ClockNews#11: The Myth of Sleepless People

You have probably seen one of those news-wires before:

UKRAINIAN MALE WIDE AWAKE FOR 20 YEARS
http://en.rian.ru/rian/index.cfm?prd_id=160&msg_id=5309602&startrow=1&date=2005-01-14&do_alert=0

KIEV, January 14 (RIA Novosti) - Fyodor Nesterchuk,
63, of the town of Kamen-Kashirsky, Ukraine's Volynsky region, has not been
asleep for the past 20 years. No soporific can do the job and no doctor has
managed to put him to sleep even for half an hour, reports the Ukrainian private
ICTV channel.
Having survived such a long period of ailment, the Volynsky
resident has already reconciled himself to it: the pensioner works as an
insurance agent in the daytime and reads at night. "I start with periodicals,
then pass to fiction. When the eyes get tired, I switch off the light and keep
dozing in the vain attempt to fall asleep," says Nesterchuk who has already
re-read the whole home library for several times.
Nesterchuk's insomnia is
treated as an exception from the rules and explained by physicians as a
side-effect of the past diseases. "If one feels comfortable, this is no
pathology," said Fyodor Koshel, chief of the Lutsk city health department.
"Nesterchuk does not look exhausted because of insomnia."

Whenever these people are brought into the lab, hooked up to EEG and monitored overnight, they are always found to sleep just fine, thank you, except that they do not remember having slept afterwards.



It's not enough just to reduce residents' hours
http://www.ama-assn.org/amednews/2005/01/17/prsf0117.htm
A new literature review reveals mixed results for patient safety when work hours are cut.

"There's been a general perception that by decreasing
work hours, by definition we'll be improving patient safety," she said. "This
review shows that can happen, but it doesn't always happen. You must do it in a
manner that still provides excellent patient care."
Dr. Fletcher said the way
scheduling changes are implemented makes a big difference in whether patient
safety improves as a result. The program in the Harvard study was able to add an
intern to make the new schedule work.
"They demonstrated that by decreasing
hours and adding an extra person, there were fewer errors," she said. "Our
review shows that you don't always reduce errors by just reducing hours."

How about paying attention to the residents' circadian rhythms?

"Systematic Review: Effects of Resident Work Hours on Patient Safety," Annals of Internal Medicine, Dec. 7, 2004, in pdf (www.annals.org/cgi/reprint/141/11/851.pdf)

...and another one of those over-precise oversimplifications:

Timing Is Everything
http://www.cbsnews.com/stories/2005/01/18/earlyshow/health/main667522.shtml

By understanding and adapting to your body's daily
rhythms, you can do everything more effectively, from exercise to intercourse,
researchers say. "Organic Style" magazine editor Janie Pyun gave The Early Show
co-anchor Harry Smith an ides of when your internal clock dictates is the best
time to take on activities ranging from exercising to eating sweets to - having
sex.