Relentless Covid duty taking a toll on doctors’ sleep: Study

There has been an increase in doctors seeking help to manage anxiety and depression that begins manifesting with disturbed sleep

Resident doctors, considered the backbone of healthcare, are facing sleep issues, reveals a pilot study done at Brihanmumbai Municipal Corporation (BMC)-run hospitals. The study, which had a sample size of 240, showed that more than 73 per cent of the doctors are having disturbed sleep patterns, including insomnia, multiple breaks during sleep and poor sleep quality, pushing them towards mental health issues.

"It was found that sleep disturbances had increased during Covid-19 times and so had the frequency of dreams and nightmares," said Dr Sagar Karia, assistant professor, LTMG Sion Hospital, who anchored the study.

He said that 81 per cent of the people they interviewed got dreams during the lockdown, 73 per cent had insomnia. "Before the pandemic, 50 per cent said they had dreams. Most of the content of the dreams during the lockdown was related to studies, illness and death," said Dr Karia.

He said while long working hours had earlier been a reason behind resident doctors getting less sleep, uncertainty about the future, fear of family and friends getting Covid-19, seeing and treating Covid-19 cases have together escalated stress levels.

Also read: US Covid-19 cases rising again, doubling over 3 weeks

Uncertainty and fear

Dr Karia said the nightmares in lockdown went up. "Most of them said the frequency of dreams was two to three times in a week; 42 per cent said they got nightmares in the lockdown and 24 per cent of them agreed they were distressing. Uncertainty on when exams will be held, fear of loved ones getting Covid-19, not being there with the loved ones during such trying periods are the factors that have manifested into dreams," said Dr Karia.

He said the psychiatry departments have seen a rising number of resident doctors coming for help in dealing with anxiety and depression. "For sleep issues, we advise them to follow and maintain a daily routine and have sleep hygiene. Sleep hygiene includes no caffeine intake before going to bed, keeping gadgets like mobile phones away and not indulging in social media sites before sleep," said Dr Karia.

He said there is an urgent need to tackle the sleep issue among resident doctors as it affects the immune response. "Escalating levels of stress is one reason behind sleep problems. Inadequate amount of sleep affects the immune response and as we all know that the Covid-19 virus affects the immune system," said Dr Karia.

Agreeing with the study results, Dr Nilesh Kalyankar, president of Maharashtra Association of Resident Doctors (MARD) at BYL Nair Hospital said apart from long working hours, fear of them or their loved ones getting Covid-19, there is no source of mental relaxation. "We are working in PPE for long hours. We are treating Covid-19 patients day in and day out without breaks. Many factors have led to mental illness issues in resident doctors beginning with sleep issues," said Dr Kalyankar.

Need frequent breaks

Dr Harish Shetty, senior psychiatrist at Dr LH Hiranandani Hospital has held stress management programmes for Covid-19 warriors, including resident doctors.

"It has been 15 months now since the pandemic began. The resident doctors have been working for a long time without breaks which has led to exertion and exhaustion. The Indian Medical Association should start a voluntary workforce across the country that will give weekend or some weekday breaks to the resident doctors. Increasing the number of breaks for these doctors will be the best way to tackle the situation," said Dr Shetty. He added that resident doctors also need appreciation for the service they have offered in the pandemic, which is missing.

81%
Proportion of doctors who got dreams during lockdown

50%
Proportion of doctors who got dreams before Covid