The author, an M.D., speaks first-hand of the pressure to go without sleep for long durations especially during residency, and the misperception most of us have that there no adverse health implications. You may feel fine, but your mind and body ultimately pay a price. As with most things, the author notes, proper sleep begins with self-awareness.

Should you drink more coffee? Should you take melatonin? Can you train yourself to need less sleep? A physician’s guide to sleep in a stressful age. Mauricio Alejo During residency, I worked hospital shifts that could last 36 hours, without sleep, often without breaks of more than a few minutes.

Sleep deprivation manifested as bouts of anger and despair mixed in with some euphoria, along with other sensations I’ve not had before or since. I remember once sitting with the family of a patient in critical condition, discussing an advance directive—the terms defining what the patient would want done were his heart to stop, which seemed likely to happen at any minute. Would he want to have chest compressions, electrical shocks, a breathing tube? In the middle of this, I had to look straight down at the chart in my lap, because I was laughing.