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Like many Americans, doctors tend to brush off grogginess on the job. Turning up music volume or opening a window has a short-lived effect; nodding off tends to resume minutes later. In this report, two physicians operating out of midwestern sleep centers weigh-in, along with a Hollywood celebrity, about how dentists might handle daytime drowsiness.
In a 24-hour period, the period of 1-3 p.m. poses the second highest risk for dozing off; the first is midnight-7 a.m. Years ago, I had an afternoon appointment with a dentist whose focus kept shifting, head bobbing, while light-curing my composite restorations. No harm was done, but the dentist and hygienist were embarrassed.
During dental school and specialty residencies, students are sleep deprived. As practitioners, many find interrupted sleep an occupational hazard, especially oral maxillofacial surgeons (OMFS). In one blog post at studentdoctor.net, an OMFS wrote:
“I get woke up a lot taking care of issues just from our clinical practice. Nausea, vomiting, can't eat, pain, bleeding, bone sticking out, dry socket, subperiosteal abscess, etcetera. I was on call last Friday night and I got called eight times between 9 p.m. and 2 a.m. to talk to patients.”
Steven Zorn, MD, an adjunct professor at the Des Moines University Medical School and medical director of the Iowa Sleep Disorders Center in West Des Moines, estimates that 20 percent of the U.S. population is sleep deprived. He based this estimate on research reports and his own experiences with patients using the Epworth Sleepiness Scale. Dr. Zorn is concerned that lack of sufficient sleep causes negative moods and behaviors such as depression, aggression and impulsive behavior.
Dr. Zorn said to pay attention if you get drowsy working with dangerous equipment (handpieces, lasers, etc). “That’s a red alert. You can’t tell if you will fall asleep. The moment of awareness that your eyelids feel heavy and a conscious effort is required to keep them open, action has to be taken immediately,” Dr. Zorn said.
Common but ineffective actions are chewing gum, eating candy or nuts, and splashing cold water on the face. After several minutes, sleepiness resumes.
Here are some remedies that work better: Taking a short, fast walk outdoors; caffeine, if not overused or used routinely; and improving sleep.
Adults need at least 7.5 hours good quality sleep. Some try dental anti-snoring or continuous positive airway pressure appliances if snoring and sleep apnea are issues.
Kathryn Middleton, medical director at St. Mary’s Sleep Disorders Center in Fitchburg, WI, explained that those getting less than 7.5 hours should go to sleep 30 minutes earlier, and work up to 60 minutes earlier. After 10 days, you should feel more rested — unless something else is going on.
Having trouble falling asleep? “Checking email or playing laptop games right before sleep is a problem. Laptops and computers release blue wave length light, which tells the brain it’s time to wake up,” she said.
Dr. Middleton, like Dr. Zorn, uses the Epworth scale and thinks it is a simple tool for discerning a need for professional assessment versus self-remedies. “Dentists should use it for their patients and themselves,” she advised.
Suzanne Somers of Los Angeles, a New York Times best selling author of 20 books on health also known for her career in television, contacted me to talk about feeling rested by napping. She said dentists and physicians should be looking for sleep deprivation signs: “Bags under the eyes, lack of concentration and focus, irritability and weight gain; yes, you lose weight sleeping [well] because your insulin levels decrease,” Ms. Somers explained.
Ms. Somers, who said she napped on the plane to Minneapolis the day she answered my questions, is on a media campaign to get people to nap more. In fact, she touts her “nap app” called nap26, downloadable on smart phones, as one tool to ease into a power nap. I paid $1.99 to test its 26-minute recording, sounding vaguely like a vacuum cleaner crossed with a hair dryer. And a waterfall. After 26 minutes elapsed, there was silence. Moments later, the gentle chirping of birds ensued. It worked on me, but what about dentists?
Said Ms. Somers, who naps about four times per week: “Forget sleeping pills; that's not sleep, it’s a suspended state where none of the healing happens. Dentists should schedule a half hour break and (nap) in their dental chairs or couches.”
A tradition of working for the dental profession. The Chicago Dental Society was organized in 1864 and incorporated in 1878. The objective of the Chicago Dental Society is to encourage the improvement of the health of the public, to promote the art and science of dentistry and to represent the intrest of the members of the profession and the public that it serves.
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