Ana Paiva Nunes, doctor: “The prevalence of insomnia due to depression is increasingly high”

Ana Paiva Nunes

Ana Paiva Nunes is a 38 year old doctor of internal medicine at São José Hospital, in Lisbon. She treats patients who suffer from insomnia due to depressive symptoms and fear of having another (sudden) stroke. She says that she does not resent the four emergencies shifts that she does every month. – She is still young, Ana admits. However, her family knows that on the following day she will be suffering of lack of patience and easy irritability”.

How many “emergencies” do you do every month?

At least four 24-hours emergency medicine shift work per month.

Does night shift affect your sleep pattern in the following days?

Not yet, because I am still fairly young and able to cope with all the stress and running arounds and, really, it has been on and off like that ever since I became a doctor, for 14 years now.

Does it somehow affect your family or social life?

Well, my family is already aware that an emergency shift the following day it can possibly be filled by some lack of patience. As for my social life, I try not to make any arrangements when I am off, which often is not possible, so I end up being a kind of a dull company, sometimes.

Which sleeping patterns/behaviours do you adopt?

May it will be not possible to rest during the emergency period – which it is frequently the case – I try to have an early-night the day after, since I have to continue working.

As an internal medicine doctor doing night shifts, you do certainly come across many complaints of insomnia. Which are those most frequent complaints?

I treat patients with cerebrovascular disturbances, where insomnia in its initial state after the stroke is linked to the fear of having another stroke or even dying while sleeping. In the recent phase, insomnia starts to be linked to depression. I also work for a retirement home where insomnia is the most common problem among the users.

Do you usually give these patients direct indications relating to sleep hygiene/ patterns?

I give many indications to the elderly, such as the need to go out and get some sun, but the prevalence of the benzodiazepines dependence is rather high.

Do you think that the curricular plans of the Medicine courses in Portugal sufficiently empathize sleep disturbances and its treatment?

In my case, I only studied sleep pathologies after finishing the medicine course. I do not know how the medicine course curriculums are currently structured.

Do you recall any curious event in your medical activity having to do with sleep?  

It happens frequently when I am on the emergency shift feeling very tired in the early hours while “trying” to have a quick nap, when it is possible, but still able to answer my colleagues every single question I am asked, accordingly and flawlessly!