Can't sleep the night before I go into work

Pediatric Critical Care Columnist · Jun 27, 2008

I'm not a new grad and I've worked in PICU for eleven years, but I still have trouble sleeping the night before a day shift. It was ever thus. I've goen to workshops on maximizing your sleep, staying healthy while working shift work and several other classes relating. Still I have a problem. (I live in the northern part of Canada and it's light most of the night up here in summer.) I make judicious use of melatonin tablets, and find them to work fairly well. And there's no hangover. Ask you doctor about that.

SoundofMusic · Jun 28, 2008

I was having the same problem and just nipped it in the bud quickly before it go out of hand. Asked for an RX for Lunesta. I take a 1/2 tab before bed and it just knocks me right out -- have no problem waking up the next day -- might need a cup of coffee or something, and I'm ready to go.

Much better than the insomnia insideous vortex which I can get trapped in very easily.

Pediatric Critical Care Columnist · Jun 28, 2008

Yeah, Lunesta isn't approved in Canada. The alternatives are just not worth it.

**canoehead, BSN, RN** · Jun 28, 2008

I had the same problem as a new RN, I couldn't sleep, and then I'd worry about my performance the next day, then I'd get more anxious, etc, etc.

A mild antianxiety med may help you break the escalation cycle. I also did a lot of nights as a new nurse and found them less stressful.

Try to put your brain on a different path by reading, or nature sounds, do NOT think about work and every little thing that could happen. A couple counselling sessions paid by EAP may be well worth it.

Sterren, BSN, RN · Jun 28, 2008

I have this problem too and it definitely makes the first shift hard. There is just so much to learn and remember that I feel stressed the night before. Oddly enough once I get to work I'm fine and enjoy the day, it's the apprehension that gets me.

TheCommuter, BSN, RN · Jun 28, 2008

I had the same problem when I worked on a stressful short-term rehab unit. I worked two 16 hour shifts every Saturday and Sunday, and I never was able to fall into a restful sleep on Friday evening. The lack of sleep was always a groggy prelude to a tense weekend at work. The anxiety kept me awake for much of Friday night, when I should have been sleeping.

And, magically, the problem seemed to have disappeared into thin air the moment I switched to a less stressful workplace.

Virgo_RN, BSN, RN · Jun 29, 2008

I am a new RN working in a PICU at the only level 1 trauma center in this area. I love my job and I love all my awesome co-workers but as a new nurse I am stressed out and have a lot of anxiety, especially the night before I go to work (I work three 12's a week). I am literally up ALL night long , tired, but can't sleep. Any other new grad shave this problem??
Any tips? If it doesn't get better I'm going to have to go to the dr to get something to help me---I can't keep going to work so tired like that.

Have you ever tried meditation or guided imagery?

NewEnglandRN, RN · Jun 29, 2008

I have been an RN for two years, but I can completely relate... my mind races non-stop when I try to sleep before a shift. I am also a clock-watcher. If I work days and cannot fall asleep, I am always looking at the clock to see how much time I have left before I need to get ready.

I have tried OTC sleep-aids, as well as Ambien and Lunesta. Ambien helped, but I need a refill. Even though I felt fine when I woke-up, I hate feeling I 'need' to take something to get to sleep.

I am just starting a new position in Telemetry and know the stress of a new job is making things worse... hopefully it will improve!

registeredin06 · Jun 30, 2008

Definately agree. I don't know what or why, but I go through the same thing. Nursing for 2.5 years, and still happens. Lots of nurses go through it. It's only when I don't work the next morning that I can fall asleep at nine, of course the times that I would like to stay awake. I started taking tylenol PM's right before I get in a hot bubble bath with hot tea or a glass of wine. By the time I'm getting out, my eyes are getting heavy. Helps you sleep and helps with aches.

cpnegrad07 · Jun 30, 2008

I find that i have to keep a certain schedule and not vary it: eat at 6, shower at 8, last sip of wine at 9 while reading calm stuff, encourage alpha waves until 9:30, then into bed.

I prefer that my wife go to bed then, as i sleep better, but that doesn't always happen.

THEN... if i find myself laying awake, i get up and get the ambien.

justme1972 · Jun 30, 2008

I do the SAME thing, and alot of it has to do with the fact that I am afraid that I won't wake up in time for work.

Here is my solution to build confidence:

1. Set your alarm and install the battery back-up...so if the power goes out during the night, you know it's still working.

2. Set your alarm on your cell phone as an additional backup, about 15 minutes later than you normally get up....you'll be rushing, but you won't be late.

3. NEVER look at the clock when you wake up during the night...this creates anxiety and can make your insomnia worse.

4. Don't consume caffeine or sugar after 6:00.