The NYT published this article Friday about people who regularly work the overnight shift - they feature a nurse, a DJ, and a campus security officer. (This is, of course, inspired by the recent hubbub of the air traffic controllers falling asleep while working at night.) There are many more jobs out there that require working overnight at least occasionally, if not regularly. Personally, in my ideal world we would be rid of overnight shifts altogether. But since we don't live in my world, here are some practical tips to prepare for the occasional overnight shift.
1. Stay up late the night before
Shifting from a diurnal schedule to a nocturnal schedule is like shifting several time zones. It's estimated that it takes about one day for your biological clock to shift one hour, so making a dramatic shift will be really taxing on your body. Easing into the night shift by staying up late the night before will help a significant amount, and starting a couple days earlier would be even better.
2. Nap before the shift
I mentioned the idea of 'sleep pressure' in an earlier post. The theory is that sleep pressure starts to build the moment you wake up, and continues building until your next sleep episode. Taking a nap prior to your night shift can relieve some of that sleep pressure and help you stay alert. Keep in mind that it's easiest to nap in the early afternoon (the afternoon 'lull'), typically between 2 and 4p.
3. Adjust your meals
Food is another way your body can entrain to a different day-night cycle. It may be advantageous to adjust your meal schedule so that you have one large-ish meal during your overnight shift.
4. Sleep right after your shift
Delaying sleep even further will have the effect of shifting even more time zones - and consequently, make it more difficult to adjust back to your regular diurnal schedule. To help you sleep, avoid taking caffeinated products close to the end of your shift.
will let louis know of these before his next overnight shift! :)
ReplyDeletewhy bother doing these things for the occasional overnight shift? seems like they would just ruin your day during your normal day shifts.
ReplyDeleteAlex, that's a fair point. The goal in these suggestions is to be as alert as possible while working the overnight shift, without much consideration for what happens after - especially if the overnight shift is rare. However, external cues make it much easier to shift from a nocturnal to diurnal schedule than the other way around. Daylight is the strongest clock-setter, but meals, activity, and other stimuli will contribute.
ReplyDeleteOn the flip side have they gone too far in regulating shifts and sleep schedules for doctors? Interns capped at 16 hour shifts, can't work more than 80 hours a week, etc. What's your take on being told you have to sleep vs regulating yourself? Some people just don't need as much sleep. Also, there's a substantial argument that doing less overnights makes us worse doctors in the long run. Overnight calls are where we learn to be independent and responsible for our patients and learn to make important decisions
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