Balancing Your Lifestyle in Healthcare: Sleeping on the Job

You have studied hard, pulled countless all-nighters, trained for years, and you’ve finally landed your dream job.  You are ready to work hard, to be dedicated, and to give it your all.  You are a caring professional and proudly put your patients’ interests first.  After all, that is the defining characteristic of an excellent clinician.

So the last thing you would want is for someone to sabotage all the time, effort, and money you’ve invested in getting this position.  What if that someone actually meant well, had the best of intentions, but still managed to trip you up anyway? Think of a big, goofy dog who is so excited to get you out the door that he wraps the leash around your ankles and drops you before reaching the front door.  What if that someone were you?

Most health professionals are smart, hard-working, and very capable individuals, yet it is not uncommon for them to be the ones who sabotage their own performance at work.  By caring so much for their patients, these individuals tend to neglect themselves.  They are, in effect, burning the candle at both ends.

Many clinical jobs require one to get up at an extraordinarily early hour, stealing precious recharging time from needed sleep.  These jobs also require one to be fully focused on not one or two but several critical tasks at hand, all at once.  This usually goes on uninterrupted for the better part of 8, 12, or even 24 hours, after which one has to find his or her way home at some level of consciousness to then collapse in bed, just long enough to do it all again at some time in the near future.

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So, what is wrong with this picture?  You are doing the very best you can, so how could you be the saboteur of your own career?  Well, the problem is in the details.  It is very hard to over-state the importance of having a solid and steady supply of high-quality sleep.  In fact, it is so important that experts even come up with a whole name for it: Sleep Hygiene.  If this term conjures up thoughts of flossing, gargling, and brushing, then you are not you are not too far off.  This is because sleep hygiene also requires us to establish a daily habit so solidly as to make it second-nature and practically automatic.

Everybody knows that it is recommended that we have 7 to 8 hours of sleep every night, but few may know why it is important to do so, how to implement this, and how to make the number of sleeping hours your job allows you to have to be the very highest quality rest time.

First let’s review the reason why sleep is important.  Sleep allows the body to rest, recharge, relax, stretch and wind down.  Sleep research has shown that the brain is just as active during sleep as when it is awake.  However, what the brain is actually doing may be somewhat different.  In a way, the brain is sorting through all of the day’s activities, searching for previously undetected patterns in our experiences.  During this sorting, the brain is blunting down all the monotonous and repetitive rote of everyday life and flagging anything unusual, important, or extraordinary.  When this process is interrupted or postponed (during an all-nighter), the mind has much greater difficulty taking in information, sorting through the noise to hone in on what may be important, retaining what’s important, and even recalling it when it may be needed.  Surely that is no state for the brain of a clinician who may have a person’s life in her hands!  And yet, here we are, with thousands of nurses and doctors working while running on empty.

But that’s not all! Fascinating new research on sleep deprivation has revealed that tiredness impacts the very molecules that make up our bodies!  Every one of our trillion cells requires ongoing housekeeping and maintenance in order to remain functional and contribute to the overall workings of our bodies.  Each cell needs a constant supply of fresh and new building materials made up of proteins.  Proteins are chains of amino acids folded and arranged in three-dimensions, like very intricate origami structures whose shapes determine their exact function.  As it turns out, sleep deprivation hinders proper protein folding processes.  In other words, when you don’t sleep enough, you begin to fall apart at the molecular level!  Think about that the next time you are tempted to stay up late in front of the television before a long day at work.

Here are some evidence-based tips on how to improve the quality of whatever sleep you can manage to get:

1.  Establish a regular bedtime, and stick with in, even on the weekends.  Alternations of more than one hour will cost you for several days in re-adjustments.
2. Create a ritual. Develop a routine that allows you to wind down during the last hour of your day.  This will allow your pulse and blood pressure to slow down as your melatonin levels rise, leading your mind and body to go to sleep.  The routine may include dim lights, relaxing music, quiet conversation, or reading. Whichever routine you decide upon, remember that it’s important not to let your work affairs infringe upon this time.
3. Avoid substances.  Caffeine, alcohol, as well as any other stimulant or relaxant, will hinder your ability to establish and maintain the best quality of restorative sleep.
4. Exercise regularly.  Staying active regularizes your basal metabolic rate and your blood sugar levels, and facilitates the onset of sleep.
5. Watch your diet.  Have an early dinner relatively low in fat, processed carbohydrates, spices, or very strong flavors to keep possible indigestion at bay.
6. Make of your bed a hallow place.  Every sleep medicine specialist will tell you that beds are for sleep and sex, so make it an electronics-free zone: No TV, tablet, or cell phone.  Just a simple alarm clock and light.  Also, lower the temperature to make the room comfortably cool, and minimize ambient lighting and noise.
7. Download.  Keep a pen and paper near by and write down every concerning thought you may be having before bed time.  This will ensure that they’ll be out of your mind as you try to fall asleep, and the paper will remind you to act on them in the morning.
8. Follow nature’s cues.  If you happen to wake up before your alarm and you have the slightest difficulty in falling back to sleep, then go with the flow and get up and start your day.

Even though these tips should work on most people, everyone’s sleep is a little different.  What are some of your most useful sleep-having habits?  And how do you readjust your sleeping patterns after a nightshift at work?

Previous article in this series: Balancing Your Lifestyle in Healthcare: Surviving the Hospital Lifestyle