Sleep Deprived and Always Tired? How to Overcome It

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Now that I've started surgical residency, sleep deprivation is an issue that I am

intimately familiar with. Let's talk about the science of sleep deprivation

and how to best handle it.

What's going on guys!

J from

I'll start off by saying that I do not recommend you deprive yourself of sleep and if you have

difficulty maintaining or getting enough sleep, then you should speak to a professional.

Now there is a strange culture surrounding sleep, we wear our sleep deprivation as a

badge of honor reflecting our productivity and commitment to what we do.

But this is an unhealthy way to go about it.

There is nothing to be proud of with sleep deprivation.

In fact I would argue that it is often due to poor time management and inefficiencies

throughout your day.

That being said, there are a few instances where sleep deprivation is nearly impossible

to avoid such as during residency such as myself or during certain rotations of medical

school or other demanding professions outside of medicine.

However, there's always a way to increase your efficiency and thereby increase the amount

of time available to sleep.

I have also gone over how to maximize your hours of sleep in this video above.

Six hours of high quality sleep goes a lot further than six hours of low quality sleep.

So what's the big deal with sleep deprivation anyway?

We know that chronic sleep deprivation is not good for us but how come?

Well, sleep deprivation leads to impaired memory, compromised problem-solving abilities,

impaired fine motor skills and an increased risk of getting in a car crash if you're behind

the wheel without getting enough Z's.

In a study on sleep deprivation and alcohol intoxication, researchers found that performance

on various cognitive and spacial reasoning tasks was impaired by sleep deprivation.

More specifically, 17 to 19 hours without sleep correspond to performance equivalent

to a BAC, that is blood alcohol concentration of 0.5%.

After longer periods without sleep, performance was equivalent to a BAC of 0.1 percent which

is above the legal limit.

Sleep deprivation has also been associated with increased levels of amyloid beta, a protein

associated with Alzheimer's disease.

More prolonged sleep deprivation also increases the protein tau, another protein linked to

brain damage and Alzheimer's and other diseases.

A recent study in the Journal of Neuroscience suggests that sleep deprivation alters the

activity of astrocytes and microglia in the brain.

These are support cells for neurons and this results in the brain being more susceptible

to damage.

Clickbait titles describing the study read that sleep deprivation causes your brain to

eat itself.

While that is it quite true, these supporting cells are critical to healthy brain function.

All right, so let's say you don't care about the long-term effects of sleep deprivation.

As I've said many times on the channel, all-nighters are going to cause you more harm than good.

So don't do them!

This also ties in with the next point on sleep inertia.

Sleep inertia is a period of mild cognitive impairment and motor dysfunction that occurs

when someone wakes up from non REM sleep, usually in the middle of the night or when

sleeping after a long period of sleep deprivation.

It can last between 10 and 120 minutes and can leave you more prone to poorer judgments.

This is one reason why sleep deprivation in residents working in the hospital is so worrisome.

Alright, so what can you actually do about it?

The first and most obvious thing is of course to get more sleep.

If you think that's not possible, I encourage you to critically look at your day and see

if you can be more efficient opening up more time for sleep.

After that, I suggest watching my video on how to wake up early and not be miserable

and my second video on sleeping science and ways to sleep more effectively.

Links will be in the description below.

So let's go back to sleep inertia; you can mitigate the effects of sleep inertia with

light exposure, physical activity, frequent napping and good nutrition and hydration.

If you know that you will have an irregular shift coming up such as overnight call, plan


I personally recommend sleeping a few hours before and a few hours after your shift.

So let's say you have a shift from 10:00 p.m.

Until 8:00 a.m., sleeping for hours before and four hours after would not be a bad approach.

If you don't have time for a few hours of sleep, let's say you're on night call after

a full day, then try to take a power nap.

A power nap of even 15 to 30 minutes has been shown to improve an individual's alertness.

Again, avoid longer naps because of sleep inertia which will impair your performance.

Eating properly is crucial as you burn additional calories when working intensely.

Dehydration and reduced glucose levels can impair decision-making.

It generally takes two full nights to recover from one night of sleep impairment.

Now, among resident physicians working in the hospital such as myself, the most common

countermeasure is of course caffeine.

Use caffeine wisely however.

Like any other substance, you can develop a tolerance and/or become dependent on it.

I personally save caffeine for my sleep deprivation emergency situations where I am having trouble

staying awake, such as last week when I was on overnight call.

I use a French press with freshly ground coffee and a zojirushi thermos.

It is an excellent system and even straight black coffee tastes amazing.

I have also resorted to caffeine tablets as backup when I don't have coffee on hand.

Links to these items are in the description below.

I will be going over caffeine science and how to use it effectively in an upcoming video.

Now last point, please do not drive while you are sleep deprived.

It is very dangerous and like we learned earlier can impair you to the same level as driving


It's better to pay for an Uber than to risk your life and many hospitals offer this as

a service.

Alright guys, that is it for this video.

Thank you all so much for watching.

If you liked the video, make sure you press that like button.

New videos every week, so hit subscribe if you have not already and I will see you guys

in that next one!