Authors: Anna M. Bonner, BA, R. EEG T., RPSGT, and Pat Lordeon, R. EEG T., FASET
We used to think that the responsibility of shifting work schedules from days to nights primarily impacted nurses and sleep techs, but with the increased use of continuous EEG monitoring in epilepsy and in the ICU, more and more neurodiagnostic technologists are finding themselves working variable shifts. This edition of the ASET News Tech Tips is focused on providing tips for shifting shifts, so you can be your best for your patients and yourself, safely and effectively.
CONSISTENCY & DISCIPLINE
When not at work, and especially on days off, it is important to make sleep a priority. The Sleep Foundation1, the American Academy of Sleep Medicine2 and the Centers for Disease Control3 recommend that healthy adults aim for 7–9 hours of sleep within a 24-hour time period. It is important that you, your family and/or roommate(s) understand the demands that working night shifts can have on your body and mental health. You must be physically ready and mentally focused when you are at work. Your patients and coworkers depend on you to be prepared.
If you work a regular night schedule, you will want to train yourself to sleep, which takes discipline. While it is recommended that you maintain the same sleep-wake scheduled on your days off as your days on4, many technologists find that they have to shift between working nights and days, so keeping the same schedule isn’t always possible. Never go to work without getting some sleep the day before. If you are able to obtain only a few hours of sleep during the day, a 90-minute nap before a shift could be beneficial in getting you through the night. The goal is 7–9 hours per day, so if you must break it up into more than one sleep session, doing so can help you make strides to reaching this goal.
PREPARE YOURSELF A SLEEP SANCTUARY
Preparing for sleep is important, both mentally and physically. First, the physical: Keep your bedroom tidy and linens clean. Block out as much light as possible, using black-out curtains or a sleep mask or both. Keep the room temperature cool and comfortable. Often, a noise machine or app (such as the Rain, Rain App) or a fan is helpful to buffer outside noise, or use ear plugs if necessary. Avoid using your phone as your alarm and use a regular clock instead. Doing so will help you avoid the temptation of checking emails, texts, social media, and news. If you insist on keeping your cell phone nearby, at least turn off all notifications so your sleep will not be interrupted.
Now, the mental: Follow a routine and keep it consistent. Whether it is to go to bed right after a shift, or allowing yourself a few minutes to wind down, keep it consistent so you can ‘train’ your body and brain to sleep on demand. Practice relaxation exercises, such as light stretching, or meditation to help you relax, if needed. Many people relax by reading but beware of reading by an electronic device5. Blue light emitted from electronics and energy-efficient (LED) lightbulbs is beneficial during waking hours because it boosts attention and suppresses your body’s secretion of melatonin, a natural sleep-promoting hormone that influences your circadian rhythm, but it can interfere with your body’s ability to sleep if you are using an electronic device before sleeping.
- LIGHT THERAPY & MELATONIN
Just as light avoidance is necessary for good sleep, a lighted workstation is important to get you through the night shift. Your sleep-wake cycle depends on it6. Lamps or lighting with intensity of 1,200–10,000 are the most effective. In fact, light is the “strongest entraining agent of circadian rhythms,” and the American Academy of Sleep Medicine (AASM) provides guidelines on using light therapy for the treatment of circadian rhythm sleep disorders7. Whether you work from home as a remote monitoring tech or in a facility, keep the lights brightly lit during your shift to help you stay focused and alert, but avoid light, especially blue light from devices, before trying to sleep. If you travel to and from work, wearing sunglasses during your commute home will help with the transition from work to sleep.
Some night shift workers take melatonin supplements or other sleep-promoting medications to help them sleep. However, it is important to know that melatonin supplements are not regulated by the FDA, which means some products could carry impurities or specify improper dosages. It is always advisable to seek the advice of your doctor before using these products.
POWER NAPS & POWER BREAKS
Never skip a break – whether it is for a quick nap, exercise, or to eat something nutritious. Numerous sources recommend a 10- to 20-minute nap during a work break to provide you with a quick energy boost 8, 9, 10. Always make sure to set an alarm and do not allow yourself to sleep for more than 20 minutes. Also, be sure to check your facility’s policy on napping. If a nap is not an option, consider exercise for an energy boost; jumping jacks, a quick jog around the parking lot, anything to get the heart rate up and your adrenaline pumping will help.
Important: If you drive to work, especially if you have a long commute or face early morning rush hour traffic on your way home, a quick power nap before you leave work could be essential, not only for your safety, but the safety of other drivers and commuters.
NUTRITION & HYDRATION
It is important to eat well and avoid heavy, refined carbohydrates and sugar. Providing yourself with the fuel you need will help you stay more alert and aware throughout your shift. Many night shift workers choose to eat smaller, more frequent meals, but it is important that if you choose to do the same, eat lighter, healthy meals. Frequent eating, especially of sugary or carb-heavy foods keeps the body’s insulin levels up, which contributes to diabetes and obesity. Best foods for night shift workers are high in proteins and low in fat. When you think of proteins, don’t just think meat, which can often include high fat content. Plant-based proteins are a great source and contain essential minerals and vitamins necessary for overall good health.
Dehydration is often a source of fatigue, affecting mood and job performance. Keep water on hand and load up on fruits and vegetables, which also serve as great sources of hydration. Use caffeine in moderation, limiting it to the beginning of your shift, and not to power you through it. Avoid caffeine 3–4 hours before you plan to sleep.
Overall, whether you are working the second, third, or the regular first shift, it is important to use good Sleep Hygiene11. Consider seeking support from a physician who specializes in sleep medicine if you are experiencing excessive sleepiness for longer than 2–3 months. He/she may be able to help you strategize alternative approaches or find a treatment that works best for you. Remember to be patient with yourself and be mindful and disciplined with your sleep schedule.
- Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, et al. The National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40–43.
- Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. 2015;38(6):843–844.
- National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. How Much Sleep Do I Need? Cdc.gov. Reviewed March 2, 2017. https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html
- Pacheco D. & Singh A. Tips for Shift Workers. Sleepfoundation.org. Updated October 9, 2020. https://www.sleepfoundation.org/shift-work-disorder/tips
- Harvard Health Publishing. Blue Light Has a Dark Side. Health.harvard.edu. July 7, 2020. https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side
- Dodson ER & Zee PC. Therapeutics for Circadian Rhythm Sleep Disorders. Sleep Med. Clin. 2010 Dec: 5(4): 701–15.
- Celmer L. New Clinical Guideline to Help Clinicians Treat Circadian Rhythm Sleep-Wake Disorders. October 14, 2015. Aasm.org. https://aasm.org/new-clinical-guideline-to-help-clinicians-treat-circadian-rhythm-sleep-wake-disorders/
- Pacheco D & Wright H. How to Stay Awake During the Night Shift. Sleepfoundation.org. Updated October 16, 2020. https://www.sleepfoundation.org/shift-work-disorder/tips/staying-awake.
- University of the Cumberlands. Survival Guide: How to Prepare for Night Shift Nursing. ucumberlands.edu. November 5, 2019. https://www.ucumberlands.edu/blog/survival-guide-how-prepare-night-shift-nursing
- Ballard A. Sleep Tips for Shift Workers. Circady.com. June 26, 2019. https://circady.com/blog/2019/06/26/8-sleep-tips-for-shift-workers/
- Suni E & Vyas N. Sleep Hygiene: What It Is, Why It Matters, and How to Revamp Your Habits to Get Better Nightly Sleep. Sleepfoundation.org. August 14, 2020. https://www.sleepfoundation.org/sleep-hygiene