The Effects of Sleeplessness on the Brain, Behavior and Mind - Research Proposal Example

? THE EFFECTS OF SLEEPLESSNESS ON THE BRAIN, BEHAVIOR AND MIND OF FIRST YEAR NEUROLOGY RESIDENT PHYSICIANS INTRODUCTION Sleep is an important part of animal physiology. It allows us to replenish the amount of neurotransmitters needed to connect the brain to the rest of the body parts it directs. Nowadays, however, certain occupations demand long working hours or night shifts. Physicians have to stay awake at night for their 24 hour shifts. People in the field of outsourcing have to work in the night to get in touch with their clients based in different time zones. Law enforcers and security personnel sometimes have episodes of sleeplessness due to their line of work. These fields demand high quality work from their people. Physicians need to make important medical decisions that literally affects the lives of their patients as part of their profession. However, these people are subjected to non-optimal working conditions that prevent them from getting enough rest in preparation for another work day For resident physicians, the long hours of work and subsequent sleeplessness are caused by several factors. First, it is thought of as a right of passage for these training doctors. Second, it is a means of cost-cutting for hospitals. Indeed, if all residents are to be given optimal work hours, the hospitals have to hire and subsequently pay more doctors. Third, the long hours serve as an opportunity for these residents to see first-hand certain medical conditions that does not happen very often. Finally, the long hours are believed to help the physicians get to know, and subsequently to treat, their patients better. Whether or not the sleeplessness affects the work of these individuals affect the people they serve, such as the patients treated by doctors, clients of outsourcing personnel, and citizens protected by law enforcers. If lack of sleep indeed affect their work, then working conditions should be revised not only for the benefit of these workers but for the people they serve as well. Many studies have thus been dedicated to determining the various effects of sleeplessness human functions. What really are the specific effects of sleeplessness? The cognitive abilities, measured by paced auditory serial addition, and anatomical features, as assessed through pupil size, are just some parameters looked into by researchers for the effects of lack of sleep. Reimann et al. (2009) found out that after staying up the whole night, neurology residents were sleepy but not slow in their decision-making. Klein (2009) supported these findings, when he reported that neurology residents that 1) did a 24-hour shift, 2) worked during the day only, and 3) took a night shift only had similar scores on math tests. However, an earlier study (Arnedt et al., 2005) found that the cognitive ability of sleepy neurology residents have a cognitive ability as that of people with blood alcohol content (BAC) of 0.04-0.05%. At 0.05% BAC, the vision is impaired. Specifically, there is impaired sensitivity to brightness, there is difficulty in the detection of colors, depth, and motion perception. Simple motor functions are also not as fluid as it is when sober. However, Klein’s study is not standardized. This means that their data may or may not be due to the sleeplessness of the participants. Particularly, when the pupils of the test groups were measured and compared among one another, any differences noted may not be due to sleep or lack thereof, because pupil sizes have inherent differences among different people. In addition, the comparison of math test results for the assessment of the effects of sleeplessness may not be valid because other factors may affect the scores, one of them is the inherent differences in their cognitive ability. Aside from issues on standardization, the effects of sleeplessness cannot be completely understood by just looking at its effect on cognitive ability. Especially on physicians that should have exceptional cognitive abilities, measuring the changes in the efficiency of their work-related activities and behavior might be a more conclusive approach in the assessment of the effects of sleeplessness. There have been many reports on the occurrences of unprofessional behavior and flaring attitude from some people from the medical field. In efforts to understand such events, some people attribute this to the long working hours and sleeplessness of these professionals (Klein, 2009). This study will thus aim at making a more comprehensive assessment of the effects of sleeplessness. In this novel approach, first year neurology residents will be the subjects of this study. With such premises, the research question of this experiment will be, “what are the behavioral, mind and brain changes induced by lack of sleep on first year neurology residents?” The specific objectives are 1) to know whether sleeplessness affects the brain activity, behavior, cognitive ability, and work-related activities of the subjects by measuring their respective parameters in their initial and final states, 2) to determine which working condition is optimal to the brain activity, behavior, cognitive ability and work-related activities of the first year neurology residents by comparing 24-hour shifts, day shifts and night shifts only, 3) to find out whether the effects of sleeplessness, if any, are aggravated over time and 4) to suggest means of optimizing the working conditions of first year neurology residents based on the data to be obtained through the first two objectives. There is thus a need for a different means of measuring the effect of sleeplessness to be done. For this study, the same treatment groups, 24-hour shifts, day shifts only, and night shifts only of the same line of work and company, will be utilized. However, not only will pupil size and cognitive ability, be measured, but so are brain activity, behavioral change, and the efficiency in work-related activities. Brain activity will be measured through electroencephalography at regular intervals, while behavior will be assessed by different tasks that tests the patience of these subjects. The work-related tests will include what questions to ask the patient during the interview, which body part to examine depending on the patient’s complaint, which area of X-ray to focus on, and where to make an incision depending on the cases provided (Klein, 2009). The initial states of these parameters will be measured. This will then be compared to their corresponding final states. Within group and among groups comparison will then be performed to assess if the effects are felt among most of the subjects and if there are indeed differences in the test groups. In addition, four measurements will be conducted. Probably, after all the shifts are finished, all subjects will be given a day of rest before they work and subsequently undergo testing again. The multiple measurements will be conducted to determine whether or not the effects of sleeplessness, if any, will be aggravated. There are opinions that people, especially physicians, can train themselves to have optimal decision-making despite sleeplessness (Klein, 2009). Moreover, other measures will be done to standardize the protocol for this study. Firstly, the subjects must come from the same work type, probably strictly day shifts only. In the event that they agree to participate in the study, they will also be asked to stay in the same housing unit and eating the same type of food. They will be transported in and out of the holding area to ensure that most conditions, except the time of work, are the same for all subjects. References Arnedt J. T., Owens J., Crouch M., Stahl J., & Carskadon M. A. (2005). Neurobehavioral Performance of Residents After Heavy Night Call Vs After Alcohol Ingestion. JAMA, 294, 1025–1033. Klein, E. (2009). Sleep and Neurology Training. In Spencer, D. C. & Karceskl, S. (Eds.), Patient Page. Neurology, 73, e104-e105. Reimann M., Manz R., Prieur S., Reichmann H., & Ziemssen T. (2009). Cognitive Performance is Preserved in Sleep-Deprived Neurology Residents. Neurology, 73, e99–e103. Read More