What are the consequences of sleep deprivation?

What happens to a doctor’s mind, and how is brain function impaired, if he/she goes without sleep for 30 hours on a regular basis?

Medical residents protest long working hours outside Knesset, June 17, 2020 (photo credit: Courtesy)
Medical residents protest long working hours outside Knesset, June 17, 2020
(photo credit: Courtesy)

Many doctors have recently shared difficult and disturbing stories about mistakes they made due to lack of sleep. We asked Dr. Liora Berzag-Peru to explain why this happens and what the long-term consequences are of continuous sleep deprivation.

The Health Ministry recently made breakthrough changes to shorten the shifts of hospital residents, after some 2,590 of them submitted their resignations over their 36-hour shifts. The challenge, they had said, is that it is almost impossible to work or function effectively without sleep.

As part of this struggle, many doctors shared their experiences of sleep deprivation, but it seems that the most disturbing story of all was the director of Alyn Hospital, Dr. Morit Beri, who explained what happened to her in a publicly shared Facebook post.  

After a long shift, while she was sleeping, she answered a phone call from a nurse in the neonatal intensive care unit (NICU). Through her fog, the doctor said that the preterm infant’s breathing tube could be taken out.

When she woke up and went to the NICU, she was horrified to see the little baby without breathing assistance, and didn’t remember the phone call. Fortunately, the baby was fine, but this story certainly raises questions: Would you like a doctor who is sleep deprived to make life and death decisions for you or your child?To better understand this story and others, and how sleep deprivation affects our body and brain, we asked Dr. Liora Bergaz-Peru what happens to our bodies when we don’t sleep enough, and how dangerous it is. Here are her answers.

How long does a person need sleep to function?

This is a question that is difficult to answer, since the need is individual. One approach claims that a person will need sleep until spontaneously awakening. Another approach examines a person's ‘awake state’ after being woken up after a variable number of hours of sleep. Let’s factor in that the need for sleep also changes with age. Questionnaire-based studies have indicated that most people will feel rested after seven to nine hours of sleep a night.

 What is sleep deprivation?

Sleep deprivation occurs when sleep is insufficient to feel fully awake, to function normally and to be healthy, whether due to short sleep time (quantitative decline) or due to disturbances during sleep (qualitative decline). Like any disease, sleep deprivation can be acute - for one to two days - or chronic, a condition in which the body is deprived of sleep for a long time.

Has the effect of sleep deprivation been researched?

Many studies have been done on sleep deprivation in hospitals, especially on behalf of patients who suffer not only from the disease but often also from the hospitalization itself, noises around them, medications, too many bright lights and even being in an unfamiliar environment. There are many ways sleep deprivation can harm patients.

What happens when doctors and other hospital personnel are deprived of sleep?  

Studies of medical residents have shown that numerous doctors misdiagnose patients after performing a shift of 24 hours or more compared to a regular working day of the same doctor. 

One interesting study indicated fewer correct diagnoses on colonoscopy results when the same doctor was suddenly awakened the night before. These are mistakes that happen when the deprivation is acute, but of course increase over a longer period of sleep deprivation.

Chronic sleep deprivation can lead to fatal accidents, even at work, in the case of diagnoses being made by these doctors, but also in the personal lives of the people who have not slept, both on the psychological and physiological level.

Does sleep deprivation also affect the health of doctors?

Yes. In a state of chronic deficiency, there is continuous damage to neurons, which of course leads to many other damages, from mood swings to brain dysfunction, heart disease, hormonal changes and more.