Sleeping Our Way to Lower Healthcare Costs

When I say sleeping, I actually mean sleeping.

But first, a story:

A few years ago, I spent some time working with a company that had attempted, with less success than they would have liked,  to turn around and operate failing public schools on a for-profit basis.  Leaving aside basic business model issues, neither they nor anyone else has cracked the code on how to systematically deliver superior education results.  (Not quite true.  KIPP charter schools consistently delivers great results, but at the cost of teacher burnout.  Their teachers last an average of just two years).

Around that time, I came across research showing that children who eat a nutritious breakfast every day perform better in school than those who don’t.  Shocker, that.  I can’t find a citation for it, but I recall the impact being about one grade level – C’s turn into B’s and B’s into A’s.  I also encountered the work of Harvard Medical School psychiatrist John Ratey, who studies the impact of exercise on the brain (Spoiler Alert: it’s good).  Ratey, whose research includes a junior high school near me, has found that a half-hour of vigorous exercise in the morning alleviates depression as well as Prozac, scares the crap out of ADHD, and facilitates the production of new brain cells and connections, which improves learning.  Like breakfast, the academic impact turns out to be. . .wait for it. . . about one grade.

That got me to thinking – maybe we’ve been going about this education thing all wrong.  Perhaps we should forget about trying to perfect the curriculum, the instruction, the leadership and the school management models.  Maybe we should just bring those kids in, feed ‘em a big bowl of oatmeal, take ‘em out to the playground and run ‘em hard for half an hour.  Poof!  Two grade levels of improvement.  Take that, Taiwan!

What about the kids who can’t run fast?  Hey, this is America.  We leave no child behind.

It is in this spirit of heavy-duty problem-solving that I turn again to healthcare.

LinkedIn sends me lots (too much, actually) of interesting stuff these days.  One such was a recent blog post by Boston Globe columnist Tom Keane.  In it, he recounts how his father, during a recent stay at Beth Israel hospital, was actually allowed to sleep through the night, which Keane said made a big difference in Dad’s return to health.

His post resonated with me.  My first experience as an overnight guest in a hospital was about eight years ago.  I had gotten some mystery infection that got into a lymph node, which then had to come out.  That required what amounts to hernia surgery (getting a little personal here, I know), followed by a drip feed of every antibiotic known to man because they couldn’t figure out what the infection was.

The surgery itself was no big deal (I went skiing 2 weeks later), but the in-hospital recovery was an exercise in sleep deprivation (something the military describes as an “enhanced interrogation technique” so they don’t have to call it “torture”).  It wasn’t just the beeping equipment.  It was nurses waking me up every four hours to check my vital signs.  It was the pain management guy bursting through my door at 6:00 AM.  “Hi!  I’m here to see what we can do about your pain!”  “I don’t have any pain.”  “No pain?”  “No pain.  Get out of here.  And next time, please ask somebody if I’m in pain before you knock down my door.”  It was the food service people bounding in unannounced to serve me a breakfast I didn’t want at an hour when I wouldn’t have eaten it even if I wasn’t in the hospital.  And on and on and on.

After three days and nights of this, I negotiated a deal with my doctor and my nurse.  I got the doctor to prescribe an Ambien.  I asked the nurse to give it to me at 10:00 PM, and to wake me up in order to give it to me if she had to (she didn’t).  I also got her to agree to give me six hours between vital sign checks.  So I got six hours of uninterrupted sleep.  I woke up feeling so much better that they discharged me pretty much on the spot.

Ironically, I got home to find a big article in the Sunday Chicago Tribune explaining how important it is for hospital patients to sleep, and how bad hospitals are at allowing that to happen.  The link above is to the actual article published in 2004.  When I searched for it, I discovered that this issue has been covered in the Trib at least three or four times since.  The healthcare value of sleep, it seems, is not much of a secret.

Hospitalization accounts for 30% of the $2 trillion we spend every year on healthcare every year.  I figure a decent night’s sleep would have taken at least one day off my four-day hospital stay, maybe two.  25-50 percent.  Let’s split the difference and call it a third.

So here’s my big idea.  While the healthcare debate rages on, and it’s not going to stop raging anytime soon, how ‘bout we save ourselves $200 billion a year by just letting the poor patients get a little shut-eye?

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3 Responses to “Sleeping Our Way to Lower Healthcare Costs”


  1. 1 Jack Altschuler August 22, 2012 at 11:51 am

    I played football in high school and as a sophomore running back was instructed in new ways to bend an ankle by three really large guys who tackled me. The resulting break in my tibia wasn’t a big deal, but the wrenching of all the soft tissue in my ankle and foot were.

    The hospital provided my housing for the night, as they wanted to monitor me for shock. Mom told me not to be a hero and to take something for my quite significant pain, which I did. Of course, it didn’t help and to this day I think it was just aspirin.

    I don’t know what time it was when I finally fought past the pain and into sleep and it seemed only seconds later (actually, it was a couple of hours) when Nurse Sleep Deprivation awoke me to ask if I wanted a sleeping pill. No, really. This is not apocryphal – it actually happened.

    It is possible to be a slave to procedure at that very real cost of good sense. Our healthcare system is fraught with examples of this and it is both wasteful and compromises the best healthcare outcomes.

    Sez me.

  2. 2 Spence August 22, 2012 at 8:09 pm

    Hey Dan
    As usual you hit the nail on the head. When I was in the hospital in 2001 for the heart valve surgery I eventually had to make a deal with my nurses. I said from 6am to 10pm I am yours – have at me and I shall not complain. However 10pm to 6am is MY time and if I need you I will press the little button. It worked great and I got the sleep I needed and, just like you, they quickly told me I was well enough to go home.
    Spence

  3. 3 Steve Smolinsky August 24, 2012 at 7:33 am

    Gee, just like mom said. “Eat your breakfast and get enough sleep.” Now if only mom had spent more time sharing this will people going through medical school.


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