Taking a sleep aid when on call?

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I'm wondering what you all think about taking sleep aids when on call. I'm not talking about call where you might have to actually go in to work, but call for outpatient care where you have to manage patient complaints overnight, possibly call the doctor/pharmacy, and possibly refer to the ED.

What do you think?

I'm not talking about something like Ambien, btw. I'm talking about Benadryl or doxylamine, a low dose of a med I am used to where I am confident I would still wake up and my clinical judgment would not be impaired. Are we not allowed to take NyQuil if we have a cold while on call?

The job is a great fit for me; it's call that's not a good fit, and I'd hate to give up the job just because of a call requirement every 6 weeks or so. Did I mention it's my first time? No one wants to try to reassure me that maybe I'll get used to it or suggest any non-pharmacological coping strategies?

I take doxylamine all the time. I would have zero concern with impaired judgement being on call for phone calls. I would only have concern with next day SE of drowsiness, if taken less than 8 hours before, slowing me down.

BUT, I know how doxylamine affects me. I say test it out first.

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Oh, and btw... doxylamine has the possibility of kicking your butt way more than Ambien. So don't assume bc it's not prescription that it can't knock you on your feet. But you have to see how it worjs for YOU. Everyone is different. Take it on a night off and set an alarm or ask a significant other to wake you up and ask some questions lol. Seriously

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Specializes in OB.

As someone who takes call on a regular basis but had a REALLY hard time with it initially, I just want to say that it really does get better. I used to have trouble sleeping and be pretty anxious too, and it just naturally becomes more normal over time. I hope you find some short term solutions while you're adjusting!

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Oh, and btw... doxylamine has the possibility of kicking your butt way more than Ambien. So don't assume bc it's not prescription that it can't knock you on your feet. But you have to see how it worjs for YOU. Everyone is different. Take it on a night off and set an alarm or ask a significant other to wake you up and ask some questions lol. Seriously

Thanks; I've taken doxylamine and Benadryl both many times and am very familiar with how they affect me.

As someone who takes call on a regular basis but had a REALLY hard time with it initially, I just want to say that it really does get better. I used to have trouble sleeping and be pretty anxious too, and it just naturally becomes more normal over time. I hope you find some short term solutions while you're adjusting!

Thank you. This is good to hear.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I wouldn't do it. If taking call is causing you so much anxiety that you either need to take sleeping pills or function with a severely sleep deprived brain, perhaps this job is not a good fit for you.

This!

Or perhaps you could split call with another person -- you do four days of your work, and they do three. Then in their week, you do three days and they do four. Or whatever you can work out.

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I'd trust your own gut for how things affect you. I have pretty severe insomnia at times, and can stay awake (or wake up easily) with everything from ambien to benadryl to doxylamine. While this occasionally comes in handy, it's mostly a pain in the bum, so I definitely understand your pain. I have a hard time sleeping if I know something different/stressful has to be done the next morning, because I fear oversleeping (even though I never do, knock on wood).

I would suggest a couple of nonmed ways to cope. Try meditation before you go to sleep (Headspace is wonderful, especially their sleep programs), make sure you practice the regular good sleep hygiene stuff (going to bed at the same time every night, exercise most days, and no screen time an hour before bed if you can), and double check that your phone ringer is on and on LOUD before you go to bed (this may assuage some of your anxiety). Keep your phone on your nightstand, and remember that once you get used to this on call stuff, your anxiety should lessen quite a bit. Especially, I think, after you get a call or two and realize that you will wake up when you need to.

If you absolutely need it, I would say to take something that you know you won't react badly to (melatonin might be the least harsh, depending on how you react personally) if you do need to take something. Sleep deprivation is far worse on judgement, imo, than a benadryl (but that's just my body and my experience, of course).

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Oh, and good luck! Not being able to sleep is awful, and I hope you're able to get through this okay.

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Oh, and good luck! Not being able to sleep is awful, and I hope you're able to get through this okay.

Thanks so much. I really appreciate your suggestions.

Sleep deprivation is far worse on judgement, imo, than a benadryl (but that's just my body and my experience, of course).

See, this is kind of my bottom line too, and I feel like in general we don't respect sleep deprivation as the danger that it is. We don't blink at a practitioner working sleep-deprived; it's considered acceptable, at least, if not oftentimes necessary. I don't understand why. It's so incredibly dangerous, and yet I imagine we'd be hard-pressed to find a clinician who hasn't worked on inadequate sleep.

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Specializes in LTC.

Doesn't sound like a good idea.

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I know that I am FAR more dangerous sleep deprived that on a little benadryl or something similar. But I guess we're all different. When I don't sleep enough I have a very hard time thinking/driving. And I believe that studies have indicated that being sleep deprived while driving is just as dangerous as driving drunk.

Here's a site discussing how sleep deprivation compares with blood alcohol levels: Driving While Drowsy Can Be As Dangerous as Driving While Drunk - National Sleep Foundation

Bottom line, sleep is very important. More important, I think, than many people realize or like to admit. I think it's because people feel like they are being somehow tougher or that they have more willpower if they can push through while sleep deprived. But it's straight-up dangerous.

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Personally, I feel this is a bad idea and not ethical. If you are not able to take call without suffering from exhaustion and anxiety... then bow out. I get it, I really do. Working in the OR and being on-call makes for a challenge to fall asleep knowing the pager could go off any second. BUT - if we are being paid to do a job if called, it's not our right to medicate ourselves and disrupt our jobs. What did help for me was down loading a couple of relaxation apps on my phone... specifically geared towards sleep. The would help me actually fall asleep (which for me was the hardest part). Good luck! Do the right thing - don't take any sedatives.

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Give me more. What's your schedule? Do you work a day shift, then are on-call all night long? Is it everynight? Is it only a couple nights? Are the nights grouped together?

Attempting to use your brain sleep deprived and/or with sleepy time pills is not the best.

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