All too often we do not get enough sleep. It is generally recommended that adults get between six to seven hours of sleep per night. While this is ideal, for some it is not always realistic. Whether it is because of the late nights studying or catching up on the current state of politics I can stay up for hours. In today's world, it is not uncommon for people to work for long hours, and commute for long periods of time only to work some more. As a STEM major pursuing a career in medicine, well let's just say sleep is not something I take for granted.

Researchers in Australia determined that going 18 hours without sleep is the equivalent of having a Blood Alcohol Concentration (BAC) of .05 (.08 is legally drunk). Since 2003, first-year residents have worked 16-hour work shifts, and second and third-year residents work up for up to 24 consecutive hours. There is now talk that residents may be allowed to work for up to 26 hours straight.

According to the Accreditation Council for Graduate Medical Education, this extended period would not pose a risk to patients. They asserted that it would encourage training for real situations under supervision by comparing it to the way drivers learn. The residents would work no more than 24 hours straight and then spend up to 4 hours transitioning their patients to the next round of residents. The goal of this shift would be to minimize patient hand-off and therefore minimize mistakes.

But what about mistakes made by residents. We have all heard the saying "you cannot pour from an empty cup". Well, how can residents effectively use their medical training to help others, when they are at risk themselves?

Lack of sleep has led to some serious problems for Americans. It impairs mood, memory, reaction time, and learning. One is the increase in "drowsy driving" where sleep deprived commuters pose a serious threat to themselves and other drivers due to the aforementioned impairments. Every hour that you are sleep deprived your rate of crashing increases rapidly. Drivers are urged to take a 10 to 20-minute nap every few hours during a long drive. This aligns perfectly with the ACGME's analogy previously mentioned. Strict rules have been in place since 2003 to ensure that patient's live are not at risk due to a provider's lack of sleep. However, studies have shown that shorter shifts may be just as detrimental. In addition, late shifts force residents to work later at night which can cause even more fatigue.

If lack of sleep causes an impairment that can be equivalent to being drunk, does it make sense to take already sleep deprived individuals and give them, even more, hours? Sleep is definitely not the only thing medical professionals are deprived of, but it is definitely one of the most important. Because the way we treat healthcare providers does not only affect their bodies and their lives, but it also affects the wellbeing of those they care. Sleep-deprived residents are more likely to injure, and possibly infect themselves, during procedures and they are more likely to get into car accidents.

What we really need to be looking at is how to we can improve institutions that encourage sleep deprivation.