Expert interview: Why stimulants and sleep aids aren’t the answer for doctors

Doctors and other healthcare professionals (HCPs) often turn to energy supplements and sleep aids to ward off exhaustion from extensive shifts—sometimes to the detriment of their own health.

With patients' lives in their hands, it's easy to see why HCPs might turn to stimulants like energy drinks and pills to help them stay alert, or sedatives to fall asleep. Sleep deprivation and fatigue not only affect HCP physical and mental health, but can disrupt job performance and lead to medical errors as well.^[]

But, as it turns out, these substances can take their own toll on health. In this article, we interview a physician to get an expert take on the use of these substances and consider safer, healthier alternatives for boosting energy or improving sleep.

The downside of energy supplements

Too much caffeine can also lead to dehydration, insomnia, and feelings of anxiety. Heart complications, including irregularity or even heart failure, can arise as a long-term effect.^[]

For these reasons, most doctors warn against energy supplements, as many of them contain higher levels of caffeine than a standard cup of coffee. On average, a cup of coffee has roughly 100 milligrams of caffeine, but supplements like 5-Hour Energy can have double that amount.^[]

In an exclusive interview, MDLinx medical advisor Kristen Fuller, MD, said energy supplements are common in the workplace.

“I believe that myself and the majority of physicians—especially medical students, residents, fellows, and physicians who work in shifts (ER and hospitalists)—have all tried some sort of energy booster and/or sleep aid,” she explained.

And it's not just over-the-counter stimulants that are of concern. Some doctors are misusing prescription medications in order to stay awake on the job.

Those caught doing so could be at risk of losing their job and license.

Fuller points out that most doctors would never advise a patient to ingest a substance apart from its intended use—and should follow their own advice, adding that illegal use of prescription drugs to enhance performance compromises the integrity of physicians.

The importance of sleep

Healthy adults require 6 to 10 hours of sleep; anything below that will diminish cognitive performance, according to a study published in the British Columbia Medical Journal.^[]

According to a 2017 article published by the British Journal of Oral and Maxillofacial Surgery, more instances of self-inflicted needle-stick injuries occur when clinicians are tired.^[]

It also reported that fatigue due to being on call could increase apathy and medical errors. A study cited in this article found that even loss of one night's sleep could yield an increase in mood changes such as impulsiveness and anger, regardless of whether the situation was identified to be low-stress.

The danger of sleep aids

In addition to stimulants, sleep aids are also taken by healthcare professionals to balance their circadian rhythm.

According to Fuller, products such as Zolpidem, Nyquil PM, and Benadryl are supposed to be taken for short-term use (less than 1 week). Although they help users fall (and stay) asleep, many users wake up groggy. They may turn to energy supplements to alleviate this, and enact a vicious cycle. Fuller noted this is especially dangerous, since sleep aids also can be highly addictive.

What you can do

Fuller’s comments pose an interesting dilemma: physicians often overtax themselves with long, exhausting shifts, but are also expected to practice what they preach to patients.

A nationwide shift that lessens clinician demands (and gives them time to recuperate) is an ideal solution, but one that requires institutional change. Instead, physicians suffering from burnout can take small steps to make their hours more manageable.

There also are safe, healthy alternatives to stimulants and sleep aids. A diet with fiber-rich food is the best way to keep energy levels up and constant. Nuts and seeds are two sources of fiber and protein that can be snacked on throughout the day.^[]

Decaf teas and those with low caffeine levels can also boost energy. Ginseng root, another natural energy booster, has been used as an important medicinal plant for 2,000 years in East Asia, and is widely available in most supermarkets.