Monday, July 23, 2012

Need for Sleep (Mine and Yours)

Let's see, I'm way behind on my race blog reports (a full year/six races for the 100-milers), but having just finished Angeles Crest almost 7 hours slower than my first running two years ago when I eked the sub-24 hour finish despite bonus mileage and initially giving up, I felt it would be useful first to explain to you all a few things about the need for sleep in general and my personal need for it.  I will then be able to refer back to this posting when I get around to writing my reports for the inaugural Zion 100 Mile (May) and the 25th Angeles Crest 100 Mile Runs (just this past weekend / July).  Although the weather was hot for both races, I'm pretty sure the fundamental reason for my taking so long to finish both races was not weather, but my acute on chronic sleep deprivation.

Three points I wanna make.


Training to become a physician does not make me or any other medical or osteopathic doctor more resistant to the effects of sleep deprivation.  This is a myth that doesn't need to be circulated to be held widespread-- seems like common sense.  Of course doctors don't need to sleep, all that medical training without sleep trains them to not need it. 

Although one can learn to function as well as one can while sleep deprived (much as one can learn how to deal with the pain and fatigue of having run 30, 60 or 90 miles), the adaptation is far from perfect.  People vary in the amount of sleep they need to optimally function; this is probably more important than  whether one has undergone a few years of working ridiculous hours in a high-stress situation for ridiculously little pay. My need for sleep is probably average/median to slightly more.

2. (just a reminder):

I don't take call around the clock.  I'm an emergency physician.  I wake up the other doctors to ask them a question or ask them to come in.  My schedule, however, is constantly in flux.  My group has sick call coverage for shifts that each of takes once a month-- I call in both hospitals at 8:30 am and if no one called in sick, I'm free that day.  (Incidentally, I am free to run all day.  Hence my call days either suck because I got called in to work in between a two blocks of multiple shifts in a row, resulting in working something like eight days straight, or a great day with a much needed break, when I get an awesome, long training run in.)


Intelligent people are devoting their careers to learning more about sleep and our need for it, because like all things scientific, we don't everything about it.  Thanks go to them.

Asking how much sleep one got the night before (or even the touted as more crucial night before the night before) doesn't allow one to make any reliable conclusions about whether someone starts an ultra well rested or not.

Here is an analogy given and tweeked by some sleep researchers published my alma mater's alumni magazine.

Sleep researchers sometimes use the analogy of an hourglass to illustrate how we lose our ability to function as the day wears on. A good night’s sleep gives us a full ration of sand at the top of the glass; the grains begin to fall when we wake up, and “with each grain that drops, there’s an increasing level of impairment,” Cohen explains. The new study’s findings led its senior author, associate professor of medicine Elizabeth Klerman, to refine the analogy: “She says chronic sleep loss essentially enlarges the hole between the halves of the hourglass, so the sand falls a lot faster. That means you can be fully restored [by a long night’s sleep], but you peter out very quickly.”

link to the full article, "Lost Sleep Is Hard to Find" (well-written and not too long)

So now I will be able to write, "desafortunadamente, my hourglass hole was too (f***ing) wide," and link back to this post or the on-line article.

Hopefully, I won't have to do this so often.  On hearing about my last run, she advised me I should be more careful with scheduling plane flights, trips and work shifts and other events in the days before my 100 milers.  However, not sure how practical this would be.  My life does not revolve around my racing.  I do not have anything close to complete control over my work schedule.  It is more like my racing goes on despite how busy my life is.

Thanks for reading.  Everyone get a good night's rest tonight (and most nights)!