Trouble Sleeping - excessive wakefulness/insomnia

Published

Specializes in Cardiac, Med/Surge, Oncology.

Hey, so I work night-shifts, 12-hr shifts (7p-7a), 36-hrs/wk. I work in ICU/SICU/IMCU.

Before that, I worked the same schedule for a med-surge unit.

I recently took this new position in June. I am still learning a lot. And in the past few months I have had the worst sleep schedule ever. I tried chamomile tea and blocking out the light with heavy drapery, but for some reason they are not working well anymore.

My team told me, "oh you're young, you'll be able to handle [iCU position]," but lately I have been losing motivation to learn anything since I'm too tired to look at text books, etc.

So this happens when I get back from work:

I keep getting a "second wind" when I get home. I can't sleep and my mind is moving a billion times an hour when I'm in bed. And if I do sleep, I end up waking up 2 or 4 hours later, and have trouble getting back to sleep.

It's affecting my mood and I find myself getting depressed when I'm too tired to do anything on my off day. I know when I don't feel like myself so I make it my goal to just get out and be with other people, but I'm too tired to even enjoy other's company.

I am also very active and love going to the gym or just exploring or playing sports, but when I'm tired because of lack of a proper sleep schedule --- it really takes a toll.

I once overslept and was late for work because I didn't sleep until 1pm (I usually wake up at 5pm to get ready for shift-change at 6:45pm).

Do you guys have any suggestions what's going on? ICU is stressful enough but the team is very helpful so I'm not that stressed out about it. What's stressing me is the lack of sleep or outlets for me to enjoy the things I do.

I don't really want to take sleep meds because I get scared of "not waking up," if you know what I mean. I wanted to exhaust all options before talking to my doctor.

I'm also aware it's against AN's terms to ask/provide health recommendations/diagnoses so if you recommend I should go talk to my primary doctor then let me know please.

Thanks for your help!

Up Vote Up Vote ×
Specializes in LTC, assisted living, med-surg, psych.

Yes, you do need to see your primary care provider to help you with these issues, as sleep is so very important---especially when you're in an intense, high-stress job that you're still learning. Best of luck to you.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

As a night nurse.....you need to make your environment conducive for sleep. Black out shades. White noise. Wear sunglasses on the ay home as sunlight decreases serotonin production. Shut your phone off. I would take a hot bath....a warm glass of milk. Watch a boring movie I KNOW will make me sleep. Keep a similar schedule on your days off....and yes talk to your doctor.

But you are right we can't give medical advice.

Up Vote Up Vote ×
Specializes in Short Term/Skilled.

Ditto the above posters ;-) talk to your doc!!

Up Vote Up Vote ×

AAhhhh, shift work disorder at it's finest. I am lucky enough to be the "team player" that gets to bounce between day and night shifts when the nights are short for charge. I have a hard time sleeping at night normally!

I went and saw my FNP and talked with her about what I could do besides the: sleep mask, ear plugs, supercharged fan blowing, ocean waves sleep sounds environmental stuff I was trying (and failing). She diagnosed me with shift work disorder and gave me a RX for hydroxyzine (vistaril) and Nuvigil. These are 2 medications that can be used PRN when you encounter trouble while training your body it's new sleep cycle (or in my case, just getting by for a shift or two). I had a long discussion with her about my concerns regarding taking the medications to sleep and wake up and together we decided to stay away from benzos (which I understand a lot of night shift nurses use to help sleep) and the understanding is that I only take the medications if I need them. If I work at 7pm and at noon I still haven't been able to fall asleep on my own, I take a hydroxyzine. If I feel foggy or am afraid I am not thinking clearly I can take a nuvigil. I will admit that it is not ideal and I don't like doing it, but most of the time I am less anxious because I know I have a back up plan and it is enough to let me calm down and rest. Because of this I find that I don't use the medication very often.

Shift work disorder is a problem that needs to be addressed if that is what you are experiencing. Try all the environmental stuff and talk with your PCP.

Up Vote Up Vote ×
Specializes in NICU, ICU, PICU, Academia.
As a night nurse.....you need to make your environment conducive for sleep. Black out shades. White noise. Wear sunglasses on the ay home as sunlight decreases serotonin production. Shut your phone off. I would take a hot bath....a warm glass of milk. Watch a boring movie I KNOW will make me sleep. Keep a similar schedule on your days off....and yes talk to your doctor.

But you are right we can't give medical advice.

I think you mean 'melatonin' not serotonin.

Also OP- be sure you are cutting off caffeine intake by about 0200.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I think you mean 'melatonin' not serotonin.

Also OP- be sure you are cutting off caffeine intake by about 0200.

Jeeze....:banghead:

I sure do!!! :facepalm: Thanks for catching it....LOLOLOL

Up Vote Up Vote ×
Specializes in NICU, ICU, PICU, Academia.
Jeeze....:banghead:

I sure do!!! :facepalm: Thanks for catching it....LOLOLOL

Only wrote my MSN thesis about it.......... :)

Up Vote Up Vote ×
+ Join the Discussion