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Medical School And The Science Of Sleep

Discussion in 'Hospital' started by The Good Doctor, Sep 22, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    The article can be read or listened to. It is in the format of an interview between a radio host and the sleep scientist and director for Human Sleep Science at the University of California, Berkeley, Matthew Walker. He takes the audience through the journey of sleep and the dangers of sleep deprivation. Some of the risks include but aren’t limited to concentration, memory, blood glucose, and, most importantly, immunity. The interview starts by explaining how to tackle acute or chronic insomnia by dampening the sympathetic nervous system, then describes the epidemiology of short sleep predicting a shorter life, biology of the circadian rhythm, and pharmacological or non-pharmacological therapies.

    I thought this was an exciting and essential topic that ties the brain, mind, and body functioning. The tips given by Walker include controlling the racing thoughts in your mind to help your brain’s ability to send calming signals to the body.

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    When I read the title, I was immediately drawn to it and wanted to continue reading because sleep is crucial. Although in my previous undergraduate degree, I spent countless nights of sleep deprivation, all-nighters, and constantly stimulating my sympathetic drive. I was aware of ‘my underslept state’ for years, but my hunger for knowledge and perfecting my honors thesis took more importance over my well-being. After completing my undergraduate degree and the many gallons of coffee, I promised myself never to be ‘underslept’ again and approach medical school with a “self-care first” approach.

    Coincidently, during the first weeks of medical school, we were lectured on “Safe-Drs.” and I remember one of the lecturers discussing self-care through a balanced diet, social life, hobbies, and adequate sleep. The lecturer said, “No matter what – you cannot learn everything in medicine; there will always be new information, so do not lose sleep over wanting to know everything.” Those words have remained with me. Not only did it give me hope for the unknown future, but it also gave me comfort that imperfection is inevitable and self-care is a must. My interest in self-care, especially sleep, was sparked on the first day of medical school. Before finding this article, I knew from previous psychology classes that I had caused irreversible damage to my mind-body because the brain couldn’t get back to that lost sleep. Still, I wasn’t sure of any of the negative impacts on the body.

    The author explains that from the moment we wake up, there is a sleepiness chemical that builds up to create sleep pressure. This chemical is adenosine, and the more it builds up, the sleepier we feel. The way caffeine works are by entering the brain and masking the adenosine receptors. But the fact that adenosine continues to build up despite the masking effect of caffeine stood out to me. Walker explains that once the body gets rid of the caffeine, we go back to that level of sleepiness before caffeine, plus all of the additional tiredness built up in between. This suggests that my body has constantly experienced a caffeine crash, and it makes me wonder what effects it can have on my long-term mind-body connections. He mentions the brain having a ‘sewage system’ called the glymphatic system that gets rid of metabolic waste. This system kicks into high gear during deep sleep. Indeed, this is relevant to many people and could be a wise connection between the development of Alzheimer’s associated beta-plaques building up in some people and not others.

    He does have a point that is backed with scientific evidence, and it is relevant to me. Being aware of this draws my attention to my overall well-being and re-assess my daily coffee needs. There are days where I drink coffee, not because I am tired, but because I am bored or craving a hot drink. This article has made me re-evaluate my caffeine choices and further researching the effects of my daily cup of coffee, caffeine-crash on my mind and body.

    From the previous science classes I took, I learned that caffeine is a nervous system stimulator, but it delays the metabolic sleep rhythm, thus impacting the ability to fall asleep. This comes into a full circle with what the author describes in this article. I have a greater understanding of the impact of caffeine on the body’s restoration process. I think controlling my consumption of coffee will be a marathon. I will train my mind to run without coffee on most days and stay regular with my circadian rhythm.

    I look forward to comparing how well my body functions with caffeine versus without caffeine.

    I have started to incorporate mindfulness into my daily routine. I have found that it can be a reliable and effective tool in focusing on the ‘now’ by allowing us to pay more attention to our internal and external experiences. It helps acknowledge the inevitable stress one can experience from time to time, rather than fighting the feeling. Recognizing a negative emotion and fully living it strengthens your mind’s ability to respond efficiently. Most importantly, being able to respond by expressing self-compassion and sending kind messages to ourselves. The better one gets at expressing self-love and compassion, the better sleep and feelings of alertness can be achieved.

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