I can't sleep!!!

LobotRN, BSN, RN · Apr 12, 2013

Routine Routine Routine! I usually work 3 NOC 12s (7-7) in a row, I have a family with kids who for some reason do not want to be nocturnal to suit my job, so here's my sleep hygiene equipment and routine:

Equipment: Ear plugs, sleep mask, OTC sleeping pill, clean/tidy bedroom, blackout curtains, cold temperature, LOUD alarm clock/ipod set to max, oscillating fan, diet coke or caffeine beverage of choice, LARGE water bottle.

1. Afternoon before my first shift I sleep/rest for at least 2.5 hours somewhere between 1p and 5pm. No sleeping pills during the rest period, and no caffeine all day before sleeping. I use the earplugs/mask/fan.

2. Wake up and drink 1 or 2 diet cokes, eat a small meal, futz around the house and do fam stuff, shower and then off to work.

3. Get to work and fill up my water bottle. I let myself drink as much diet coke as I like but alternate each can with an equal amount of water. Yes, I pee a a lot.

4. Eat my dinner around 0100, light amount of protein, complex whole grain carbs.

5. Cut off any diet coke/caffeine consumption at 0300.

6. Cut off any liquid intake at 0500 (so I don't have to pee all the time I'm trying to sleep)

7. Wear sunglasses home (I read that medscape article a while ago, too, and found out that it does help a little!)

8. Home around 0730 to 0800, shower, and hopefully everyone remembered to leave the curtains/shades shut so the house is dim, take an OTC sleeping pill right after the shower, small meal with good protein, and little non caffeinated something to drink.

9. In bed by 0900 at the latest, usually feeling really sleepy at this point. Alarm set, plugs in, mask on, shades drawn, fan on, phones muted except specific callers on my iphone.

10. Hopefully don't have to pee during the day, but if I do I try to be sure that the path to the bathroom and the bathroom itself are as dark as possible so that it would be more like waking up in the middle of the night and easier to go back to bed.

11. Up around 430p and repeat all over starting at step 2. On the subsequent days I usually don't take a sleeping pill.

12. On the morning home after my last night shift, I sleep from 0900 to no later than 1p. I'm exhausted and generally look at it as a wasted day, and I will try to something simple like grocery shopping done. Then I sleep a regular night and get in bed by 9p. I also make myself get up by 6a the next day.

I found that for a while I would sometimes wake up in the middle. The more of the routine I did the less that happened. When it occasionally does, I just roll over (don't look at the time, keep it dark!) and make myself go back to bed, or at least lay quietly until the alarm.....

http://www.amazon.com/gp/product/B0013A0C0Y/ref=wms_ohs_product?ie=UTF8&psc=1

http://www.amazon.com/gp/product/B005L811OK/ref=wms_ohs_product?ie=UTF8&psc=1

I bought the bulk earplugs 2 years ago and still have plenty. I strongly encourage sleep masks, even with blackout curtains. Get the kind that are formed so that your eyelashes can "flicker" when you're sleeping. Like anything, you likely will have to "train" yourself to sleep with stuff on/in your head, but the darkness and quiet are worth the good sleep they promote! It took me about a month of shifts to get used to, even look forward to, shutting off my head by putting all this stuff on.

QTNurseBSN · Apr 12, 2013

The eye mask worked wonders for me. I no longer work nights, but sometimes when I am sleeping at night, I still wear it. It blocks out the light from the alarm clock, the light from the cable box and even the moon light. Plus I always have the fan going. I tried ear plugs but I felt kind of "weird" not being able to hear anything. A robber could've came in my home and I would have never known about it wearing ear plugs. Definitely avoid any caffeine after 1 or 2am because that will keep you awake when you are trying to sleep. I never thought about keeping sunglasses on when going to the bathroom or trying to keep the path clear and room dark...that's a good idea. I would wake up, open my eyes, get blinded by any bright light, go to the bathroom, then wonder why I was wide awake, getting frustrated because I couldn't go back to sleep and knowing I had another 12 hr shift to rest for.

TheCommuter, BSN, RN · Apr 12, 2013

I've been working 12-hour night shifts for the past three years (6pm-6:30am).

Although I'm a coffee drinker, I drink no coffee or cola within 6 hours of bedtime. So if I plan to be asleep by 9:00am, I stop drinking coffee by 3:00am.

I also exercise on most days of the week. I notice that regular cardiovascular exercise helps regulate my sleep/wake cycle. I frequently visit the gym immediately after my night shift ends and will work out for 45 to 60 minutes before going home in the morning. I have no problems falling asleep after exercise.

Certain foods such as cheese and chicken cold cuts make me sleepy due to the naturally-occurring tryptophan levels, so I'll sometimes snack on these before going to bed. Chamomile tea is wonderful since it has a natural, mild tranquilizing effect. I'll drink this tea and become drowsy within 30 minutes.

If all else fails, I have had success with over-the-counter sleep aids such as Unisom and Benadryl.

Long Term Care Columnist / Guide · Apr 12, 2013

I have to do the same sort of thing with the glasses, only in reverse because I work days. My psychiatrist told me I am extremely light-sensitive and it messes with my moods, so in order to wind down enough to sleep, I have to shut down the computer at least 1-2 hours before bed and wear these amber wrap-around glasses for however long I'm awake. I'm also supposed to sleep in complete darkness (sleep mask) and put the amber glasses back on if I have to get up in the night.

It's a total PITA, and even with all this folderol I still need to take meds for sleep, but it does help me detach from the day and get to sleep faster, which is the purpose of any type of light manipulation.