not a morning person, any tips for intern year?

[lotus]

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Hi all,

I have always been the kind of person who likes to stay up late
and sleep late. Obviously, for intern year and most of residency,
this will not be a option. Any tips or survival strategies to share?
Getting less sleep isn't really an option. This is for an internal med
residency.

Thanks!
Lotus

 

[NinerNiner999]

Sorry - you're hosed.

 

[swpm]

I have always been the kind of person who likes to stay up late
and sleep late. Obviously, for intern year and most of residency,
this will not be a option. Any tips or survival strategies to share?
Getting less sleep isn't really an option. This is for an internal med
residency.

Sounds like you already have the answer: go to bed early. 🙄 🙂

 

[Kingora]

Sounds like you already have the answer: go to bed early. 🙄 🙂

1. Dont sleep comfortably:that leaves u with a chair infront of the TV or computer.
2. Leave the TV,radio or comp on.
3. When you hear the alarm,make sure music you like is playing loudly.

you'll be groggy and incoherent the rest of the day as your going 4 ur rounds

 

[lloyd braun]

How did you make it through medical school on the wards, particularly your surgery rotation? Just do the same thing. Seriously, I think your body will adjust, and you will start to get tired around 9 PM. Good luck!

 

[MBK2003]

Starbucks

 

[colbgw02]

Cocaine's a helluva drug. - Rick James

 

[lotus]

Thanks for responses, yes, I've been able to adapt with caffiene and sleeping
early for short term periods (on clinical rotations), I guess I'm worried that I'll have problems over the longer term (several years), but it sounds like most people's bodies adapt to the new schedule. I guess I just needed
encouragement from other non morning people that it can be done 🙂

lotus

 

[Long Dong]

Hi all,

I have always been the kind of person who likes to stay up late
and sleep late. Obviously, for intern year and most of residency,
this will not be a option. Any tips or survival strategies to share?
Getting less sleep isn't really an option. This is for an internal med
residency.

Thanks!
Lotus

I feel your pain and have the same problem.

 

[McGillGrad]

Start working out with weigts every day. You will have no problem going to sleep early.

 

[Mirror Form]

coffee is the solution, lots of it!

 

[SLUser11]

Hi all,

I have always been the kind of person who likes to stay up late
and sleep late. Obviously, for intern year and most of residency,
this will not be a option. Any tips or survival strategies to share?
Getting less sleep isn't really an option. This is for an internal med
residency.

Thanks!
Lotus

I was similar in my sleep schedule up through the end of my MS2 year. Honestly, it's just about growing up. You have to learn to do things you don't like. Nobody is a "morning person" when it's referring to 4:30am.

As for having problems going to sleep, you need to practice good sleep hygiene (no TV in bed, no late snacks or caffeine drinks, etc). You'd be surprised how much of a difference this can make.

When sleep hygiene fails you, you can always progress to benadryl and gin. That helped me a lot early on......

Start working out with weights every day. You will have no problem going to sleep early.

Just looking at your AV this kind of caricatures your personality. I don't disagree, and I think exercise is important, but now I have the idea in my head that this is your solution to everything.

Post: My attending gave me a bad review. What should I do?

you: Have you tried working out with weights?


Post: Any suggestions for the surgery shelf?

you: Lift weights.

 

[Legion560]

Contrary to the above, you are not hosed. Your body will adjust for sure. What helps me stay alert is to do interval cardio in the morning. Try a search on HIIT (high intesity interval training). Pick your poison of stairmaster, bike, treadmill or street. If you can drag yourself out of bed, ten minutes of high intensity cardio will keep you on fire for the rest of the day. No need for caffeine.

Legion

 

[Legion560]

Contrary to the above, you are not hosed. Your body will adjust for sure. What helps me stay alert is to do interval cardio in the morning. Try a search on HIIT (high intesity interval training). Pick your poison of stairmaster, bike, treadmill or street. If you can drag yourself out of bed, ten minutes of high intensity cardio will keep you on fire for the rest of the day. No need for caffeine.

Legion

Also, use stimulants wisely. Caffeine products and the like (ephedra, thermogenics etc) will keep you high for a period of time, and then you will crash and feel like ****e. Its better in the long run to stay awake by regulating your sleep cycles and eating a healthy diet before solving problems with triple shot lattes.

Legion.

 

[LukeWhite]

Provigil. Approved for shift work, minimal side effect profile (gentler than caffeine) and no addictive potential. Insurance probably won't cover it and you'll end up paying $6 a pill ($2 if you get Modalert from India) but the bright-and-early wakefulness and increase in concentration makes it a valuable investment. I'm coming to the conclusion that it's almost immoral to do medicine without it.

 

[McGillGrad]

Just looking at your AV this kind of caricatures your personality. I don't disagree, and I think exercise is important, but now I have the idea in my head that this is your solution to everything.

Post: My attending gave me a bad review. What should I do?

you: Have you tried working out with weights?


Post: Any suggestions for the surgery shelf?

you: Lift weights.

Haha!

I was afraid that it might sound too simplistic.

😀

 

[swpm]

Provigil. Approved for shift work, minimal side effect profile (gentler than caffeine) and no addictive potential. Insurance probably won't cover it and you'll end up paying $6 a pill ($2 if you get Modalert from India) but the bright-and-early wakefulness and increase in concentration makes it a valuable investment. I'm coming to the conclusion that it's almost immoral to do medicine without it.

I have to disagree.

For someone who likes to stay up late and sleep late the solution isn't a prescription drug like Provigil or even an OTC drug like caffeine. It's changing your sleeping habits to reflect the life you've chosen. It's easy to get up at 4 AM if you go to bed by 9 PM.


To back off on my snarky attitude just a little bit, I'll add that as an undergrad I was as much a stay-up-late and sleep-late person as anyone ... to the point that I'd frequently hit the snooze button several times through my horribly early 8 AM classes. 🙂 And then, one day, I figured out that there really wasn't anything I just had to do at 11 PM or 1 AM. So I got in the habit of going to bed early. These days, I share my elementary-school-aged kids' bedtime, and I'm never ever tired during the day.

Granted, I'm an anesthesia resident whose work hours typically top out around 70/week, not some self-flagellating "getting under 80 requires falsifying my log" medicine or surgery glutton for punishment.

 

[LukeWhite]

Of course you know it's not as simple as going to bed early. There's a reason Provigil snagged FDA approval for an indication as nebulous as "shift work": circadian rhythms are important. Some folks are just not morning people, and early to bed does not guarantee early to rise. We can quibble about whether the use of stimulants is wise (provigil, incidentally, isn't really a stimulant). Getting to work at 6 AM, however, is and always will be physiologically unnatural for some people. And we are in a profession that looks rather kindly on pharmaceutical solutions to suboptimal physiology.

 

[swpm]

Of course you know it's not as simple as going to bed early.

Oh, but sometimes it is. I'll stand by my opinion. If it's hard to get up early because you're a person who likes to stay up late, the problem is poor sleep hygiene, not a Provigil deficiency.

Your point about circadian rhythms is well taken, but there is nothing "physiologically natural" about a self-inflicted rhythm consisting of a many-hours-after-dark bedtime and a many-hours-after-dawn wakeup.

Irregular call schedules, true shift work that requires one to frequently alter sleeping habits, shifts >24 hours ... that kind of disordered sleep stress is what Provigil is approved for. Not daytime sleepiness caused by "I wanna watch Letterman tonight, even though I've gotta be in to preround at 4:30."

 

[LukeWhite]

A not insignificant number of people have circadian rhythms that favor nocturnality. This isn't, as far as I know, in dispute. A tendency to stay up late and sleep late that has lasted over the person's lifetime is a not-bad indicator that we might have a case of this here.

So in light of that, what's your beef with the drug? If the risks outweigh the benefits, obviously it's a bad idea. If the benefits outweigh the risks, where's your quibble? To dismiss wholesale the complaints of everyone who "likes to stay up late and sleep late" as the symptom of poor sleep hygiene isn't particularly helpful.

 

[Flopotomist]

I am just a lowly med student, but I too am a night person, and I too am finding that my natural sleep desires are incompatible with med school. Some things that I am finding helpful:

1. Make yourself wake up on the weekends / or days off. It sounds like horrible torture, but by forcing yourself to stay in the same schedule, it makes it a bit easier.

2. I avoid caffeine after about 12:00 noon. For some reason, once I eliminated caffeine in the afternoon, it made it easier for me to go to bed later - not sure if caffeine just breaks down super slowly in me or what.

3. A bit of light excercise in the afternoon (I hate excercise too, so I have to disguise it in the form of a game of racquetball or a jog on the treadmill while watching TV).

4. Set your sleep environment up so you get REALLY good sleep when you do sleep. Make the room very dark. Get earplugs so it is very quiet. Don't do anything in bed but sleep (or sex I guess if you are the sort that is getting some). No lounging in bed, no TV in bed - get yourself to mentally associate the bed with sleep.

5. No high intensity mental activity for half an hour before bed. In fact - try to avoid even something like TV or the Internet for half an hour before bed. For some reason, this worked for me in a big way. I just do a bit of recreational reading, or something brainless. Helps me slow down and mentally prepare for sleep.

Good luck! I don't even need an alarm clock now to get up at 7:30 (which of course is not 4:30...but I don't have to get up that early yet). I was used to waking up at 11-12 for many years before med school, so this has been quite a shift.

 

[blanche]

Not daytime sleepiness caused by "I wanna watch Letterman tonight, even though I've gotta be in to preround at 4:30."

yesss! finally someone who understands our pain.

as an aside, i find the central time zone espeically appealing in this regard b/c i can watch the daily show and conan an hour earlier, but still feel true to my nocturnal self. i don't care if people think i sound lazy, i never am as efficient work-wise as when it's dark and quiet out. i've cranked out some of my best work after 2 AM. i can't wait to start night float as a resident.

 

[Hard24Get]

I am just a lowly med student, but I too am a night person, and I too am finding that my natural sleep desires are incompatible with med school. Some things that I am finding helpful:

1. Make yourself wake up on the weekends / or days off. It sounds like horrible torture, but by forcing yourself to stay in the same schedule, it makes it a bit easier.

2. I avoid caffeine after about 12:00 noon. For some reason, once I eliminated caffeine in the afternoon, it made it easier for me to go to bed later - not sure if caffeine just breaks down super slowly in me or what.

3. A bit of light exercise in the afternoon (I hate excercise too, so I have to disguise it in the form of a game of racquetball or a jog on the treadmill while watching TV).

4. Set your sleep environment up so you get REALLY good sleep when you do sleep. Make the room very dark. Get earplugs so it is very quiet. Don't do anything in bed but sleep (or sex I guess if you are the sort that is getting some). No lounging in bed, no TV in bed - get yourself to mentally associate the bed with sleep.

5. No high intensity mental activity for half an hour before bed. In fact - try to avoid even something like TV or the Internet for half an hour before bed. For some reason, this worked for me in a big way. I just do a bit of recreational reading, or something brainless. Helps me slow down and mentally prepare for sleep.

Good luck! I don't even need an alarm clock now to get up at 7:30 (which of course is not 4:30...but I don't have to get up that early yet). I was used to waking up at 11-12 for many years before med school, so this has been quite a shift.

Get married. Sex is probably the easiest way to fall asleep early.

Also, exercise in the morning really helps me to wake up - I don't even need caffeine on most days. And, of course, you could switch to EM - the shifts don't start that early and you get to stay up all night 😉

 

[elizabeth5863]

I'm a night owl and have a hard time waking up in the morning too. I chew gum to help me stay awake in the morning during rounds and early morning lectures. I've seen a lot of residents chew gum and started doing the same. It helps a bit.

 

[mig26x]

you can be part of the night float team all year round!!!! LOL.

 

[colbgw02]

Hard24Get, I think you forgot the word "ridiculously" in your Zoolander quote.

 

[Hard24Get]

Hard24Get, I think you forgot the word "ridiculously" in your Zoolander quote.

Thanks. I pasted it from somewhere, but your version seems more accurate. 😉

 

[nacho77]

Fellow "night person" here ... and I really DID think that intern year would tire me out enough to help me fall asleep at a reasonable time - but ya know, it didn't ... even if I got close, I'd finally get that one day off and screw the whole sleep cycle up again ... of course there were plenty of times that I crashed when I got home and slept for an hour or two - of course, then I'd wake up hungry and need to fix dinner at 10pm and not really get back to sleep very well ...

I guess what I'm trying to say is DON'T do what I did - the advice above is good: keep an exercise schedule and practive good sleep hygiene ... (and if you need benadryll once in a while thats OK too)

BUT - either way, you'll find a way to make it through and before you know it you'll be at the end of the year and be pre-rounding for the LAST TIME (like I did today!!! gotta love ending on elective)

Good Luck!

 

[ekydrd]

I must say that as an above average aged resident (OK, I'm old) I found it hard initially to keep the early wake time, but now I am awake at 5am whether I need to be or not. Guess after two years of residency I've now become a morning person (but don't expect any cheerful "good morning"'s).

 

[lowbudget]

Buy an analog clock, rotate it 90 degrees to the right, and go to bed when the hands are up and down.

Or, smoke crack rock and just stay awake all night. All your patients are doing it.

 

[ajce9]

Have your girlfriend wake you up in the morning. 😀😍😱

 

[deleted113029]

Starbucks

coffee is the solution, lots of it!

anyone who knows me knows that I 😍 caffeinated products. However, I came across some interesting info as to what gets people going in the morning.

Coffee is no way near the best way to wake up. There is always some lag...kinda like a turbo system. An apple will wake you up better than caffeine and the best thing is a GRAPEFRUIT!

Regardless of this new info, i will continue to drink anything caffeinated supplemented with apples and grapefruit.

 

[radonc]

Get married. Sex is probably the easiest way to fall asleep early.

i thought that being married decreased your sex life...and you dont have to be married to have sex on a daily basis...

 

[werewethere]

Volunteer for 12 months of night float as an intern.

 

[Hard24Get]

i thought that being married decreased your sex life...and you dont have to be married to have sex on a daily basis...

Well, many of us don't have time to run out and get some each night. As for your other suggestion.... it depends on the marriage, honey. 😉

 

[thewebthsp]

Surgery.... that's when I was chronically on 2 hours of sleep for 2 weeks straight... probably not good for my future mental function

A good sleep schedule is very important... Provigil is ok short term, but doesn't it have a higher odds ratio for cardiac arrest when used long term??

 

[tum]

Well, many of us don't have time to run out and get some each night. As for your other suggestion.... it depends on the marriage, honey. 😉

go starr!

 

[Adcadet]

2. I avoid caffeine after about 12:00 noon. For some reason, once I eliminated caffeine in the afternoon, it made it easier for me to go to bed later - not sure if caffeine just breaks down super slowly in me or what.

The half life is variable, but probably 3 hours on the low end assuming your not pregnant or in liver failure. Perhaps you're just not very tolerant. How's your P450 1A2?

 

[Kingora]

Yeah sex,masturbating etc. After sex or masturbating your prostaglandins increase which normally thicken your blood(normally blood thickening leads to comas i.e hematomas subdural/epidural).
In no time you will be asleep i asure you, porn is good for guys if you need to wake up early, have tried it works

 

[Kingora]

Hard24get is right i had forgotten exercise

 

[MossPoh]

Not even a med student, but I do wake up at 5 a.m. every morning. I think I'm a bit more of a morning person than most though. I don't even need an alarm. Anyway, some form of exercise is good to exhaust energy, avoiding caffeine as stated and just force yourself to go to bed early. It gets surprsingly easy after a while..as a side note I only sleep about 4 hours a night, and then a 20 minute power nap during the day...so I'm a little different. (I catch up all in one or two days though)

 

[deleted4401]

I don't know, maybe you can just continue what you are doing. I'm a night person, and during internship, I hated getting up early and I was pretty fried usually, b/c I couldn't fall asleep at night, so I tended to get 5-6/night. Granted, I did prelim medicine not surgery, but I still hate sleeping early and waking up early. I think caffeine is a great idea, eating a good breakfast always helped, and maybe closing your eyes a bit at noon conference if possible. Then, when you get a day off, do your thing that evening and sleep in hard the next day. If you are on a rotation with weekends, really pound out the hours on the weekends. I think the medical literature says that "sleep banking" doesn't exist, but it works for me. I guess my mentality is that it was better to continue doing what felt right (staying up late, going out sometimes on weeknights) and suffer in the morning, while catching up on weekends. I think sex is a great idea to help you sleep if an option and 'playing solitaire' is not a bad idea, either. I think it gets better during PGY-2/3, and when you're an attending, you can go in later as long as your willing to deal with the consequences (maybe less money, maybe working later, eye rolls from the hard core guys).

-S

 

[Blade28]

Start going to bed earlier - by 8 or 9 or 10 if that's what it takes. I used to be a night owl during college/early med school also, but that kind of lifestyle just doesn't work in most residencies.

I've never been one to use caffeine much, and I've also found that when I have a big cup of coffee in the morning, I have a tendency to get a little too jittery...bad for the OR!

 

[shantster]

I agree with the high intensity exercise in the morning and getting to bed earlier. Also make sure that you turn on all the lights in the room you are in. The lights and exercise will help you release hormones to wake you up.

 

[Flopotomist]

The half life is variable, but probably 3 hours on the low end assuming your not pregnant or in liver failure. Perhaps you're just not very tolerant. How's your P450 1A2?

OK.. as a resident, don't go scaring us med students making us think we need to check our P450 1A2. We are already hypochondriacs without thinking that something is wrong with us if caffeine keeps us awake.

(half life of caffeine can go up to almost 8 hours though - no?)

 

[dynx]

An apple will wake you up better than caffeine and the best thing is a GRAPEFRUIT!

yeah, one quick squirt to the eye and Im awake for the whole morning.

The solution is to go to bed early, if you get yourself in a good cycle you won't like getting up in the morning but at least you won't be functionally ******ed when you get out of bed. BTW, If you're not going into surgery...quit yer bitching.

 

[axm397]

could try melatonin to reset sleep cycle - take 30min-1hr before the earlier bedtime you are trying to get used to. It helps some people.