Sleep hygiene and related tricks.

[RustedFox]

... its so important in our line of work. This was mentioned in another thread, but really deserves its own. My "tricks":

1.) 20mg melatonin; taken ONLY during the nighttime hours. My sleep is "fuller".

2.) Before a nightshift, I get a 2-3 hour "proNap" in.

---

Members don't see this ad.

 

[southerndoc]

Blackout shades are a must for daytime sleeping. Keep your room cool (68 deg), which may be impossible during a Florida summer.

I don't use diphenhydramine, melatonin or anything else for sleep. Haven't had a problem. A dark, cool room does it for me.

 

[sawboned]

I agree with avoiding meds.

Being extremely cognizant of late day caffeine. If I use any, Runa tea is nice. Mild increase in alertness without insomnia. For me at least. May increase vividness of dreams, for what it's worth.

Padded sleep mask that also offers some sound deadening such as, Sleep Master Sleep Mask

Sleep Cycle app - senses your sleep stage and wakes you up during light sleep. A game changer.

20 minute power naps whenever feasible. The power nap app, wakes you up before you fall into deep sleep.


Sent from my iPhone using SDN mobile app

 

[deleted547339]

Padded eye cover, loud sound machine, cold room with fan. Will get blackout shades soon.

In my day after my final night shift, I stay awake until noon, then sleep on the couch for a couple hours. This ensures I won't sleep for more than 2-4 hours. I get up in the middle of the afternoon, have a cup of coffee. When I go to bed, 25mg benadryl, a few mg melatonin. The next night I do 12.5 benadryl.

 

[goodoldalky]

Blackout shades and an understanding family

 

[WilcoWorld]

Blackout shades and an understanding family

FTW

 

[WilcoWorld]

I also use melatonin, but only to get to bed before an early morning shift. Pre-night shift I avoid sleep aids. I have tried them in the past, but since stopping I've found that I feel much better.

IMO the BEST sleep hygiene technique is the following trade off: be flexible with which days you need off, but be inflexible with your turn-arounds.

 

[Hercules]

My routine for nights which has been effective for me so far in my career and keeps me from hating nights too much is below. I also do not allow my nights to be split (I like my 3 or 4 nights each month to all be batched together). Whenever possible I avoid the 24 hr turnaround as it always hurts. Our night shift is from 10p-7a M-F and 8p-7a Sat and Sun

1st shift of nights: Work out in the morning. Try to get anything done that need to be done over the next few days. Cook food so I can have meals prepped for the upcoming night shifts (If I don't do this, I wind up eating complete garbage on shift and then feeling like crap later). Pre nap for about 3 hours in the afternoon, then wake up for dinner with the family.

in between nights: Get off shift, drive kids to school, come home take 25mg of benadryl and 4mg melatonin and get to sleep by 8:00 or 8:30A. Sleep in windowless master bedroom closet (with an air vent) with sound machine on until 3:00 or 4:00P. Refuse to get up before that time unless there is something major going on. Low goals of accomplishing anything at all other than getting sleep, playing with kids, and doing night shifts. Having an understanding spouse that doesn't work outside the home is huge on this front.

After final night shift: Get off shift, drive kids to school, come home and go to sleep by 8:00 or 8:30A this time with no meds. Take brief 2 hour nap. Wake up. Hit some caffeine/preworkout drink and hit the gym with no aspirations of settings any records (just doing some weights followed up by some light cardio). Make it through day again with low aspirations of any major accomplishments. Finish off the night usually with a few drinks and some benadryl and melatonin.

As a side note, I don't use benadryl or melatonin to sleep at any other time during the month other than night shifts.

 

[Groove]

Melatonin 3mg or 6mg (I don't know how some of you are taking 20mg. DAMN.) + Celestial Sleepy Time Extra tea (2 bags + honey) +/- Valerian Root. Works great most of the time. I don't have black out shades but probably need them. Keeping the room cool is equally important and I try to not eat or work out too close to bedtime. That's when I'm trying to get to bed a few hours earlier than I usually do without an already completely jacked diurnal rhythm.

For jacked diurnals with mandatory sudden resets... both ambien or restoril work equally great and I have absolutely no problem recommending them for infrequent use to get your body back on a new rhythm.

After a string of nights without the need to quickly turn around for days, I typically will sleep until afternoon and then do what I'm about to do which is go for a long and exhaustive work out with cardio. I'll use the melatonin, etc.. and get to bed around 3-4a.m. and sleep until 9 or 10. By tomorrow night, I'll be able to get to sleep by midnight and am pretty much back on a day schedule though I'll have to resist the intense urge to nap tomorrow afternoon or that will throw me back into nights.

Luckily, we have a lot of docs who prefer nights and so the rest of us don't have to work too many a month.

 

[dchristismi]

Agree with most of the above.

Also, saw a Mythbusters several years ago where they looked at alertness with or without 20 minute "naps." They were specifically looking at the Alaskan crab industry, but I figured it still applied. Even though the majority of people didn't truly sleep during the naps, even a doze in the dark for 20 minutes improved alertness and response times. Hence, I make myself pre-nap at least a little before the first overnight. If it works for crab fishermen, it will probably help me.

I really like the White Noise app. Free, and very customizable with all sorts of sounds. Current favorite is crickets on a low level with crackling campfire at medium. Reminds me of being a kid in the midwest during the summer, and really think it helps. It's a fun app to play with and you can mix and match and customize to your ear's content.
I'm also a big fan of melatonin, as well as a particular tea. (Sunset in Seattle, a blend from Marketspice in Seattle.) Now it isn't my only sleepy tea option, but I do love it.

As far as melatonin, I find it works pretty darn well, although it may also be a bit of a placebo effect, as I take about 5mg at bedtime pretty much nightly. Whether I have simply trained myself to sleep to the taste (it's a dissolving brand) or it's the melatonin, it's part of my sleep hygiene routine.

 

[deleted547339]

Agree with most of the above.

Also, saw a Mythbusters several years ago where they looked at alertness with or without 20 minute "naps." They were specifically looking at the Alaskan crab industry, but I figured it still applied. Even though the majority of people didn't truly sleep during the naps, even a doze in the dark for 20 minutes improved alertness and response times. Hence, I make myself pre-nap at least a little before the first overnight. If it works for crab fishermen, it will probably help me.

I really like the White Noise app. Free, and very customizable with all sorts of sounds. Current favorite is crickets on a low level with crackling campfire at medium. Reminds me of being a kid in the midwest during the summer, and really think it helps. It's a fun app to play with and you can mix and match and customize to your ear's content.
I'm also a big fan of melatonin, as well as a particular tea. (Sunset in Seattle, a blend from Marketspice in Seattle.) Now it isn't my only sleepy tea option, but I do love it.

As far as melatonin, I find it works pretty darn well, although it may also be a bit of a placebo effect, as I take about 5mg at bedtime pretty much nightly. Whether I have simply trained myself to sleep to the taste (it's a dissolving brand) or it's the melatonin, it's part of my sleep hygiene routine.

My only problem is that if I take it without Benadryl, I get really intense dreams. Like, wake up in a cold sweat or in tears intense dream.....

 

[RustedFox]

I don't understand this "melatonin to get to sleep" thing. Its not a sedative/hypnotic; and the studies that I have read don't report any decrease in sleep latency (time from in-bed to asleep); it's a matter of getting more robust, fuller, deeper sleep.

- and I do like the cherry-flavored, dissolving melatonin tabs.

 

[CraftyMed]

1. Dark room (blackout curtains, be sure to hang properly to avoid light leaks on the edges)
2. Light breeze from ceiling fan (bonus white noise!)
3. Cold temps (a/c or by mother nature)
4. Down comforter (weight can vary per season)
5. White Noise app (I prefer "Rain Storm" personally)
6. "Do not disturb" setting on phone (or non-iPhone equivalent)

--I don't use drugs/supplements/alcohol to fall asleep
--I drink caffeine in some form within 1-2 hrs of waking, +/- a cup of tea in the afternoon
--Power nap for 20mins or a 3hr 'pro-nap' before shift

I totally 2nd the needing ans 'understanding family' but that also applies to neighbors, the mailman, and our dogs.

I might start giving the dogs the Benadryl.

 

[engineeredout]

I'm a very light sleeper at baseline and was never the most sound sleeper. In order to sleep during the day, when I transition to a series of night shifts, I will take one ambien (actually breaking a 10mg tab in half) after the first shift to sleep during the day and help myself reset. Ambien for me allows me to sleep the most soundly and not wake up drowsy at all - benadryl and the similar always make me persistently groggy. Works wonders. Part of me wants to take it more often just because I sleep so well, but I don't want to be dependent on it.

 

[DeadCactus]

I don't understand this "melatonin to get to sleep" thing. Its not a sedative/hypnotic; and the studies that I have read don't report any decrease in sleep latency (time from in-bed to asleep); it's a matter of getting more robust, fuller, deeper sleep.

- and I do like the cherry-flavored, dissolving melatonin tabs.

The studies I've seen also have you take the medication hours before bed, not right before.

 

[two guys]

- Blackout curtains (and light sealed doors) for anything but a 6a or 9a shift. I can not see my hand in front of my face.
- Cooler room (fan plus relatively more open or closed ac or heat vents compared to rest of house) and 2 sounds machines (one by door and one by head)
- Set aside 1.2 hrs for every hr I want to actually be asleep if there is any change in the shifts (overnights I try to set aside 10-11 hrs in hopes that I get 8 of good sleep)
- Pre night shift - wake up earlier than usual (6hrs sleep or so), work out hard, eat something fatty (avacodo, bacon, eggs, steak etc), take a shower and lay in dark cold room for 6-8 hours)
- I sleep the 2 hrs before any shift (ie for a 4pm shift I need to be up by 2, so might be up 8-12 and then lay down for a short nap from noon-2)

Trying to exercise every day definitely helps.

An understanding spouse has been a tough bargain, but is easier than understanding toddlers and dogs.

I've been thinking of hanging a heavier bedroom door to keep some of this noise out.

I will take 50 of benedryl if I'm really worried about sleeping. This is usually for flipping back to 6a shifts. I bet I do this about 6 times a year.

Thanks for posting the question, it's an important topic.

 

[exsanguination]

I'm a very light sleeper at baseline and was never the most sound sleeper. In order to sleep during the day, when I transition to a series of night shifts, I will take one ambien (actually breaking a 10mg tab in half) after the first shift to sleep during the day and help myself reset. Ambien for me allows me to sleep the most soundly and not wake up drowsy at all - benadryl and the similar always make me persistently groggy. Works wonders. Part of me wants to take it more often just because I sleep so well, but I don't want to be dependent on it.

I've had good results with ambien 5mg as well for circadian switches

 

[styphon]

The studies I've seen also have you take the medication hours before bed, not right before.

Some people will take 1 cap 1-2hr before bed, and a second cap immediately before bed.

Personally I am stuck on benadryl,25mg, 30 minutes before sleeping. Also, a dark room with windows covered/blinds closed. I live in the countryside, so it provides its own whitenoise which I think also helps.

 

[docdragon]

Orange glasses if up in the sun before day sleep. Ear plugs, eye shades, blackout curtains. Rarely if ever NyQuil. May try melatonin eventually.
My best night shifts ever happen if I work out after nap & before the night shift. Lost the habit for a while but it's time to restart it.
Drink plenty of water at night, rare caffeine as a treat.

 

[RustedFox]

Where does one purchase "blackout shades" ? Or do you create them yourself. I must try this.

 

[d2305]

Amazon has them.

 

[CraftyMed]

Where does one purchase "blackout shades" ? Or do you create them yourself. I must try this.

I've gotten them at Target, Bed Bath & Beyond, and Amazon. Just depends on your needs for window width, length, design, etc. They also make a blackout liner if you want to hang them behind your existing curtains.

Or you can get a thermal liner material at your local crafty/sewing store. A little more work and heavier weight on the curtain rods.

 

[dchristismi]

The studies I've seen also have you take the medication hours before bed, not right before.

Hence the reason I suspect it works for me because it's more the placebo/sleep hygiene/mind-trained-to-go-to-sleep thing than the actual drug. I sleep pretty well most of the time.

 

[two guys]

Where does one purchase "blackout shades" ? Or do you create them yourself. I must try this.

The cheap and easy option is https://blackoutez.com/
- the website is not great, but they are cheap and work perfectly. If you already have blinds they fit between the blinds and the window and look normal. The only downside is you will rarely take them down which might annoy your spouse.

http://www.selectblinds.com/cellularshades/three-eighth-inch-double-cell-blackout-shades.html
Bought these, when out of residency, they don't block out as much light (but close) and make the spouse much happier because they only down for night and evening shifts.

 

[Arcan57]

Throwing my support behind blackout curtains and the White Noise app (Heavy Rain Pouring for me). If you do any strings of nights, blackout shades are a game changer. Managing caffeine intake is important. I find caffeine lasts about 6 hrs for me in terms of preventing sleep. On 12hr night shifts I have a Monster driving into work and then one at 1:30am or so. Will drive home with sunglasses and keep them on until I get into bedroom. If you do use an electronic device in bed, turn the brightness as low as possible. An iPhone or iPad at full brightness seems to mess with the brain's circadian rhythm. For daytime sleep, I also crank the volume way up on the White Noise to help deal with inevitable sonic interruptions. All of this is pretty much undone by having to get up at 6 or 7a the next day (ie working Sunday night then 7a meeting Tuesday) but it worked like gangbusters before kids and admin responsibilities

 

[Promethean]

Melatonin hits some people harder than others. I can't handle broken tablets without risking narcolepsy. That is only a slight exaggeration, and it isn't just placebo. I've accidentally taken one thinking it was something else and I was as knocked out as if I'd taken benadryl (to which I'm also exquisitely sensitive.)

I can't take anything for sleep if I hope to be useful within less than 12 hours. I stay drowsy and sluggish deep into the next shift if I try to do that. What has worked for me is to sleep ASAP at the end of the shift, at least for 2-3 hours. Get up and putter around until early afternoon, and then sleep again until time to go to work. Nothing will be accomplished except for sleep, minimal ADLs, and work during a string of night shifts. It is like those days just disappear out of the calendar entirely.

 

[link2swim06]

If you do use blackout curtain...this is a nice touch...you can make the "sun-rise" anytime you want it (since your room will always be dark).

 

[gamerEMdoc]

Get Cardio exercise daily.

Also, I've sworn by taking provigil (modafinil) for night shifts for years. I don't take it on off days (because I dont care if I'm 100% alert when off). I take it a few hours before a shift, usually before I hop on the treadmill. By the end of my run I'm completely alert and it lasts until the end of my shift. For me, I can go to sleep right after my shift, provigil doesn't seem to mess up my ability to sleep 10-12 hours later, although that has been reported.

I don't like taking hypnotic medications (ambien, etc) to get to sleep. They ruin sleep architecture, and I just never seem to feel rested after taking them.

Eventually, when you are done with residency, if you can find a job where you work all one shift, do it! Obviously, if you only want to work day shift, that job will be few and far between. But if you can adapt to working nights, its insanely helpful to have your circadian rhythm consistent. I almost always go to bed around 3-5am, and almost always wake up between 11am-2pm. No matter if I'm off or working, I stick to that schedule. Staying on the same circadian cycles makes it easy to get to sleep and keep a consistent sleeping pattern.

 

[TheBlueBlazer]

I was turned on to a product called Alteril by a colleague - it's a mixture of "natural" stuff but includes melatonin and tryptophan among others. It seems to work well for me, though I admit that it could all be placebo effect.

 

[Fox800]

If you do use blackout curtain...this is a nice touch...you can make the "sun-rise" anytime you want it (since your room will always be dark).

How well does this work? Thinking about getting one for residency.

 

[link2swim06]

How well does this work? Thinking about getting one for residency.

I don't wake up well to alarms. A bright light seems to work much better for me. I guess for a couple bucks you could rig something similar up with a electrical outlet timer and a lamp.

 

[deleted109597]

Melatonin works, but only for a short period. If you take it and aren't asleep within an hour, you're back where you started. Really high doses can reset your schedule. It won't make you groggy because it's so short acting, but it also won't keep you asleep if you don't fix your other problems (light, temp, etc).
Blackout curtains, a closet, or whatever you want will work. I use hurricane shutters.

 

[WilcoWorld]

Melatonin works, but only for a short period. If you take it and aren't asleep within an hour, you're back where you started. Really high doses can reset your schedule. It won't make you groggy because it's so short acting, but it also won't keep you asleep if you don't fix your other problems (light, temp, etc).
Blackout curtains, a closet, or whatever you want will work. I use hurricane shutters.

This description of melatonin accords very well with my experience.

 

[RustedFox]

Melatonin works, but only for a short period. If you take it and aren't asleep within an hour, you're back where you started. Really high doses can reset your schedule. It won't make you groggy because it's so short acting, but it also won't keep you asleep if you don't fix your other problems (light, temp, etc).
Blackout curtains, a closet, or whatever you want will work. I use hurricane shutters.

Data, please. I ask for two reasons: (1.) I want more data, and will admit to the potential for "placebo effect". (2.) I disagree with the statement that "if you aren't asleep within an hour, you're back where you started". I submit that if taken only during the nighttime hours (that is, when that great hydrogen ball in the sky is not shining down on us), the effect is greater, and measurable. This is unpopular because "we" currently think that nighttime = daytime because we can't identify any variables between the two. I cannot identify any, but I propose that there may be some.

Here's my n = 1.

I have a punishing schedule. I flip between "dayshift-nightshifts-dayshifts" twice a month with predictable regularity. Yes, it sucks. Yes, I complain. Yes, I try to exert influence on my schedulers to stop this practice. Yes, I tolerate it for the time being. Yes.... I have found a clear and measurable difference between "melatonin taken during the hours of 9pm-4am" and "no intervention". I have done this with regularity over three years now.

Your "three-and-five" milligrams of melatonin might as well be "naturopathic" doses. I get more melatonin by closing my eyes and thinking about my mommy.

Guys, guys, guys: I'm telling you my sleep is fuller, even only after 3-5 hours.

 

[deleted109597]

Data, please. I ask for two reasons: (1.) I want more data, and will admit to the potential for "placebo effect". (2.) I disagree with the statement that "if you aren't asleep within an hour, you're back where you started". I submit that if taken only during the nighttime hours (that is, when that great hydrogen ball in the sky is not shining down on us), the effect is greater, and measurable. This is unpopular because "we" currently think that nighttime = daytime because we can't identify any variables between the two. I cannot identify any, but I propose that there may be some.

There is a difference between days and nights in the brain chemistry. It's called "melatonin". Bright light suppresses production. Thus, you should also avoid screen time (or use something like f.lux to reduce the color spectrum of your screen) right before bed.

It's even more comical from you, because when we give data for other clinical conditions, you ignore it as "academic" and not based in reality. And then you proceed to anecdote yet again.

I have a punishing schedule. I flip between "dayshift-nightshifts-dayshifts" twice a month with predictable regularity. Yes, it sucks. Yes, I complain. Yes, I try to exert influence on my schedulers to stop this practice. Yes, I tolerate it for the time being. Yes.... I have found a clear and measurable difference between "melatonin taken during the hours of 9pm-4am" and "no intervention". I have done this with regularity over three years now.

Your "three-and-five" milligrams of melatonin might as well be "naturopathic" doses. I get more melatonin by closing my eyes and thinking about my mommy.

Guys, guys, guys: I'm telling you my sleep is fuller, even only after 3-5 hours.

Low dose isn't naturopathic. It helps with sleep onset (hence the short period). Short period doesn't mean it only works for a couple weeks. It will probably work forever if you only take it at bedtime. You can't take it like viagra, and hope to fall asleep at the drop of a hat 4 hours later. It works best in time durations of less than an hour. High doses can reset your sleep schedule unlike low doses. Works great for jet lag too.

 

[RustedFox]

There is a difference between days and nights in the brain chemistry. It's called "melatonin". Bright light suppresses production. Thus, you should also avoid screen time (or use something like f.lux to reduce the color spectrum of your screen) right before bed.

It's even more comical from you, because when we give data for other clinical conditions, you ignore it as "academic" and not based in reality. And then you proceed to anecdote yet again.


Low dose isn't naturopathic. It helps with sleep onset (hence the short period). Short period doesn't mean it only works for a couple weeks. It will probably work forever if you only take it at bedtime. You can't take it like viagra, and hope to fall asleep at the drop of a hat 4 hours later. It works best in time durations of less than an hour. High doses can reset your sleep schedule unlike low doses. Works great for jet lag too.

The difference, Dr. McSnarky... is that I'm not going to sue myself for harm caused by an "academic" argument that doesn't hold up in real life. Therefore, I am free to make whatever arguments (academic, anecdotal, or whatever) I would like... Also, I'm the one championing my anecdotes in BOTH arguments as 'real life examples'.

Yes, I am aware of the difference between night and day in terms of melatonin production. I am asking for data because I am not myself clear on the precise timing, bioavailability, or pharmacokinetics of supplemental oral melatonin. I have not read anything thus far (and I have only read few studies) that states that melatonin causes "drowsiness" or works on sleep latency (time from in-bed to out-cold). Furthermore, I have never felt that my sleep latency is shorter after melatonin. Again, I admit to the possibility of a placebo effect; but in my experience - my sleep is more robust.

 

[WilcoWorld]

It's funny, I consider myself pretty evidence based, but when it comes to melatonin I don't want to know the evidence. If it's a placebo effect that's helping me get to sleep, I'd prefer to remain ignorant.

 

[deleted77919]

…

 

[two guys]

12 hour night shift after a stretch of days (so no ability to advance schedule slowly). Up for over 24 hours. 3 hours sleep before neighbors decide this is an ideal time to cut down multiple trees with very loud chainsaws.

Any tips for sleeping through chainsaws?

I realize your question was in jest,

But, it is a reasonable goal to be able to sleep through chainsaws, garbage truck, leaf blowing, neighbors playing basketball in their driveway, etc.

Blocking outside noise is pretty easy. Most of it comes through windows. Blackout shades plus something else (blinds, roman shades, heavy curtains) do a lot to block noise. Bed placement, choice of room, better windows, better doors, and owning a house with a big yard and a lot of trees all help. If you live close to a particularity loud neighbor, don't pick the room facing them to be your bedroom (or at least position your bed on a different wall). Some of these are not possible for everybody due to location, space or spouse constraints. But, I think most people would have less "chainsaw interruptions" if they used white noise, fans, blackout shades and curtains. Inside noise is a little harder because it can come through vents and interior doors. Door sweeps on each side of a door and foam insulation can do a lot to seal out interior noise (and getting a solid core door).

The only thing that I can definitely not sleep through is work on my roof. I've got most of the other noises insulated against.

It sounds crazy to most folks, but considering sleep hygiene when you buy a house seems pretty reasonable to me.

 

[deleted77919]

…

 

[WilcoWorld]

I realize your question was in jest,

But, it is a reasonable goal to be able to sleep through chainsaws, garbage truck, leaf blowing, neighbors playing basketball in their driveway, etc.

Blocking outside noise is pretty easy. Most of it comes through windows. Blackout shades plus something else (blinds, roman shades, heavy curtains) do a lot to block noise. Bed placement, choice of room, better windows, better doors, and owning a house with a big yard and a lot of trees all help. If you live close to a particularity loud neighbor, don't pick the room facing them to be your bedroom (or at least position your bed on a different wall). Some of these are not possible for everybody due to location, space or spouse constraints. But, I think most people would have less "chainsaw interruptions" if they used white noise, fans, blackout shades and curtains. Inside noise is a little harder because it can come through vents and interior doors. Door sweeps on each side of a door and foam insulation can do a lot to seal out interior noise (and getting a solid core door).

The only thing that I can definitely not sleep through is work on my roof. I've got most of the other noises insulated against.

It sounds crazy to most folks, but considering sleep hygiene when you buy a house seems pretty reasonable to me.

Sleepability was one of the top priorities for me when house shopping.

 

[deleted109597]

Clearly my post was made in a moment of irritation, but it was also somewhat serious. Appreciate the tips.

Has anyone considered lining their bedroom with acoustic foam and turning your sleeping space into a soundbooth of sorts? If only I could convince my wife...

Find a closet that is interior walls only and a register for A/C. I've got one, and although I don't need it, I could probably sleep through an atom bomb in it if I needed to.

 

[RustedFox]

Clearly my post was made in a moment of irritation, but it was also somewhat serious. Appreciate the tips.

Has anyone considered lining their bedroom with acoustic foam and turning your sleeping space into a soundbooth of sorts? If only I could convince my wife...

I did not consider "sleepability" when shopping for my present home. I have got some work to do, too. Fortunately, I have a very understanding spouse.

Regarding the foam thing; I have a buddy out in LA that has done precisely that. I went to visit him in August, and he has his daughter's nursery doubling as his "blackout room". Foam on the windows, towel stretched out by the bottom of the door to block even THAT sliver of light. I'm not as sensitive as he is to sleep-disruptors, but it was genius what he did.

 

[Traumahawk]

A few tips and hints from a 6-year veteran of the midnight shift:
* If you rotate between days and nights, batch schedule your nights whenever possible. "Broken time" (shift on, shift off) on a midnight schedule is murder. I work straight 1800-0630, in a 6-on, 7-off rotation.
* Except in severe inclement weather (thunderstorms or snow/ice), I bicycle commute to work. 45 min of cardio on either side of a shift does wonders for stress reduction --> sleep quality. If weather doesn't permit the bike option, I run the dogs for 2-3 miles before work and hit the gym after. Nothing too ridiculous unless I'm trying to burn off excess "mad" from a rough shift... then I'll pick up a martial arts class or do a WOD featuring sledge throws or medicine-ball slams.
* My caffeine cutoff is 3 hours before end of shift (4-5 hours before bedtime). I typically drink tea at work (hospital coffee = ). Never been a fan of energy drinks; I just don't care for the taste.
* Avoid CNS depressant agents (EtOH, diphenhydramine, zolpidem, eszopiclone, etc) while post shift, either for sleep assistance or social lubrication. Chamomile tea is about as neurochemically invasive as I like to get. "Eggs & Kegs" breakfasts after a knock-down-drag-out shift are fun, but I always sleep like garbage that day and feel sluggish all the next afternoon and night.
* Agree with the recommendation for a 2-3 hour "pro-nap" the afternoon before starting a midnight series, and a power nap (20-30 min) somewhere in your shift. Power naps are a game changer for midnighters. When I get home, I usually go to bed around 0830-0900 and sleep till 1500 or so, since I need to be on the bike or in the shower by 1615 for on-time arrival.
* Coming off a shift series, I go to bed at my usual time, set an alarm to wake up at 1200, then stay up till 2200 or so.
* Since the window treatments in my room won't accommodate blackout curtains, I wear a blackout mask and turn on the ceiling fan for white noise and air flow. Open windows are fine at night, but during the day they result in a nonstop symphony of lawn equipment. In the event of neighbors with chainsaws , I'll take my sleeping bag and air mattress in the basement, which is dark, constant temperature (65 F year-round) and more or less soundproof.