Sleep. It’s a wonderful thing, but it can sometimes elude us in the healthcare profession. Simply put, sleep deprivation happens when a person fails to get enough sleep. While the number of hours a person needs to function varies, the average adult needs about seven to eight hours of sleep each night (or day) to feel their best. According to Eanes (2019), nurses sleep less than the general population. In 2011, the Joint Commission recognized that shift length and work schedule can greatly affect the quantity and quality of health care workers’ sleep.
First, let’s examine the two basic types of sleep, including rapid eye movement (REM) and non-REM sleep. Non-REM sleep occurs first when dreaming typically occurs. REM sleep happens 90 minutes after you fall asleep. In REM sleep, your breathing and heart rate quicken and intense dreams occur. You’re internal “body clock” controls when you’re awake and when you’re ready for sleep (the circadian rhythm). When you lack your REM and non-REM sleep, it can cause negative effects to the body.
The outcome of sleep deprivation is excessive daytime sleepiness. You may find yourself falling asleep while sitting in a quiet situation (i.e., a meeting or stuck in car traffic). The severity of sleepiness can be a safety concern if it puts you at risk of falling asleep at the wheel of your car or workplace injuries. But sleep deprivation goes beyond “just feeling sleepy.” It can affect one’s mood, causing irritability or anxiety. Researchers reported that negative effects of sleep deprivation on cognitive processing can show deficits in executive function, attention and memory tasks and have higher level of depressive states (Khormizi et al., 2019). Long working hours for nurses and poor sleep can impair learning, judgement, and overall performance (Eanes, 2019).
Sleep deprivation can also impact one’s overall health. A lack of sleep can put you at risk for high blood pressure and a heart attack. Eanes (2019) also found that negative side effects can also include obesity, diabetes, and certain cancers.
Our own personal obligations can often restrict sleep. Juggling job and family responsibilities often take priority over meeting our own needs. As nurses, we know that work hours can also put a toll on meeting our sleep requirements. Many of us work one shift and then stay and work another shift afterwards, then needing to be back to work in the morning. Nursing students face similar challenges attending classes, working a job, and perhaps even taking care of their family. Medical problems, like insomnia, Parkinson’s disease, or restless leg syndrome, can cause sleep problems as well.
Some individuals are more at risk to suffer from sleep deprivation than others. Sleep deprivation affects men and women equally and can impact those who are caregivers (i.e. taking care of an elderly parent or someone with a chronic illness). Again, those who perform shift work, work a multitude of jobs, or those who work numerous hours can also be impacted.
So, what can you do to get a more restful eight hours of sleep each day? Overall, there is no substitute for sufficient sleep, but there are strategies that may provide a short-term benefit to help with sleep deprivation. Many of us rely upon a big cup of coffee to get our day started. Caffeine can improve alertness and performance, but frequent use can lead to tolerance and negative withdrawal effects when not consumed. Taking a short nap (30 minutes or less) may boost alertness for a time. Any over the counter (OTC) sleep aid medication should be discussed first with your primary care provider. Overall, if you are suffering from sleep deprivation, talk to your primary care provider to see what options will work best for you.
Finally, nurses and their employers should also take note of a position statement released by the American Nurses Association in 2014. It makes the recommendation “to carefully consider the need for adequate rest and sleep when deciding whether to offer or accept work assignments, including on-call, and voluntary or mandatory overtime.” We need to remember that to provide the best and safest care to our patients, we need to make sleep a priority each day.
American Academy of Sleep Medicine. (2008). Sleep Deprivation. Retrieved from http://aasm.org/resources/factsheets/sleepdeprivation.pdf
American Nurses Association. (2014). Position statement: Addressing nurse fatigue to promote safety and health: Joint responsibilities of registered nurses and employers to reduce risks. Retrieved from https://www.nursingworld.org/~49de63/globalassets/practiceandpolicy/health-and-safety/nurse-fatigue-position-statement-final.pdf
Eanes, L. (2015). The potential effects of sleep loss on a nurse’s health. American Journal of Nursing, 115(4), 34-40. doi: 10.1097/01.NAJ.0000463025.42388.10 Retrieved from https://www.nursingcenter.com/cearticle?an=00000446-201504000-00022&Journal_ID=54030&Issue_ID=2794782
Khormizi, H., Salehinejad, M., Nitsche, M., & Nejati, V. (2019). Sleep‐deprivation and autobiographical memory: evidence from sleep‐deprived nurses. Journal of Sleep Research, 28(1). Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.12683
National Heart, Lung, and Blood Institute (NIH). 2019. Sleep deprivation and deficiency. Retrieved from https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency
The Joint Commission (2011). Sentinel Alert Event, 48. Retrieved from https://www.jointcommission.org/assets/1/18/SEA_48.pdf