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, the stress of the job, and traumatic experiences often lead to doctors struggling to get a good night's sleep, Medworld spoke with Dr Ang 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 in the consequences of untreated poor sleep due to sleep apnoea in my pursuit of seeking the best treatment for my spouse. During my exploration in 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, alongside many other studies, has shown how sleep deprivation directly impacts burnout in physicians. This in turn can contribute to the likelihood of making errors. “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 the importance of sleep in medicine is still “very undervalued” and the problem is not only in workplaces but also in the schooling system. “I think sleep issues are so common in the community that this field should be addressed at the primary care level. Universities should have more time scheduled for the teaching of medical students in how to manage sleeping problems.”
The lack of education around healthy sleep habits means that some doctors find themselves underprepared when they enter the field.
We asked Dr Ang to provide some techniques for doctors who are wanting 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 phase & parasomnia are completely different kettles of fish that require more specialised input from physicians trained in sleep medicine to treat effectively and the management of these are quite different to those of the common sleep apnoea 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 development of sleep medicine as a GP subspecialty interest.”
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>