REFLECTIONS
Sleep Camels
“What you need is a box fan.” “No way, man, that’s too cold! Just get a noise machine.” “You use a noise machine? I just need some peace and quiet.” “I get nervous when it’s too quiet.” My emergency medicine friends and I are arguing, and it’s an argument we all care passionately about, one we’ve had before. What is the best way to sleep? We each have an opinion. Like no one else on earth, it seems, except breast-feeding mothers of multiples and folks with severe anxiety, emergency medicine folk are connoisseurs of sleep. We know sleep in every permutation. The shallow sleep of needing to get up instantaneously, the deep sleep of never needing to awaken. The sleep when you should have been eating, when you meant to be reading, when the kids needed to catch the bus, the guilty sleep when someone thought you were listening. Good sleep, better sleep. We have tried them all, and there are no bad kinds of sleep. And we know how to do it. Or we wish we did. Someone has put forth the need for sound-proofing in a dark basement room. There is discussion on window coverings. One person swears by aluminum foil–covered cardboard over the windows during the day; only rookies use plain cardboard, it’s as crucial to repel the heat as the light. Thick carpet to muffle footsteps. Ear plugs. Face masks. Sensory deprivation chambers for the most sensory overloaded of medical professions. We argue for the when. Anchor sleep, circadian rhythms. Make sure you wear sunglasses when you step out those doors, don’t let your animal brain know it’s day. Someone has posited that split-sleeping is ideal. 4 hours in the morning, 4 hours in the evening, working overnight as a nocturnist. You’ll never miss anything ever. Someone says it needs to be consecutive; he’d rather stay in bed 10 hours not sleeping and convince himself he’s rested than face the reality of never being in bed more than 4 hours at a time. Do you stay up before your night and push through? Do you nap before? If you nap, can you store it? Are you a sleep camel? Could it work that way? At the end of the string, do you sleep when you get home for a few hours, or is it a hard reset? Can you even sleep when you’ve been up for 28 hours, or does one weird shift wreck you for days? Do you drink or take a pill or do yoga to follow the sun, or when your head hits the pillow are you the person who can shut it all down? When you wake up and you’re not sure if you’ve been sleeping at all, is the idea that you could have been sleeping enough? Does it have to be? The questions are unanswerable, and we argue long into the night, long past midnight, past any of our bedtimes. Whenever that may be. Rebecca Jeanmonod, MD (
[email protected]) St. Luke’s Hospital and Health Network Department of Emergency Medicine Bethlehem, PA Supervising Editor: Brian Zink, MD. doi: 10.1111/acem.12281
© 2013 by the Society for Academic Emergency Medicine doi: 10.1111/acem.12281
ISSN 1069-6563 PII ISSN 1069-6563583
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