Do Doctors Need Power Naps?

August 30, 2023


USMLE

Providing the highest level of care can be mentally and physically taxing. Recent studies suggests taking up to a 30-minute nap can help you feel more alert by replenishing the energy levels that boost motor skills and decision making. But, napping is not new. It has been a part of recorded human cultures for centuries.

The ancient Romans and Greeks were known for taking a nap every day after lunch. Homer’s famous work the Odyssey referenced a sleep pattern where adults were encouraged to sleep in chunks. This sleep pattern was coined polyphasic sleep in the early 1900s and requires you get sleep in two or more sleep periods, such as quick naps during the day and sleep time at night.

Getting sleep in one eight-hour chunk is actually a recent sleep pattern. Aristotle had suggested it was healthier to split sleep into multiple segments. So, both bimodal and polyphasic patterns were common prior to the lighting of our neighborhoods. Once again, evidence today suggests segmented sleep could actually be better for your health.

Post-Industrial Shift in Sleep Patterns

Throughout the nineteenth century, the segmented sleep patterns adopted by many different cultures began to disappear. Instead of two or more distinct blocks of nighttime sleep, industrialized societies became monophasic sleepers. Prior to that time, anthropological records suggest people’s first sleep began a couple hours after dusk followed by an awake period, where the person would actively get tasks done, followed by a second sleep period. After industrialization, even individuals who worked night shifts followed a schedule of 8-hours of sleep in a single segment.

Biphasic, Segmented, or Monophasic Sleep

The concept of two or more distinct sleep periods is believed to have disappeared with the rise of urban upper class in cities across northern Europe. During the seventeenth century, this change filtered down to other Western societies. In the United States, improvements in urban lighting during the early twentieth century saw a growth in legitimate nighttime activities. As predecessors to today’s Starbucks, coffee houses were among the first businesses to remain open all night. That’s when earlier sleep patterns became a thing of the past.

  • 1) Monophasic Sleep – In most developed societies today, people sleep once (normally at night). Give or take an hour, sleep time lasts about eight hours. Sleep research studies at the time suggested a monophasic sleep schedule was the most in tune with human biology and would afford higher levels of productivity during the single waking state.
  • 2) Biphasic Sleep – The concept of bimodal sleep with two distinct sleep periods has already been discussed as it was the norm for generations. During  human evolution, people rested during two distinct blocks of biphasic sleep split by periods of various activities. “Siesta sleep” typically included one sleep period at night combined with an after-lunch nap.
  • 3) Polyphasic Sleep – The underlying concept of segmented sleep is polyphasic and includes time devoted to nighttime sleep that is augmented by small blocks of shorter sleep duration. Following the post-industrial era, people suddenly had more things to do and decided the monophasic sleep pattern with a single waking cycle, needed to include a nap.

With the advent of publicly lit streets, urban residents shifted away from the age-old habit of a biphasic sleep schedule. However, ongoing research now suggests that sleeping multiple times in a 24-hour period may improve energy levels, alertness, cognitive function, and productivity. Nonetheless, experts warn that a polyphasic schedule that reduces your overall sleep time is difficult to sustain and can lead to the same negative consequences as other types of sleep deprivation.

So how much sleep does a med student need?

As an undergraduate student you likely felt that time spent in bed was a horrible waste of prime nighttime. Now as a medical student, you can expect that you will be challenged to balance your waking cycles and sleep cycles. This starts by gaining a better understanding of “sleep debt” and how your body will demand that the debt be repaid. After all, sleep is necessary for survival and a lack of sleep impairs your ability to make the best decisions.

Being a night owl or an early bird doesn’t dismiss the fact that you still need sleep. Fortunately, sleep patterns are mostly dictated by your circadian rhythms and sleep specialists today understand these rhythms are more flexible than first thought. But simply adding a nap a day cannot replace high quality sleep. According to the American Sleep Association, a healthy adult requires 7 to 8 hours of quality sleep each day that includes deeper sleep phases, which have a more restorative impact.

Benefits of the Power Nap

Safety-critical environments often require workers to apply fatigue risk management as a lifestyle component at work and during their off hours. To better manage long hours spent studying, or the demands of working swing shifts, you need to know how to recognize and mitigate the effects of fatigue. Although naps are nothing new, the term “Power Nap” was coined by a psychologist at Cornell University in 1998 to promote optimal on-the-job performance by encouraging the institutionalization of naps at work.

Research suggested that ten to thirty-minute power naps improve alertness and functioning almost immediately and with little to no grogginess after you wake up. In fact, it got its name from the efficacy noted in boosting alertness, creativity and productivity. Not surprisingly, all other mammals sleep at multiple points during the day. Only homo sapiens deliberately deprive themselves of sleep. However, it is not recommended to substitute power naps for nighttime sleep, as effective napping intentionally avoids deeper stages of sleep.

Truth is.. not all jobs are created equal. For that reason, research studies are being conducted at many levels across the global village to gain a better understanding of sleep debt and the impact fatigue has on job performance. Sleep experts say that impairment to cognitive functions are commonly noticed after sixteen to eighteen hours of awake time. At that point, there is a distinct loss of logical reasoning and a decreased display of empathy as well as an overall reduction in your ability to interact effectively with others.

The Epworth Sleepiness Scale

The value of power naps as being more effective in reversing fatigue is well-documented, but the scientific community cannot fully explain the paradox. Studies show taking naps longer than a half hour are more likely to result in a period of disorientation, confusion and continued sleepiness. But shorter naps never reach a deep phase of sleep, yet appear to offer reinvigorating results. Generally speaking, quality sleep at night will be needed for good health, whereas the occasional nap gives you a burst of energy to boost performance.

Since a nap or series of naps cannot replace good quality sleep at night, the National Institute for Occupational Safety and Health recommends that you use the Epworth Sleepiness Scale to measure whether or not you are spending enough time between the sheets. This simple questionnaire asks you to rate how likely you are to fall asleep on a 0 to 3 scale based on eight unique situations. It only takes a few minutes to complete and the higher your score, the higher your average sleep propensity for daily living.

WOLFPACC Is Dedicated to Helping You Prepare

Medical students and doctors from the United States, Caribbean and Europe have participated in the WOLFPACC’s courses with overwhelming success. For decades, our goals have been to help promising doctors better understand medicine through high yield concepts rather than relying on memorization. Dr. Wolf offers a revolutionary approach that teaches you how to the pass the exam by empowering you with tools and skills in a structured experience that includes face-to-face interactions with instructors and other students.

“Whether you are student or international graduate, you should already know about the unique time requirements of becoming a doctor,” says Hans Wolf, MD and founder of the WOLFPACC Physicians Achievement Concept Course. “Since demands on your time are only going to grow, our board exam prep courses can save you time by teaching you how to tap into the knowledge you’ve already learned.”

You may have heard that some geniuses only slept four or five hours per night. But, it was Leonardo Da Vinci who gets credit for creating the first polyphasic sleep process called the Da Vinci Sleep Schedule. The Italian polymath relied on twenty-minute naps over his 24-hour day. Thomas Edison, who invented the lightbulb, believed sleep was a waste of time and used segmented patterns to minimize the time he spent resting. On the other hand, Albert Einstein not only relied on ten hours of sleep each night but was known for taking multiple naps.

At WOLFPACC, we recognize the time involved as well as the importance of attaining a passing grade for each Step or Level of your board examinations. That’s why Dr. Wolf and his staff remain dedicated to helping you pursue your dream of becoming a confident clinical physician. Let us show you how to save time while ensuring a career of practicing medicine.