Surviving Nights

Do you find yourself waking up at 4am and end up eating cereal at 9pm?  Shift works takes a toll on the body and working night shifts plays havoc with your sleep patterns.  The human body is hard wired to shut down when the sun goes down so every hour you are awake on nights you are fighting evolution.

There is no need to despair, you need to know there are steps you can take to make your life bearable without sacrificing your health, family or sanity.

Your Need to Sleep
Sleep is essential, you need to make certain you get enough of it.  The average person requires at least eight hours of sleep per 24-hour period.  Studies indicate that people who average only six hours of sleep per day will eventually suffer from the effects of chronic sleep deprivation, including a slow-down in mental processing ability, gastrointestinal problems, vision problems and a weakened immune system.

This sleep is not cumulative.  When working nights, it is tempting to close your eyes, in between calls, and steal an hour of sleep.  Sadly studies have shown that sleeping in small segmented periods like this is more detrimental than just staying awake.  Your body needs to achieve REM sleep and this cannot be done in these short periods.  So besides being a tease, these micro naps actually make you feel more tired.

This happens because everything we do on a biochemical level is based on circadian cycles. Our internal organs function according to set biological cycles, and disrupting their rhythms can be hard on your body. Flipping our schedule from nights to days over a prolonged period of time can also reduce life span. The American Heart Association reports that people who flip their sleep schedules can disrupt their cardiac sympathetic and/or parasympathetic autonomic controls.

Friends and Families
Most shift workers have friends and family members who do not comprehend the nocturnal lifestyle. You know the routine: They call you at 9 a.m. and act surprised that you’re still sleeping. When you explain that you worked all night, they chuckle, apologize half-heartedly and then launch into a topic that must be settled right now.

Keep at least one form of contact private (cell no, home number, special email address for your Blackberry) so you can give it out those you trust won’t abuse it.  This way you can turn off all other phones and notifications and you can still be reached in emergencies.  Broken sleep is not restful.

Eating and Exercise
As medical professionals, we know the importance of good nutrition.  Being sleep- deprived, flipping your circadian cycle and working nights can negatively affect your gastrointestinal tract.  Putting junky food into the equation only makes matters worse.  This is a vicious cycle though.  Who feels like making 6 healthy meals to take with them on shift when they are still dog tired from the last shift?  There are healthy alternatives at fast food joints.  Just choose carefully.

Exercise is also crucial.  The important thing is that you do it consistently and stick to a regular routine.   A human body in good physical shape is better suited to handle the stresses of the job and a nocturnal lifestyle.  A body that’s in decent physical condition is also less prone to becoming sick.  Think about all the nasty things we come into contact with at work.  This alone should be enough motivation to exercise.  Just don’t exercise within two hours of going to bed, because it may hamper your ability to fall asleep.

Getting Quality Sleep
You finish a busy shift and on the way home, someone cuts you off.  As you pull into your driveway, you remember that you forgot to mail an overdue bill. You enter your home, trying to be quiet, but you stumble over some toys in the hallway and the kids wake up and want to see you. Your spouse wakes up and wants to spend some time with you. And the cat wants to be fed— NOW!  After all that, you crawl into bed and hope for some decent sleep, because you have to be back at work the very next night.

It is important that you get the most out of your sleep time.  You will never get quality sleep if you cannot let go of the stress from the day.  Your mind will go over all the calls you did and the errands and chores you still have to finish before you head back into work.  Next thing you know your sleep is cut short and you end up waking yourself early because you have so much left to do.

Some of the best stress relievers are exercise, recreational activities, solitude and having trusted people in whom you can confide. You need to have a balance in your life between stress and stress relievers.

One way to immediately reduce the stress that may be wrecking your sleep is to change the nature of your bedroom.  If you read, watch TV, it’s more difficult to make the mental transition that prepares you to sleep. You will wind down faster and fall asleep quicker if you only associate your bed with sleep.

White Noise
A fan is the best “white noise” producer you can buy.  A running fan will drown out about 90% of all the noises that so easily awaken the day sleeper.  If you don’t have a fan and you are extremely sensitive to noise, ear plugs should do the trick.

Lights Out
If you’re going to sleep, it needs to be dark.  A good set of room-darkening shades will do the trick.

It is important to remember that being awake during the day and being exposed to sunlight is essential to the mental health of millions.  Those who are deprived of it may suffer effects similar to seasonal affective disorder, which, can include problems concentrating, low energy and fatigue, reduced interest in daily activities, moodiness (depressed, sad or unusually quiet), increased appetite, craving carbohydrates (pasta, bread and sweets), weight gain from overeating carbohydrates, sleeping too much and having a heavy feeling in the arms and legs.

ETOH = ZZZZZ’s?
Generally, having an ounce of liquor, a beer or one glass of wine before you go to bed can help you get to sleep, but not stay asleep.  Small amounts of alcohol raise HDL, lowers blood pressure, inhibits the formation of blood clots and helps prevent artery damage caused by high LDL.  The obvious problems lay in alcohol abuse. EMS professionals may be aware of the problems, but are not immune.

Sleep aids
The two most widely used sleep aids seem to be diphenhydramine (Benadryl) and melatonin. Melatonin is the hormone your body naturally produces to induce sleep. Melatonin tends to induce REM sleep. Taking melatonin shortly before going to bed helped may help you to go to sleep and stay asleep, without the “hangover” feeling you can get from diphenhydramine. If you are considering using these products to help you sleep, consult your doctor first.