In August 2020, a nationwide survey of a senior medical workforce using the Copenhagen Burnout Inventory (CBI) was conducted. One of the main quantitative analysis themes was that lack of sleep directly contributes to burnout in physicians (www.asms.org.nz).
Dr Marcus Ang is a GP and director at Silverdale Medical Centre. Outside his general practice consultation times, Marcus also pioneered sleep clinics at Silverdale and Millwater medical centres, after completing the Fundamentals of Sleep Medicine course at The University of Sydney. He has also completed training from SleepGP Australia in nasopharyngeal endoscopic assessment of obstructive sleep apnoea (OSA). Marcus is a member of the ASA (Australian Sleep Association).
Night shifts, extended work hours, job stress, and traumatic experiences often lead doctors to struggle to get a good night's sleep. Medworld Institute spoke with Marcus to get some tips on how physicians can tackle this and, in turn, combat burnout.
“My interest in sleep medicine started due to my wife's snoring and my curiosity about the consequences of untreated poor sleep due to sleep apnoea in my pursuit of seeking the best treatment for my spouse. During my exploration of the subject, I was fortunate to cross paths with Dr Alex Bartle from Sleep Well Clinic and Associate Professor Dr John Malouf from Sleep GP Coolangatta (Australia), who both helped further my interest in the subject of sleep medicine & sleep apnoea.” Explained Dr Ang.
The study referenced above, and many other studies have shown how sleep deprivation directly impacts physician burnout. This, in turn, can contribute to the likelihood of errors being made. “Sleep is extremely important in combatting doctor burnout. Poor sleep can contribute to stress and lack of concentration, which may lead to doctors making errors.”
Despite studies attempting to shine a light on the matter, Dr Ang contends that the importance of sleep in medicine is still “very undervalued,” and the problem is not only in workplaces but also in the school system. “I think sleep issues are so common in the community that this field should be addressed at the primary care level. Universities should schedule more time to teach medical students how to manage sleeping problems.”
The lack of education about healthy sleep habits means that some doctors are underprepared when they enter the field.
We asked Dr Ang to provide some techniques for doctors who want to take their health and wellbeing into their own hands and work on fixing poor sleep habits.
1. Seek help early
2. Practice meditation and mindfulness
3. Cognitive Behavioural Therapy for Insomnia works and is a much better alternative to reliance on regular medications like Zopiclone, TCAs, and benzos
4. Exercise outdoors during the day
5. Night shifts, delayed sleep phases, and parasomnia are completely different kettles of fish that require more specialised input from physicians trained in sleep medicine to treat effectively. The management of these is quite different from that of the common sleep apnea and insomnia that we mostly see in primary care.
Physicians like Dr Ang and his associates are doing all that they can to educate the industry and create a brighter future in the field of sleep. “Currently, Sleep Well Clinic and Sleep GP Coolangatta (Australia's extension of Sleep Institute NZ) are both trying to develop teaching modules for GPs to further their studies and develop sleep medicine as a GP subspecialty interest.”
References:
Silverdale Medical: Dr Marcus Ang, accessed: 7th, July 2021 <www.silverdalemedical.co.nz>
Chambers. C, 2021, “My Employer is Exhausting – Burnout in the senior medical workforce five years on”. Accessed: 7th July 2021 <www.asms.org.nz>
