Tuesday, March 6, 2012

Neuroethics journal club: jobbing on the sleep

Feeling tired? You’re not the only one. According to a 2009 poll conducted by the National Sleep Foundation, 20% of Americans sleep less than six hours a night. How can people even do their jobs with less than six hours of sleep?
Oh.

Before you get too impressed by my ability to cite statistics, I should tell you I’m quoting directly from the article we read for the most recent meeting of the Neuroethics program’s journal club: “Examining the Effects of Sleep Deprivation on Workplace Deviance: a self-regulatory perspective” by Michael Christian and Aleksander Ellis.


Dr. Gillian Hue presented the article. Not only did Gillian study sleep and circadian rhythms as a graduate student, she also has extensive experience with sleep deprivation thanks to her young son, Lucas (hey, she made that joke, not me). One of the first things Gillian asked was how many of us had gotten seven hours or more of sleep the night before. Only two people raised their hands: Kristina Gupta and Cyd Cipolla, both Ph.D. candidates in Women’s, Gender, and Sexuality Studies at Emory (They are also teaching the class “Feminism, Sexuality, and Neuroethics” this semester that they developed as part of their winning Neuroethics Scholar applications). Two people out of roughly twenty had slept the bare minimum seven hours. I would make a joke here about how I should’ve gone into Women’s Studies, but I’m too tired to think of way to phrase it that doesn’t sound vaguely smarmy. Gillian asked us whether we’d gotten seven hours of sleep because that’s the criterion that Christian and Ellis use in their paper to decide whether subjects in their studies were sleep deprived. Why do they care if people are sleep deprived? Here’s the main hypothesis, taken from the abstract:
“Utilizing self-regulatory resource theories, we argue that sleep deprivation decreases individuals’ self-control while increasing hostility, resulting in increased workplace deviance.”

Christian and Ellis then proceed to test their hypothesis on two groups: nurses and undergraduates. Surprisingly, “results from both samples largely converge in supporting [their] hypotheses.” I say “surprisingly” because I would have predicted that sleep deprivation would increase self-control and lower hostility. Like all great science, their results run against our intuitions, yet allow us to explain the world more simply. If you think you detect a note of sarcasm, let me confirm that. If you also think you detect some jealousy on my part because I wasn’t smart enough to come up with a “no duh” hypothesis that would let me sail through grad school and land a cushy job as an Industrial/Occupational psychologist, let me also confirm that.

I mainly want to comment on the theory behind the experiments in this paper. If Christian and Ellis have chosen a “no duh” hypothesis, then it’s no surprise that I can’t find much to argue with in their approach. They’re working within the framework of self-control as a limited resource—as if self-control were a muscle that can tire. They cite multiple articles from the psychologist who has done the most work around the idea that people have a limited reserve of self-control, Baumeister (and I have to point out that most of the articles they cite from Baumeister’s group are reviews, not studies). Christian and Ellis argue that self-control can also be depleted by sleep deprivation. To support that idea, they cite a couple of papers that talk about lack of sleep and poor glucose metabolism in the pre-frontal cortex, of which one is a review (aargh! why don't they cite some primary literature?!) of healthy adolescent sleep (there’s no adolescents in Christian and Ellis’ paper! double-aargh!) and the other is a meta-analysis (see first “aargh!”). Not coincidentally, Baumeister’s group is now pushing the idea that self-control depends on glucose. I can hardly find fault, again, with a hypothesis like “if you use up all your glucose, then your brain will go out of control”. However, just because Christian and Ellis can point to that hypothesis doesn’t mean that they have “[integrated] research from the social psychological, sleep, and neurocognitive literatures” as they claim in their introduction. Similarly, citing a random review and a meta-analysis of sleep deprivation studies barely qualifies as “integrating evidence from neuroscience with organizational behavioral research” as they state in their discussion.

Lest you should think I’m just taking potshots at this paper, I’ll admit that it does make an important contribution. While I might think their results are a bit, well, obvious, it’s also true that their results might not be obvious to everyone. Recall that Christian and Ellis carried out the first part of their study on nurses. I don’t know how sleep-deprived nurses are, in general, but I do know that doctors in residency are definitely asked to work long hours all the time. Why hasn’t this practice changed if neuroscience shows how dangerous sleep deprivation is? Because, as our in-house medical ethics expert Dr. John Banja pointed out at journal club meeting, “the old guard” in charge of organized medicine and the professional medical societies are “very opposed to change”.

In this sense, Christian and Ellis provide some cold hard evidence that might open at least one pair of eyes. Maybe. During journal club Cyd Cipolla asked, “If we all know sleep deprivation is bad, why are Kristina and I the only ones getting enough sleep?” Kristina then wondered if, “in economic terms, the gains would outweigh the losses if people worked less and slept more”. Banja replied that, as far as hospitals are concerned, if residents work less, then attending physicians have to work more, which is more expensive.

So the cost of residents per hour might matter more to people running hospitals than the amount of deviance in whatever hospital they’re running. Christian and Ellis have asked with their study what the neuroscience of sleep can tell us about our ethics. They might not have done much for the ethics of neuroscience, though. I mean, our society still seems pretty bent on running a giant sleep deprivation experiment. That reminds me—I’d better post this and get to bed.

Be sure to RSVP for next month's meeting, on March 28th form 1230-130pm. We'll talk about Deboleena Roy's article, "Neuroethics, Gender, and the Response to Difference". The discussion will be facilitated by Neuroscience graduate student Laura Mariani (chief whistler of the Caspary lab and sitting duck exec prez of the Graduate Student Council).




Want to cite this post?
Nicholson, D. (2012). Neuroethics journal club: jobbing on the sleep. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2012/03/neuroethics-journal-club-jobbing-on.html

4 comments:

Riley Zeller-Townson said...

I'm curious if anyone brought up the potential training benefit from sleep deprivation- if you train to (examine patients)/(perform experiments)/(play video games and binge drink) while sleep deprived, one might expect that while your performance during the training might be lower, your future performance once you graduate might be helped? At the very least, could potentially act as a sort of generalized stressor. That being said, there doesn't seem to be much benefit for someone who isn't in a training mode to engage in this behavior.

Cyd Cipolla said...

Excellent write up, David! And I'm still very seriously curious- why do people not get enough sleep on such a regular basis?

Anonymous said...

thanks

Sherille Jill said...

I like that quotes about sleep that you provided. I like your analysis because its true and I had experienced some of those incidents.