00:15:01,920 --> 00:15:05,160
Speaker 1: to learn more about the ways sleep is constantly affecting

263
00:15:05,160 --> 00:15:08,600
Speaker 1: our health, so I asked Seema to explain the biology

264
00:15:08,600 --> 00:15:11,840
Speaker 1: of sleep and everything that's happening inside us as we snooze.

265
00:15:14,400 --> 00:15:18,920
Speaker 1: So REM is important for mood regulation, right, slow wave

266
00:15:18,960 --> 00:15:23,240
Speaker 1: sleep or delta sleep. This is this lovely slow wave sleep.

267
00:15:23,320 --> 00:15:25,560
Speaker 1: Kids get tons of this. This is where they where

268
00:15:25,560 --> 00:15:29,280
Speaker 1: they grow, and where they you know, sleepwalk, do all

269
00:15:29,280 --> 00:15:32,520
Speaker 1: of those things. Um, that's probably important for us to

270
00:15:32,640 --> 00:15:35,760
Speaker 1: download short term memory into long term memory, and then

271
00:15:35,840 --> 00:15:40,640
Speaker 1: REM is important for us to organize and edit those memories.

272
00:15:41,440 --> 00:15:46,040
Speaker 1: That's just in the mind and so if you can

273
00:15:46,080 --> 00:15:48,560
Speaker 1: imagine the brain has write all those little ups and

274
00:15:48,600 --> 00:15:51,680
Speaker 1: downs and on a cellular level, if you imagine it,

275
00:15:51,800 --> 00:15:53,680
Speaker 1: and I'm going to borrow this from one of my colleagues,

276
00:15:53,760 --> 00:15:57,240
Speaker 1: Dr Chuck Seisler. He was the the expert witness at

277
00:15:57,240 --> 00:15:59,800
Speaker 1: the Michael Jackson trial, and this is how he described it.

278
00:15:59,840 --> 00:16:02,400
Speaker 1: So if you picture it like a big city like

279
00:16:02,480 --> 00:16:05,320
Speaker 1: New York City, right, You've got these big, huge, tall buildings,

280
00:16:05,800 --> 00:16:08,040
Speaker 1: and then you've got these alleys, and all day long,

281
00:16:08,120 --> 00:16:10,640
Speaker 1: the garbage truck is, you know, cleaning debris out of

282
00:16:10,640 --> 00:16:13,200
Speaker 1: the alleys, right, and people are tossing stuff out of

283
00:16:13,200 --> 00:16:19,640
Speaker 1: the windows. And so when you sleep, the buildings shrink

284
00:16:20,360 --> 00:16:24,040
Speaker 1: and the alleys get really wide, and so all of

285
00:16:24,080 --> 00:16:28,280
Speaker 1: that debris gets swept away much more efficiently. And when

286
00:16:28,320 --> 00:16:32,720
Speaker 1: you analyze that debris, it is beta amyloid, which is

287
00:16:32,760 --> 00:16:35,640
Speaker 1: one of the things that builds up in Alzheimer's. And

288
00:16:35,680 --> 00:16:39,320
Speaker 1: so sleep is really really important to that, you know,

289
00:16:39,360 --> 00:16:41,640
Speaker 1: for all of that. So to your point about you know,

290
00:16:41,760 --> 00:16:45,440
Speaker 1: why does sleep impact cancer growth and why does it

291
00:16:45,480 --> 00:16:48,600
Speaker 1: impact ourselves? You know, we we know it's important for immunity.

292
00:16:49,080 --> 00:16:51,120
Speaker 1: We learned a lot with the pandemic right. We know

293
00:16:51,240 --> 00:16:53,960
Speaker 1: that if you're well rested the night before your your

294
00:16:54,040 --> 00:16:57,440
Speaker 1: vaccine and the day before that, you had better vaccine responsiveness.

295
00:16:58,040 --> 00:17:01,200
Speaker 1: Um and probably just because every thing needs to recover,

296
00:17:02,960 --> 00:17:05,080
Speaker 1: so it's not just the long term, it's these immediate

297
00:17:05,080 --> 00:17:08,200
Speaker 1: effects have an impact on your response to a vaccine.

298
00:17:09,520 --> 00:17:12,840
Speaker 1: Fascinating analogy. So when we sleep and we have our

299
00:17:12,920 --> 00:17:16,240
Speaker 1: very own sanitation department clearing the streets in our brains,

300
00:17:16,720 --> 00:17:21,399
Speaker 1: think about what that debris entails. It's imperative that George

301
00:17:21,440 --> 00:17:24,040
Speaker 1: has time to clear out those beta amyloid proteins in

302
00:17:24,080 --> 00:17:26,160
Speaker 1: his brain so that he can get back to work

303
00:17:26,400 --> 00:17:28,840
Speaker 1: and be on top of his game, saving lives and

304
00:17:28,880 --> 00:17:36,560
Speaker 1: helping people when they need it the most. With so

305
00:17:36,680 --> 00:17:39,320
Speaker 1: much of our health riding on sleep, I was curious

306
00:17:39,359 --> 00:17:42,360
Speaker 1: about the unique obstacles that e er workers like George

307
00:17:42,359 --> 00:17:45,399
Speaker 1: face when they're trying to get adequate sleep. Battling this

308
00:17:45,480 --> 00:17:47,880
Speaker 1: newze button for an early morning shift is one thing.

309
00:17:48,560 --> 00:17:51,000
Speaker 1: Coming home when the sun rises, and trying to get

310
00:17:51,040 --> 00:17:53,320
Speaker 1: healthy sleep in the middle of the day is an

311
00:17:53,440 --> 00:17:56,760
Speaker 1: entirely different challenge. So it's actually easier to get more

312
00:17:56,840 --> 00:17:59,240
Speaker 1: sleep during the winter. During the summer is when it

313
00:17:59,320 --> 00:18:02,560
Speaker 1: said it's artists, and I have to keep the sunglasses

314
00:18:02,560 --> 00:18:05,040
Speaker 1: on after an overnight shift. Actually, that's one of the

315
00:18:05,080 --> 00:18:07,959
Speaker 1: big things. On the way home. If I forget my sunglasses,

316
00:18:07,960 --> 00:18:10,160
Speaker 1: I get really messed up because my circadian rhythm wants

317
00:18:10,160 --> 00:18:12,600
Speaker 1: to be awake. So you've got to keep it dark.

318
00:18:13,200 --> 00:18:15,920
Speaker 1: And if you can get out at a time where

319
00:18:15,920 --> 00:18:17,800
Speaker 1: the sun still hasn't come up, I try and rush

320
00:18:17,840 --> 00:18:20,399
Speaker 1: home as if I'm a vampire or something like. I

321
00:18:20,440 --> 00:18:22,440
Speaker 1: have to get there before the sun comes up, because

322
00:18:22,440 --> 00:18:24,080
Speaker 1: it can absolutely throw you for a loop once the

323
00:18:24,119 --> 00:18:27,680
Speaker 1: sun comes up. You know, our impetus to sleep is

324
00:18:27,760 --> 00:18:30,280
Speaker 1: driven by a couple of things. So one is that

325
00:18:30,400 --> 00:18:34,320
Speaker 1: circadian rhythm right when we're biologically programmed to be awake

326
00:18:34,680 --> 00:18:37,480
Speaker 1: and to fall asleep. But the other is what's called

327
00:18:37,520 --> 00:18:41,280
Speaker 1: sleep pressure. So sleep pressure builds up from the minute

328
00:18:41,280 --> 00:18:44,080
Speaker 1: you wake up until you go to bed. So if

329
00:18:44,119 --> 00:18:47,960
Speaker 1: you are at your typical sleep schedule, they both peak

330
00:18:48,440 --> 00:18:51,600
Speaker 1: to push you to sleep. But now when we're asking

331
00:18:51,640 --> 00:18:56,040
Speaker 1: people to work night shift, these work against each other, right,

332
00:18:57,200 --> 00:18:59,639
Speaker 1: and so then we have to accommodate. We need to

333
00:18:59,720 --> 00:19:02,000
Speaker 1: drill just say okay, well, how can we make sure

334
00:19:02,040 --> 00:19:05,560
Speaker 1: that the sleep you're getting is as good as we

335
00:19:05,600 --> 00:19:09,000
Speaker 1: can make it, and so we really focus on the

336
00:19:09,040 --> 00:19:12,840
Speaker 1: sleep environment, make sure the room is cool and dark

337
00:19:12,960 --> 00:19:19,680
Speaker 1: especially and quiet, so especially with these ever changing shift

338
00:19:19,720 --> 00:19:22,960
Speaker 1: schedules and the on the job stresses that are the

339
00:19:23,000 --> 00:19:26,479
Speaker 1: norm in the e R George, what other tools are

340
00:19:26,520 --> 00:19:30,760
Speaker 1: there besides caffeine? Can Strategic napping for example, helped to

341
00:19:30,840 --> 00:19:34,240
Speaker 1: bridge the gap to getting rest went on twenty four

342
00:19:34,280 --> 00:19:37,440
Speaker 1: our shifts. Now, we don't necessarily do this in the

343
00:19:37,440 --> 00:19:40,280
Speaker 1: e R s everywhere, but some more rural places do

344
00:19:40,400 --> 00:19:43,920
Speaker 1: have to do twenty four our plus shifts. During residency,

345
00:19:43,960 --> 00:19:47,520
Speaker 1: I had to do. I see you rotations that did

346
00:19:47,560 --> 00:19:51,080
Speaker 1: have twenty four to twenty seven hours shifts. It doesn't

347
00:19:51,080 --> 00:19:53,600
Speaker 1: sound possible, and I didn't think it was, but somehow

348
00:19:53,640 --> 00:19:56,080
Speaker 1: you make it through it. Now, one of the main

349
00:19:56,119 --> 00:19:58,320
Speaker 1: ways was after the whole day to day was done,

350
00:19:58,359 --> 00:20:00,320
Speaker 1: when everyone else had left his own the you and

351
00:20:00,480 --> 00:20:02,800
Speaker 1: somebody else, and you would try and take shifts where

352
00:20:02,840 --> 00:20:05,359
Speaker 1: you could get to nap or sometimes even get to

353
00:20:05,359 --> 00:20:08,720
Speaker 1: sleep like four hours, and it really helps because you

354
00:20:08,760 --> 00:20:11,320
Speaker 1: had already been up since six am, and then it

355
00:20:11,359 --> 00:20:14,080
Speaker 1: was about whether it was eight pm ten pm. You

356
00:20:14,160 --> 00:20:16,200
Speaker 1: got to even sleep for two hours it was lovely

357
00:20:16,600 --> 00:20:19,520
Speaker 1: because at that time bed feels the best and you

358
00:20:19,600 --> 00:20:21,800
Speaker 1: just want to lay down. It's sometimes it's a little

359
00:20:21,840 --> 00:20:24,879
Speaker 1: more difficult to kind of wind down, and then you

360
00:20:25,119 --> 00:20:26,879
Speaker 1: end up staring at the ceiling for a while. But

361
00:20:27,000 --> 00:20:29,719
Speaker 1: to get that rest and again step away from everything,

362
00:20:29,760 --> 00:20:32,679
Speaker 1: it's it was so necessary. I don't I'm sure there

363
00:20:32,760 --> 00:20:35,040
Speaker 1: was sometimes that people couldn't do it because it's just

364
00:20:35,080 --> 00:20:38,760
Speaker 1: too busy for those twenty four hours. But the exhaustion

365
00:20:38,840 --> 00:20:44,320
Speaker 1: really takes a toll. And so now let's say for

366
00:20:44,359 --> 00:20:47,480
Speaker 1: like a health care professional who maybe works in a

367
00:20:47,560 --> 00:20:52,119
Speaker 1: rural area and it's working overnight shift pretty consistently, what

368
00:20:52,240 --> 00:20:55,960
Speaker 1: can napping do for them? Oh, so this is a

369
00:20:56,080 --> 00:20:59,440
Speaker 1: really important strategy. You know, if they are on call

370
00:20:59,600 --> 00:21:02,480
Speaker 1: twenty four hours a day, they can't count on being

371
00:21:02,480 --> 00:21:05,000
Speaker 1: able to sleep at night, can they, And so it's

372
00:21:05,040 --> 00:21:09,240
Speaker 1: important to have a strategy where if they do have

373
00:21:09,320 --> 00:21:12,720
Speaker 1: some downtime, perhaps they will be able to nap. Now,

374
00:21:13,080 --> 00:21:18,080
Speaker 1: normally a shorter nap is better, meaning twenty to thirty minutes,

375
00:21:18,680 --> 00:21:23,560
Speaker 1: just because you don't go into all of the sleep stages, right,

376
00:21:24,240 --> 00:21:28,840
Speaker 1: But that's for people who are able to sleep at night, right,

377
00:21:29,480 --> 00:21:32,760
Speaker 1: But for our e er colleagues that work those twenty

378
00:21:32,760 --> 00:21:36,720
Speaker 1: four hour shifts. Probably the single most important thing is

379
00:21:36,720 --> 00:21:40,080
Speaker 1: that they have a place where they can sleep that

380
00:21:40,240 --> 00:21:44,280
Speaker 1: is away from the e R. Not far enough away

381
00:21:44,280 --> 00:21:47,480
Speaker 1: that they can't jump up and help, but it is

382
00:21:47,840 --> 00:21:52,120
Speaker 1: dark and cool and quiet. Right Like when I would

383
00:21:52,160 --> 00:21:54,120
Speaker 1: leave the I c U, I'd be like, Okay, I'm

384
00:21:54,119 --> 00:21:57,679
Speaker 1: gonna go and try and sleep. Please let me know

385
00:21:57,720 --> 00:22:00,320
Speaker 1: what you need now you know I'm gonna go. I'll

386
00:22:00,359 --> 00:22:03,720
Speaker 1: be back in ten minutes, like, don't page me all right, um,

387
00:22:03,760 --> 00:22:06,159
Speaker 1: And and a lot of the time the nursing staff

388
00:22:06,200 --> 00:22:08,960
Speaker 1: was really protective of that time. You know, they wouldn't

389
00:22:09,000 --> 00:22:11,399
Speaker 1: wake the dock up unless they needed something. And so

390
00:22:11,520 --> 00:22:13,879
Speaker 1: twenty four hours of duty is a long time, and

391
00:22:13,920 --> 00:22:15,520
Speaker 1: so it has to be protected as much as you

392
00:22:15,560 --> 00:22:18,600
Speaker 1: can absolutely, you know, with parameters of only wake me

393
00:22:18,680 --> 00:22:21,119
Speaker 1: up if you know X, Y and Z occur, and

394
00:22:21,160 --> 00:22:24,320
Speaker 1: then that is devoted time, okay, And so you want

395
00:22:24,320 --> 00:22:26,719
Speaker 1: to set your alarm potentially to make sure you're not

396
00:22:26,760 --> 00:22:29,879
Speaker 1: going past thirty minutes. It sounds like, well the thirty

397
00:22:29,880 --> 00:22:32,760
Speaker 1: minutes isn't necessarily for this scenario. This would be we

398
00:22:32,800 --> 00:22:35,280
Speaker 1: wanted to sleep whatever you can capture as much sleep

399
00:22:35,320 --> 00:22:38,240
Speaker 1: as you can, because ideally, if we can get seven

400
00:22:38,280 --> 00:22:40,520
Speaker 1: hours in that twenty four period, that would be amazing.

401
00:22:41,080 --> 00:22:43,600
Speaker 1: You know, the realities that you may not, and so

402
00:22:43,640 --> 00:22:45,399
Speaker 1: then a lot of the time they just they truly

403
00:22:45,400 --> 00:22:48,080
Speaker 1: go without sleep for twenty four hours. And so if

404
00:22:48,080 --> 00:22:50,359
Speaker 1: you have, it's a little bit like the advice we

405
00:22:50,400 --> 00:23:00,560
Speaker 1: give new parents, right sleep when you can. That's all

406
00:23:00,600 --> 00:23:03,440
Speaker 1: for this episode. Join me again next week when we

407
00:23:03,520 --> 00:23:06,720
Speaker 1: learn about the global stage of professional video gaming, where

408
00:23:06,720 --> 00:23:10,520
Speaker 1: around the clock gameplay feels high stakes tournaments and gaming

409
00:23:10,560 --> 00:23:15,000
Speaker 1: content on streaming services. To our brains, these developers and

410
00:23:15,000 --> 00:23:20,159
Speaker 1: these games are so good that they create real experience,

411
00:23:20,520 --> 00:23:24,879
Speaker 1: like you feel like you were in the deserted compound

412
00:23:25,400 --> 00:23:28,360
Speaker 1: surrounded by zombies trying to figure out how to kill

413
00:23:28,440 --> 00:23:30,679
Speaker 1: them and get to this next place where all the

414
00:23:30,680 --> 00:23:34,000
Speaker 1: other players are like when in fact, no, you're just

415
00:23:34,040 --> 00:23:37,159
Speaker 1: sitting in a chair in your bedroom looking at a

416
00:23:37,200 --> 00:23:40,800
Speaker 1: box of light. We want to hear from you. Leave

417
00:23:40,840 --> 00:23:43,400
Speaker 1: a rating or review for our show on your podcast

418
00:23:43,400 --> 00:23:46,320
Speaker 1: player of choice. You can find me on Twitter at

419
00:23:46,359 --> 00:23:50,440
Speaker 1: on at O'Connor. Until next time, Hoping you're living your

420
00:23:50,440 --> 00:23:54,560
Speaker 1: best while sleeping your best, chasing sleep is a production

421
00:23:54,600 --> 00:23:58,040
Speaker 1: of I Heart Radio in partnership with Matches Firm. Our

422
00:23:58,080 --> 00:24:01,480
Speaker 1: executive producer is Molly Sosha. Our EP of Post is

423
00:24:01,560 --> 00:24:06,040
Speaker 1: James Foster. Our supervising producer is Kia Swinton. Our producer

424
00:24:06,200 --> 00:24:09,640
Speaker 1: is Sierra Kaiser. This episode was written and researched by

425
00:24:09,680 --> 00:24:13,480
Speaker 1: Erik Lesia and Jess Kapadia. Our show was hosted by

426
00:24:13,520 --> 00:24:15,040
Speaker 1: me on a hot O'Connor