In a new survey, physicians report they are not getting the sleep they need to function at their best and current work schedules may contribute to their inadequate sleep. The survey, issued by the American College of Chest Physicians Sleep Institute (ACCP-SI), found that most physicians sleep fewer hours than needed for peak performance and nearly half of physicians believe their work schedules do not allow for adequate sleep. Results further indicated that, when compared to the general population, physicians reported more caffeine use but better overall health.

"Call hours during training and in the practice of medicine desensitize physicians to the importance of sleep. The pervasive message is that sleep is optional or dispensable," said Barbara Phillips, MD, FCCP, Chair of the ACCP Sleep Institute. "Self sacrifice also may be seen as part of the lifestyle. This may impact physicians' awareness of their own, and their patients', sleep deprivation lifestyles."

Physician sleep habits

In a randomized, internet-based questionnaire, the ACCP-SI surveyed 5,000 US physician members about current sleep habits and how sleep affected work and day-to-day performance. Of the 581 respondents, 70 percent reported needing at least 7 hours of sleep to function at their best during the day, yet physicians reported sleeping an average of 6.5 hours on a workday.

Physicians reported "making up" for lost sleep on the weekends or days off by sleeping an average of 7.5 hours a night. Furthermore, 43.1 percent of physicians indicated their current work schedule did not allow for adequate sleep. Physicians rarely reported insomnia or difficulty initiating or maintaining sleep. However, 21.8 percent reported not feeling refreshed upon waking at least a few nights a week.

"The upside of chronic self-imposed sleep deprivation is that it essentially eliminates insomnia complaints," said Dr. Phillips. "Although adequate sleep is important, too much time in bed is a common finding among insomniacs; the lack of insomnia complaints among physicians probably relates to the chronic, low level sleep deprivation that many experience."

Most physicians indicated that sleep issues did not significantly impact work performance or other daily activities. However, 18 percent of physicians reported missing at least one family or leisure activity due to sleep issues.

Physician caffeine use

Survey results were compared to the results of the 2008 National Sleep Foundation Sleep in America Poll, released during National Sleep Awareness Week, March 3-9, 2008. Caffeine use was more common among physicians than the general population, with 93 percent of physicians having at least one caffeinated beverage a day, compared with 81 percent of the general population. However, the average number of caffeinated beverages consumed, approximately 3 servings daily, was similar between physicians and the general population. Most physicians (83.3 percent) reported using caffeine out of habit rather than to "keep awake".

Physicians also reported being in better overall health than the general population, with 83.6 percent of physicians stating they were in very good or excellent health compared with 56 percent in the general population.

"Although physician sleep habits may not be ideal, physicians understand the relationship between behavior and health. Physicians are less likely to smoke, to be obese, or to be sedentary, which are all lifestyle factors that can have a negative impact on overall health," said Rochelle Goldberg, MD, FCCP, ACCP Sleep Institute Steering Committee.

"Like many who experience long work days and inconsistent schedules, physicians, too, are vulnerable to the effects of inadequate sleep," said Alvin V. Thomas, Jr., MD, FCCP, President of the ACCP. "Just as they help their patients recognize the importance of good sleep habits, physicians should take the necessary steps to ensure they are meeting their own sleep needs."