Friday 1st October 2010
Night shift can play havoc with your sleep patterns. For nurses juggling shift work and busy lives, heres what you can do to make sure you maximise your quantity and quality of sleep.
Research shows the average night shift worker loses around one to two hours of sleep every day. Humans are not naturally nocturnal, and constantly switching from day to night duty can result in poor-quality sleep that can lead to health problems.
‘The most important thing to realise is most people don’t really adapt so they don’t become nocturnal,’ says Dr Delwyn Bartlett, co-ordinator of medical psychology at the Woolcock Institute of Medical Research.
‘The average person is sleepy at night and more alert during the day. Anecdotal evidence of case histories suggests it takes 70 days and 70 nights for the average human to become nocturnal so the average person won’t do it, even if they are on full-time night shift because they have a day off, so they are constantly pushing against their sleep-wake clock.’
To sleep at night you need a falling body temperature, but anyone who has done night shift knows that towards the morning you get cold and sleepy and find it hard to concentrate.
‘By the time night shift workers go home in the morning they are starting to wake up,’ says Dr Barlett. ‘Even though they are exhausted, their brain is telling them to wake up for the rest of the day.’
We all go through various stages of sleep, with each cycle having its own benefits.
‘During deep sleep or slow wave sleep, you’ll get the secretion of growth hormone, which provides the opportunity for the body to repair damaged cells as the brain shuts down, especially the front part of the brain,’ says Dr Barlett. ‘What people seem to miss out on is dream sleep and stage two sleep, which is light sleep. We are still learning about the significance of stage two sleep.’
Night shift workers miss out on the lengthy sleep that comes after doing day shifts. This is due to the body temperature becoming warmer as the day goes on and also because external noises are likely to disturb sleep.
So what can nurses who are rostered on night duty do to maximise the quantity and quality of their sleep?
‘It’s good to get an afternoon bright light so go for a walk in the late afternoon after you have woken up if you can because it delays sleep onset,’ says Dr Bartlett. ‘You want light at work too – bright for the first half of the shift and in the latter half the perfect circumstance is reduced light.
‘When going home in the morning you should wear sunglasses because light in the morning is not helpful for you. If you can, don’t do the washing or take the kids to school. The optimal situation is for you to go home and go to sleep straight away while your body temperature is cool.
‘Use sleep masks and if the room gets a lot of light, blue-tack some black rubbish bags to the window to make it as dark and as cool as you possibly can. Use white noise such as a fan, unplug your landline telephone and turn your mobile off,’ says Dr Bartlett.
Straight to bed, no distractions
Theresa O’Leary is a midwife who does rotating shifts, including nights, at Royal Prince Alfred Hospital in Sydney. She’s single and goes to sleep as soon as she gets home.
‘I wear ear plugs and I’ve got a very good eye mask that’s very dark and comfortable. These help a lot, especially the ear plugs.
‘I put my mobile phone on silent. That’s a shift work strategy for me. I don’t have a landline phone in the house and in the past when I have had one it’s been unplugged.
‘I’m able to come home and go straight to bed. I’m always exhausted in the morning so I go to bed and get my best sleep in the morning – I’ll get about four hours. If you have a break at night when you’re at work, snooze for an hour in the chair so the hours of sleep add up.
‘Don’t do anything that will stop you sleeping when you get home – like checking your emails and try not to organise to do too much when you’re on night duty. I find I sleep in the morning, wake during the afternoon, then probably get a couple more hours sleep in the evening, so try not to pack too much in so you can get the sleep when you need it – no mega shopping sprees!
‘Be organised about the food you eat. Bring healthy meals in to work. At 4am you always feel dreadful and a cup of coffee or cakes and biscuits won’t help you sleep.’
Exercise helps me sleep
Donna Hopkins is an RN who works in the psychiatric unit at Nepean Hospital. She has worked permanent night shift for the past four years as it allows her to juggle her work/life balance with three young children.
‘I use exercise to help me sleep. I do a lot of running around with the kids but I also go to the gym four or five times a week to do kick boxing.
‘I finish my night shift 7.30am. I go home and get the kids ready for school and drop them off at 9am. Then I go to a 9.30am kick boxing class, which finishes at 10.30am, so I go home and go to bed. I’m pretty exhausted by then. I get about four or five hours of sleep, except if someone gets the blower out and does their lawn, but generally I’m out like a light and wake up when my alarm goes off to collect the kids from school.
‘I don’t wear an eye mask as my room is pretty dark. In the summer it’s more muggy and more difficult to get off to sleep, so I usually set the timer on the air conditioner so it comes on around lunch time when the weather really starts to warm up.
‘I take the landline phone off the hook. I do have the mobile beside me and switched on in case of an emergency with the kids but I tell people not to call me on the mobile unless it is an emergency.
‘I don’t drink any coffee. I have a health drink in the morning to get me through the kickboxing class. I recommend drinking plenty of water when on night shift. Because of the air conditioning you get dehydrated. Tea and coffee are no good as they act as a diuretic so you go to the toilet all the time and this doesn’t help you sleep.