The good news is there are ways to combat the evils of night shifts. I will make a few suggestions here, but I’d also like to hear from you about the strategies that you have found helpful. Send your tips to acepnow@acep.org.
1. SLEEP!
This one seems obvious, but sleep needs to be a priority. The day after an overnight is not the best time to have someone cleaning and running the vacuum in every room of your house. Don’t schedule a meeting in the middle of your daytime sleep and assume you’ll be OK. Be selfish with your sleep! Let family and friends know that you are out of commission until a certain time and request that they avoid texting or calling during your sleep times. Put a sign on the door that reads, “Day sleeper, do not disturb, and do not open the door.”
2. DARKNESS
Our bodies want to sleep when it is dark. Create a dark, quiet place for daytime sleeping. Think about installing blackout shades on your windows to create artificial nighttime. Unplug the phone and use earplugs. One overnight attending in the Bronx wears blackout goggles on his way home from work to avoid seeing the bright sun and throwing off his sleep cycle. (Just to paint a picture, this man is 6’5” and riding the subway home during morning rush hour in a hooded sweatshirt and black metal goggles.) You can wear sunglasses home instead of blackout goggles. Your fashion sense will guide your decision.
3. SCHEDULE
A schedule that bounces from day to night, then night to day without a second to breathe is going to be hard for anyone. Some emergency physicians bundle their night shifts together, while others find that night shifts randomly worked throughout the month is better. You should experiment with both strategies and find which best fits your biorhythm and lifestyle.
4. REWARD FOR WORKING NIGHT SHIFTS
It is possible that some people just can’t do night shifts. One emergency medicine program just implemented a policy where employees do not have to do nights in the third trimester of their pregnancy. Many EDs do not require physicians over a certain age to do night shifts. One hospital in the Northeast has shortened the night shift from midnight to 6 am so that the overall impact on sleep is less.
Certain medical and psychiatric conditions, for example, seizure disorders, depression, and attention deficit hyperactivity disorder, are also affected by overnight shifts. Does your practice have specific guidelines for who is not required to work night shifts? This is a discussion that should take place. Many departments offer compensation for night shifts to ease the pain.
5. DRIVING
The solution to driving after a night shift was developed by a residency director in Washington, D.C. She recommends that if you come to a stoplight, put your car into park. If you then doze off, drivers behind you will beep their horns and alert you that it is time to move. You cannot inadvertently run into the car in front of you with this fail-safe strategy.
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3 Responses to “Combat Sleep Disorders From Working Night Shifts”
April 12, 2015
Charles AkinAt what age do you begin less exposure to night shifts? Does it create tension among the other colleagues?
How do you begin a series of night shifts. Do you stay up late the night before? How many hours of sleep do you try to get the day of the first night of a series?
Do you take meds to sleep?
April 14, 2015
James SteenAt age 65, I have just completed my first month of all nights after doing mostly nights with a few days thrown in for the past two years. I plan on doing all nights until my retirement at age 67. I really love the night shifts. Better nurses, total independence with no administrative interference and sometimes I do get to sleep a little.
My strategy is similar to what you outline above.
1. Protect your sleep with a room that has no disturbances from any outside noise. No phones, doorbells, kids or spouse.
2. Dark room
3. I always sleep the same hours, somewhere around noon to 4 PM with expansion possible in either direction depending on how tired I am. My night shift is 10PM-7AM.
4. Always sleep before the first night shift after being off, sleep as needed on the first day off.
5. Use some type of sleep aid if needed to make sure that you do sleep soundly for at least a few hours. My sleep aid of choice is vodka, in minimalist moderation.
6. I never bounce to other shifts anymore which really helps.
7. I take short naps during the same time period on most of my days off.
I find that I can get a lot done before and after sleep on work days and I have an evening family life every day of the year. I can accept evening invitations because I am always up from 6-9 PM before going in to work.
It is really a great life.
August 24, 2016
better sleepTo deal with it, I usually wear earplugs, sleep mask and keep my bed clear. Besides that, I avoid using caffeine and alcohol