Lack of Sleep

  1. Hi all,

    I graduated in Dec, passed my boards in Jan, and started working in the ICU last month. I'm having a huge problem sleeping the night before a shift. I don't sleep at ALL the night before, which means I'm awake for 36-40 hours by the time I get home and in bed. I just lay there and start to get frustrated about how much sleep I'm missing out on and how miserable I'm going to be the next day. I've tried melatonin and Unisom. If anyone has any advice or tips/tricks I'd really appreciate it!
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    About Melissaxoanne1

    Joined: Mar '18; Posts: 1; Likes: 1
    Specialty: 1 year(s) of experience

    14 Comments

  3. by   Buckeye.nurse
    Every situation is different, but as a very long time shift worker, I have a few ideas that might work for you.

    ~Try to keep your sleep schedule as consistent as possible (ie. try to avoid staying up till 2 am and sleeping till 10 on days off, and then trying to fall asleep at 10 pm before work days).
    ~Avoid a heavy dinner right before bed. Sometimes a small snack helps though.
    ~Get some exercise at some point in the day, preferably outside.
    ~Stop drinking anything with caffeine in it at least 6 hours before you plan on going to bed.
    ~Banish all electronic screens an hour before bed. Take a shower or soak in the bath, then grab a good book or listen to relaxing music. Melatonin isn't a bad idea. I use it sometimes, but not every night.

    If you've tried everything you can think of and still can't sleep, talk to your doctor. Persistent lack of sleep isn't doing your health any good, and isn't particularly safe either. Hang in there!
  4. by   AceOfHearts<3
    I stop caffeine at 2 o'clock unless I'm extremely desperate or off work the next day. I do this on day shift and night shift.

    I agree with what Buckeye has stated. Especially about exercise and a consistent sleep schedule. I know I don't sleep as well if I haven't physically exerted myself that day, especially if I slept late.

    I use melatonin myself sometimes, but it took me a while to find one that I like. I like the Olly brand which can be found online or at Target and GNC.

    Good luck!
  5. by   Been there,done that
    Your circadian rhythm cannot adjust. Been there, did that. Get on day shift.

    Best wishes.
  6. by   meanmaryjean
    Quote from Been there,done that
    Your circadian rhythm cannot adjust. Been there, did that. Get on day shift.

    Best wishes.
    OP is on day shift. She/he cannot sleep the night before.
  7. by   Nurseinprocess
    Definitely must be on day shift for orientation I would think (I had no idea any hospital would hire a graduate nurse in the ICU). It sounds like your brain won't shut off. Not sure how to fix that! If sleeping aid pills won't even help I think you maybe need to do yoga or something to settle yourself down.
  8. by   Davey Do
    Buckeye.nurse gave some outstandingly excellent advice and I pretty much follow that regimen, in addition to this:

    I keep a cup of valerian tea at my bedside. I have one glass of wine with my last meal before bedtime.

    The coolest thing I ever discovered was regular breathing, repeating a mantra, and focusing on phosphenes.

    Here's what I do when my mind won't shut off: First, I get into a regular breathing pattern to a count to 8 to 12. I focus on my breathing, inhaling entirely, exhaling entirely. Once my breathing is regular without counting, I say my mantra, something I repeat in my head over and over again. My favorite mantra is the Lord's Prayer. Deep, regular breathing and a mantra. Now comes the phosphenes.

    Phosphenes are little blobs of light you seen when you close your eyes, caused by the intermittent firing of the optic nerve. Our brains won't allow us to see total blackness, so our optic nerve fires and we see those blobs of light.

    I focus on those phosphenes and make pictures out of them, sort of like seeing images in clouds. I watch them move and swirl and show me things. I remember one of the first things I ever identified when I got into this technique: I saw a courgar jump off of a gas pump!

    Regular breathing, mantra, and focusing on phosphenes has never failed to allow me to fall asleep as long as I do as I described. I've been through some major life crisis, and this technique, along with exercise, art, and some other things, has allowed me to fall asleep with almost 100% success.

    I have also used, in the past, the Delta sleep System which includes a CD with some soothing flow of noises.

    Good luck to you, melissaxoanne !
  9. by   pixierose
    I just recently came off orientation at a new job, and stress can keep my mind going all night long if I let it.

    The new routines, new coworkers, new politics ... just being new can set your mind on edge, even if things are going ok.

    The pp's came up with great suggestions. Time will help with the rest if it's indeed stress/anxiety related. I'm waiting for myself to just get used to the job; coming home and doing what helps me relax and ease into a normal routine helps with the rest.

    Hang in there.
  10. by   thoughtful21
    Phosphenes...Davey Do, I just learned a new word!
  11. by   adventure_rn
    Starting with our nursing assessment...do you have any sense for why you're having difficulty sleeping? Is it because of anxiety/stress, distractions (light, noise, sounds, screens), etc.? I would imagine it isn't simply that you 'aren't tired' after running for 36 hours on no sleep, but rather that you are tired and yet something is keeping you awake. Once you understand the cause(s), you can address the underlying problem.
  12. by   TruvyNurse
    I tend to take the easy way out and take some Benadryl lol. However you need to get on a sleep schedule. I was having sleep troubles a few years back(even on dayshift) my doctor prescribed me some Ambien. It really helped me get into the rhythm I needed. I no longer take it because I'm just exhausted being a mom, wife, nurse and student lol
  13. by   Serhilda
    If this is a new issue for you, I'd suggest seeing a doctor. I was put on temazepam for short term use when I started nursing school. I was already a light sleeper and the added stress of nursing school turned that into some serious insomnia. Now I'm off temazepam and taking something over the counter every now and then to ensure I fall asleep and stay asleep, usually before clinicals.
  14. by   maxthecat
    I second Davy Do's phosphenes. I never knew what they were called, but they work great for getting me to relax and slip off to slumberland.

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