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19 ideas for shift nurses to get more sleep

ScrubsSleeping

When you don’t get enough of it, you suffer. Big time.

No, we’re not talking about money, we’re talking about sleep.  And if you’re among the third of working nurses who work the night shift, you probably don’t have the luxury of setting a typical sleep schedule.

Sleep expert (and fellow nurse) Terry Cralle helps you identify whether you have what is called “shift work disorder,” suggests ways for night shift nurses (and their managers) to ensure a safe working environment, and offers up the following tips to help you get some shuteye.

Here are 19 things you can do at home to ensure you’re getting the sleep you need:

  1. Make sleep a health priority, like diet and exercise.
  2. Wear sunglasses if you’re commuting home in bright sunlight. Light is the most powerful zeitgeber, or influencer of the body’s circadian clock, and will negatively impact your ability to fall asleep. In contrast, once you wake up, go outside into the sun to cue your biological clock that it’s time to be awake and alert.
  3. Only go to bed when you’re sleepy. Don’t go to bed just because it’s “time.”
  4. Your body likes routines. Like light, your bedtime routine is a powerful zeitgeber. Establish a standard, relaxing, soothing bedtime ritual. Put on your pajamas, wash your face and brush your teeth to signal your brain you’re preparing for sleep. Play soothing music; take a warm bath for 30 minutes, one hour before bedtime; read a relaxing book or magazine. Allow enough time to unwind and relax, but try to go to bed as soon as possible after your shift, ideally within two hours. Don’t fall asleep in your recliner or sofa with a television blasting in the background.
  5. Try to maintain a consistent and regular sleep schedule on work days AND days off/weekends. Keeping a routine helps your body know when to be alert and when to sleep.
  6. Stop working at any task and attempt to resolve anything potentially stimulating, worrisome or upsetting one hour before bedtime. Writing down your emotional worries and thoughts in a journal may help release these concerns from your mind. Learn a relaxation technique, such as progressive muscle relaxation, and practice it in bed.
  7. Use your bedroom only for sleeping and sex. Keep it stress and clutter-free. No paperwork, bills, unfolded laundry, TV, electronics or pets.
  8. A darkened room signals your brain that it’s time to sleep. So keep your bedroom as dark as possible. Blackout shades, heavy curtains and eye masks can help. Standard window shades let too much light in. Cover an illuminated alarm clock, especially if you’re a “clock watcher,” or remove it, if necessary. If you need to get up, use a small nightlight instead of turning on bright lights.
  9. Eliminate noise with earplugs, a fan or a white noise machine. Turn off or unplug the phone. Install carpeting or sound-absorbing curtains, drapes or shades.
    Keep your room well ventilated and the temperature on the cool side, ideally between 60 and 65 degrees (range: below 75 and above 54 degrees).
  10. Invest in a good mattress. A poor or an old mattress can disrupt your sleep. The average mattress lifespan is about seven years.

More tips:

  1. Make your sleep time sacred. Enlist the help of your family and friends and request that they respect your sleep. Put a “Do Not Disturb” sign on the front door, so friends and delivery people won’t knock or ring the doorbell. Have family and friends wear headphones when watching TV or listening to music. Ban vacuuming, dish washing, lawn mowing, loud games and any other noisy activity.
  2. Tell your kids not to go into your room unless it’s an emergency, and be sure to specify exactly what is and is not an emergency. Schedule appointments outside of your sleep period.
  3. Get at least 7.5 to 8.5 hours of sleep per day. Try to make up for lost sleep on days off.
  4. Nicotine and caffeine are stimulants. Alcohol, while initially a sedative, causes arousals and awakenings, sweats and nightmares after it’s metabolized. Ideally, avoid caffeine-containing beverages and food such as coffee, tea, sodas and chocolate at least six to eight hours before bedtime. If you’re having problems falling asleep in the morning, avoid caffeine after midnight. Avoid cigarettes before bedtime and during awakenings, and alcohol at least five hours before bedtime.
  5. Don’t go to bed too hungry or too full. Avoid eating two hours prior to bedtime. If needed, have a glass of milk or light snack before bed. Milk contains the amino acid L-tryptophan, which research has shown helps people fall asleep. Avoid consuming protein at bedtime, which may be harder to digest. Don’t drink excessive fluids prior to bedtime to avoid having to get up to urinate.
  6. Don’t lie awake in bed for more than 20 minutes to avoid developing a negative association between your bedroom and sound sleep. After 20 minutes, leave the room and do something relaxing, such as reading, listening to music or watching television. Don’t return to bed until you feel sleepy.
  7. Schedule 20 minutes of regular aerobic exercise and work it into your normal routine, but not within three hours of going to bed. Exercising raises the body temperature and can be alerting too close to bedtime. Walk or bike to work instead of driving; climb the stairs instead of taking the elevator. Consider exercising before work or during breaks to help you stay alert on the job. Keep a resistance band or hand weights at work for strength training. Find an exercise buddy to make exercising more fun and keep you motivated. Exercise will improve your sleep, energy level, mood, stress and cardiovascular fitness.
  8. Address your partner’s sleep issues, if present. One partner’s sleep problem causes the other to lose, on average, nearly one hour of sleep a night.
  9. Begin altering your sleep schedule three days in advance of a shift change. On the third day prior to the shift change and each subsequent day, postpone your bedtime and wake time by one to two hours compared to the previous day. By the time you begin the new shift, your circadian sleep-wake rhythm will be reoriented. For example, if you’re on a 5 p.m. to 1 a.m. shift and moving to an 11 p.m. to 7 a.m. schedule, do the following:
  • Three days prior to your shift change, rather than sleeping from 3 a.m. to 11 a.m., postpone your bedtime to 5 a.m. and sleep to 1 p.m.
  • Two days prior to the shift change, sleep from 7 a.m. to 3 p.m.
  • One day prior to shift change, sleep from 8 a.m. to 4 p.m.
  • On the day of the shift change, sleep from 9 a.m. to 6 p.m.

To learn more about shift work disorder and what you can do to make your work environment safer and more productive, read all three parts of our Shift Work Disorder series!

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Terry Cralle

Terry Cralle is Co-founder and Corporate Vice President of the Keswick Sleep Institute in Charlottesville, Virginia. She holds a B.A. in Sociology from Randolph-Macon College and received her Bachelors of Science in Nursing at the Virginia Commonwealth University and completed a Masters of Science in Healthcare Management with an Emphasis in Healthcare Risk Management from the Finch University of Health Sciences at the Chicago Medical School. Terry is a Certified Professional in Healthcare Quality as well as a Certified Quality Auditor. Terry has had over 20 years experience as a healthcare consultant. She has published on clinical research topics as well as serving as Lecturer at Piedmont Virginia Community College in Charlottesville, Virginia.
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12 Responses to 19 ideas for shift nurses to get more sleep

  1. Bonita Garcia

    The last point is wrong-should be 9am to6pm

  2. Miriam Bookey

    Thanks Bonita! Fixed.

  3. kellyew1973 RN

    An 8oz serving of milk contains about 8 grams of protein!

    • Honeybunny58

      My schedule is work 12 hr night then off a day and then 2 12 hr nights in a row, off a day then a 12 hr day office day. So exhausted by end of week, spend weekend in bed to recover and start all over on Monday. Impossible to set a sleeping schedule because I work all shifts with one day off between them.

  4. SJP

    With all the information out there that nurses are not getting potty breaks or meal breaks the advice to exercise on break is ridiculous. Very few hospitals offer anything other than 12 hour shifts so the “getting ready schedule” is also ridiculous. Most work schedules are 2-3 shifts on and 2-3 shifts off, so, again, the advice to “get ready” is ridiculous. If night shift has to avoid caffeine after midnight there will be many more errors, early morning medication, something missed in report, driving home, etc. This article is ridiculous, an insult to nurse who are struggling with night shift adjustment and demonstrates how out of touch with reality SCRUBS magazine is.

  5. Smith Fan

    I would sink into the deepest of depressions if I followed the advice of staying on my night schedule on my off days. If I’m only off for one night, I stay close to my night schedule and try to make the best of it, but for anyone with friends and family, it’s unrealistic to suggest to us that we spend the majority of our off-shift waking hours alone. You try keeping to your night schedule when you have a family — ridiculous!

  6. Mindy McCartney

    The tops in this article are not practical for a nurse on night shift. There are very few nurses who work 8 hour shifts anymore. No caffeine after midnight? Yeah right, not if you want my care to be effective. Exercise on breaks? What breaks? Keep the same sleep schedule? Yeah right, not if my family and friends want to see me or I’ve kept my appointments for non sleeping hours. Go to bed two hours after my shift, but not if I’m not sleepy, not within three hours of exercising (but if I bike home as suggested after my shift, am I supposed to wait three hours?). Get up and watch tv if I can’t sleep, but other sleep professionals have suggested turning that off a couple hours before bedtime. Get 7.5 -8.5 hours of sleep each day, between 12 hour shifts??? Yeah right. Maybe someone could suggest some practical solutions, maybe someone who has actually worked night shift…

  7. gapeach

    What if you work nights during the week and days every other weekend… it’s wearing me out quick

  8. Honeybunny58

    You are So right. Not able to participate in family meals,outings or kids sports…lonely existence if you stay on night schedule on your days off!

  9. bubble

    2: I live in England, no sunglasses required
    3: If I followed this advice would be asleep at 4am and therefore fired
    7: Sex? That would be nice!
    9: Ear plugs are a sure way to ignore the alarm to wake up in time for shift
    10: Or less if you are getting a lot of number 7
    More tips….
    4: Caffeine is the only reason I get home alive
    9: I think work would ask questions as to why I’m not getting in until the afternoon when my shift starts at 7.30am.
    The normal night shift routine:- first night, been awake since 8am, done grocery shopping, cooking for the next 4 nights and laundry. Work, finish at 8am, very aware that I have been awake for 24 hours already. Get into car and drive through rush hour traffic past 5 schools. Wonder how I manage to miss suicidal children who are unaware of my slowed reaction time and dart straight in front of my car.
    Get home, manage to throw self into shower and into bed. Sleep. Wake. Work. Repeat x 4. Wonder what the sun looks like. It’s dark when I wake. It’s dark all night. It is vaguely light on my way home but probably raining so probably pretty dark.
    The night shifts of an English nurse

  10. Ruth Pace

    there really is no set rule on how to cope with working night shift. Each person must figure out what works for them. I don’t have any kids, so I had it easy – however, I’ve had to deal with rotten jobless neighbors who would deliberately blast music. thank goodness that’s been resolved when they destroyed the house to the point it had to be demolished. – I stay on a night shift on my nights off – I don’t go to bed until 5 or 6am. Appointments are made in the afternoon. (need the night before off and the night of off).
    eating on a 12 hour shift. (I work 7pm to 7am) oboy! I get up around 2 or 3pm. soup or sandwich around 5pm. I take a can of Progresso soup with me – have that around 9 or 10pm. I also bring a sandwich with me to eat around 1 or 2am. Used to have a thing of yogurt around 6am – but now, too busy – so I like that new yogurt protein drink. on my nights off – I have dinner with hubby around 8 or 9pm.
    I see that I am fortunate, I don’t do swing shifts like some people do. that is horrible to do to a person. I wish they’d stop that.
    thank goodness I’m retiring in 3 and a half years – I’ve been working night shift for 38 of my 42 years on the job. it was easier when I was younger – like everything else.

  11. breehat

    You cannot make up the lost hours by sleeping on the weekends or offs. What sleep-hours you lost, you lost it. There’s nothing you can do to take it back.

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