“There just aren’t enough hours in the day.” You’ve probably heard this uttered many times. Nurses who are balancing work, home and friendships have so many things on their daily to-do list, sleep is often viewed as being the one variable they can change. Sleeping less at night creates more time in the day to get things done. “I’ll sleep when I’m dead,” they think.
The problem is, this personal mantra could put you in your grave sooner rather than later. Science does not yet have the full answer about why we sleep, but evidence is mounting that critical functions paramount to maintaining good health occur during sleep.
Fatigue Can Kill
The American Academy of Sleep Medicine reports that adults should regularly be getting 7 or more hours of sleep per night, but 2014 data from the Centers for Disease Control and Prevention (CDC) show that a whopping 83 million Americans (1 in 3) report sleeping 6 hours on average.
SEE ALSO: Earn CE: The Importance of Sleep
This is a scary statistic when you consider that insufficient sleep is associated with a broad range of health and safety risks, including vehicle crashes and other types of accidents, worker errors, obesity, bad moods, various chronic diseases (i.e., heart disease, diabetes and cancer), and premature death.
“NIOSH Training for Nurses on Shift Work and Long Work Hours,” a free, comprehensive online program launched by the National Institute for Occupational Safety and Health in May 2015, aims to educate nurses about the deleterious effects of not getting enough sleep. NIOSH reported that being awake for 17 hours is similar to having a blood alcohol concentration (BAC) of 0.05%, and being awake for 24 hours is similar to having a BAC of 0.10%. The United States defines “legal intoxication” for purposes of driving as a BAC of 0.08% or greater, but driving impairments occur at a BAC of 0.05%. In some countries, 0.05% is the “drunk driving” cutoff.
Equate Sleep with Water
“Nurses wouldn’t dream of going to work drunk, but they may not realize going to work without enough sleep could cause them to perform the same way,” said Claire C. Caruso, PhD, RN, FAAN, a research health scientist at NIOSH and the lead author on the above-referenced training program. “Sleep is not a luxury, it’s a necessity. Not getting enough sleep can negatively impact job performance.”
Marquetta Flaugher, PhD, ARNP-BC, RN-BC, who practices in the sleep disorders clinic at Bay Pines Veterans Affairs Medical Center in Florida, agreed. “Sleep is a crucial component of good health,” she noted. “It’s as important as drinking water and breathing.”
Caruso said NIOSH created its online training program because “This is vital information that nurses need to know, so they can improve their sleep practices. Their health and safety, as well as the safety of their patients, should improve as a result of better sleep.”
Night Shifters Fight Mother Nature
Now factor 12-hour shifts and night shifts into the equation. According to data from the 2010 National Health Interview Survey, more than 50% of healthcare night shift workers report getting 6 hours of sleep per night (or less) on average-much higher than the percentage given earlier for Americans working typical 9-to-5 shifts.
“Working the night shift is a problem unto itself,” Flaugher commented, because you are fighting the body’s natural circadian rhythms, which are internally-driven cycles of biochemical, physiological and behavioral processes that spur feelings of wakefulness and sleepiness.
According to the NIOSH training program, the light/dark cycle of the sun is the body’s strongest cue for circadian rhythms-bad news for night shift nurses. If your circadian system has not adjusted to working at night and sleeping during the day, the circadian rhythms that drive wakefulness will continue to rise during the daytime (pushing you to be awake) and will fall at night (pushing you toward sleep).
“Night workers might fall asleep quickly, but they will struggle to remain asleep. Noise or minor discomfort can awaken them easily, because of the circadian rhythms pushing them toward wakefulness,” Caruso explained. “Although they don’t feel refreshed, they might have difficulty falling back to sleep. Conversely, during their night shift, a nurse’s circadian rhythms will start causing strong feelings of sleepiness, especially between 2 a.m. and 6 a.m.-just as the nurse is driving home.”
How do you prepare for battle when you’re fighting Mother Nature? Both Caruso and Flaugher agreed on this: You must prioritize, prepare and plan for sleep. “It’s not going to occur naturally,” Flaugher remarked.
Secrets to Better Snoozing
Even if you are stuck with a schedule that isn’t optimal for sleeping, there are steps you can take to get sounder, more restorative shuteye.
• Keep a consistent sleep schedule. Go to bed each night and rise each day at the same time-even on your days off.
• Create a bedtime ritual. This might include a warm bath or shower (the rise, then fall in body temperature promotes drowsiness), listening to soothing music or reading (preferably with the lights dimmed). Doing the same things every night alerts your body to the fact that it’s time to wind down.
• Prepare your bedroom. Make it dark (you shouldn’t be able to see your hand in front of your face), comfortably cool (adjust room temperature, bed clothes and covers so you are not too cold or too warm) and quiet (earplugs and white noise machines can help). Eliminate the clutter. Your resting zone shouldn’t resemble your cubicle at work, a daycare, or a zoo. Kick computers, paperwork, files, televisions, pets and kids out of your bedroom.
• Unplug electronics one hour before bedtime. WebMD reports that small amounts of light from these devices pass through the retina into the hypothalamus (the area of the brain that controls several sleep activities), delaying the release of the sleep-inducing hormone, melatonin. Turn that clock-radio so it isn’t facing you as well-yes, its bluish light really could be keeping you awake.
• Avoid caffeine, nicotine and alcohol. The half-life of caffeine (the time it takes to eliminate half of the caffeine consumed) is generally 5 to 6 hours, but it can be much longer. Remember that caffeine is found in coffee, tea, chocolate, cola and some pain relievers. Nicotine is also a stimulant, so plan to have that last cigarette at least 3 hours before bedtime. Alcohol, which initially makes people feel drowsy, causes sleep disturbances and awakenings, and decreases the quality of sleep later in the night so you will not feel refreshed when you wake up.
• Exercise early. Getting enough exercise is important for both falling asleep with ease and staying asleep, but timing is crucial. If working out early in the day isn’t an option, finish exercising at least 3 hours before bedtime.
• Don’t go to bed starving-or stuffed. If you do, your own discomfort might interfere with falling asleep. Likewise, drink enough water to avoid waking up thirsty but limit it so you don’t need middle-of-the-night bathroom breaks.
• Nix napping. Your afternoon siesta might be the reason you can’t fall or stay asleep. If you must nap, keep it short (between 10 and 30 minutes) and make sure you get your shuteye in the early afternoon.
What is Flaugher’s best advice for falling asleep? “Pick up a boring book,” she laughed. “You’ll never fall asleep reading the latest thriller. But just try to get through that book on geology!”
Anne Collins is a staff writer. Contact: email@example.com.