Abstract
As clinicians, the more we focus on, practice, and talk about wellness, the more likely we are to engage in healthy activities. In other words, wellness begets wellness. However, busy clinicians trying to meet the needs of their clients and balance work and home life can lose sight of their own health needs and prioritize themselves last. Fortunately, an emphasis on clinician self-care and wellness is a growing movement and absolutely essential to help healers stay well. In this clinician wellness column, experts offer practical advice for optimizing health and provide helpful suggestions for incorporating more wellness in day-to-day living.
Tip
Lack of proper sleep can contribute to a variety of medical problems. Interferences to the natural circadian rhythm have a cumulative effect on one's health. Overworked and overwhelmed doctors, nurses, and other essential health care workers are notorious for being sleep deprived. It should be no major revelation that lack of sleep affects one's mood, which in turn, can affect the quality of patient care. 1 Healthy health care practitioners are better suited to advise and support their patients.
For clinicians' wellbeing, sleep must be taken seriously. Avoiding illness by practicing wellness promoting activities certainly comes in many forms. Sleep may be one of the most significant, but poorly considered factors. One's health depends upon both the quantity and quantity of sleep. Some people, peculiarly, take pride in being sleep deprived! This conscious decision to impair one's health is a disturbing trend. Reversing this trend should begin with health care providers themselves setting the best possible example. Preaching what one practices, and practicing what one preaches makes for better providers, regardless of medical specialty.
Prescription and over-the-counter sleep medicine is conventional Western medicine's answer to sleep difficulties. However, it arguably has little scientific basis for improving one's health. Applying a brute force attack to induce drowsiness does not support improved sleep physiology. Some of the serious potential side effects from some of the most popular prescription sleep drugs include amnesia, hallucinations and delusions, coordination difficulty, increased appetite, decreased sex drive, and impaired judgment. Residual effects from sleep medications are commonly reported and are associated with various impairments. 2
Practice
Although the quantity of sleep each individual optimally needs may vary, many would benefit from improvement in sleep quality, quantity, and consistency. We are diurnal beings. This is of course, no brilliant observation, yet it is largely not considered. As a result, many suffer circadian rhythm disturbances, resulting in physiological disruption in the body. Sleep disorders and deprivation can result in hormonal imbalances linked to obesity and type 2 diabetes. 3
Correcting the causes of sleep troubles takes much more than merely prescribing a drug. There is no substitute for natural sleep. There are many possible reasons for poor sleep. For many, an overactive mind at bedtime is the primary cause of insomnia. Health care providers can feel exhausted both physically and mentally, but when it comes down to bedtime, turning off one's own brain can be extremely difficult. One's thoughts can prevent sleep from occurring. Ruminating over the events of the day, the day before, and what is going on tomorrow can block the natural process. Bedtime is not solving time. For those who suffer the inability to shut down their own thoughts, waking up many times during the night can repeat the whole maddening and frustrating process over again and again.
My clinician (and patient) advice is my personal method for overcoming this common cause of sleep difficulty. It is common for one to fall asleep on the couch while watching television, only to subsequently lie awake frustrated in bed trying to sleep afterwards. For many, the problem lies in the trying. In the living room watching television, there is no pressure or conscious effort to sleep. In the bedroom, the mind can become focused on the goal of falling asleep; it can be the very thing that interferes with the natural process.
The solution I recommend is to create a gentle distraction and a new nighttime ritual. It comes in the form of a bedtime story, specifically, listening to audiobooks. Reading bedtime stories to children has been a time-tested method; it can work equally well for adults. Most library systems have thousands of titles of audiobooks that can be downloaded and then added into a folder of an MP3 player. Listening to audiobooks provides a distraction from one's own thoughts. It is critical that the listening material does not include commercials, fluctuating volumes, or materials of engagement. The volume should be set at the lowest level possible to clearly listen.
Meditations and music can also be helpful for many people to fall asleep. However, in my clinical experience, patients report that these measures tend to stimulate active thought. Different listening materials should be considered to match one's preferences and success. The intention and mechanism of action is to distract one's mind from active thought, so it can shut down and sleep, naturally. A word of caution: it is critical to never use a cellphone, which is a source of electromagnetic radiation, next to one's head all night. A radiation-free, wire-free, and inexpensive MP3 player with a built-in speaker can go under the pillow and be set to turn off itself in 15–30 minutes. Waking up during the night can be managed effectively by immediately turning the audiobook back on. Hoping or waiting to fall asleep engages the mind and undermines the process.
Benefits
Clearly, one or two good night's sleep cannot even the sleep debt many clinicians suffer. However, the cumulative effects of better sleep are infinitely healthful, and worth the effort. The potential benefits derived from trying this easy, safe, and extremely inexpensive approach for several months cannot be overestimated. A well-rested clinician becomes more alert and energetic, less moody, and improved in other capacities. This translates into better patient care. The greatest benefit comes from practitioners becoming qualified to advise patients to implement this approach, based upon their personal successes with it. Better rested and rejuvenated clinicians are healthier and happier. They can lead their patients by example.▪