19 ideas for shift nurses to get more sleep

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!