Published Nov 30, 2008
medsurgrnco, BSN, RN
539 Posts
I recently started working 12 hr day shifts, after working 12 hr nights for several years. I am naturally a night person, and prefer going to bed at midnight or later. I have insomnia prior to working each day shift, but sleep fine when I don't work the next day. I am trying to go to bed at 2200, and plan to keep that bedtime regularly unless there is an occasional late night event. I think I'm better off with the same bedtime daily, even if I have to get up earlier on the days I work. I realize I've been trying to do too much in the evenings after work since I'm not sleepy, and need to cut back to using that time just to eat a light meal and wind down.
My toolbox for insomnia includes:
Camomile tea with valerian root
Glass or two of wine
Benadryl or Tylenol PM
Melatonin
Trazodone 50-100 mg
Ativan 0.5 mg
Neurontin (which I haven't tried)
Doxylamine (which I just read about and will also try)
Of the above tools, only Ativan is always effective while the others work sporadically. Reading, hot baths, watching TV, nature sounds, etc. help me relax but are not effective solutions once I get in bed and am not able to sleep.
I am wondering if day shift nurses usually are able to obtain adequate sleep without sleep aids once they become accustomed to working days. Thanks in advance for any suggestions of what works for you when you have insomnia!
yousoldtheworld
1,196 Posts
I worked days for about a year, and I was never able to get a good day shift routine going. I just can never manage to go to sleep early enough to allow me to get up at 5 a.m. and still be well rested. I am a night owl, though, and there are plenty of people who have no trouble with it.
I think that a natural night person trying to force their body to adjust to a day schedule is just as difficult as a morning person trying to adjust to nights. You can do it, but you'll probably never sleep quite as well as you would if you were working a more natural shift for your body.
This is what I did to attempt to adjust to going to bed early:
First night, I stayed up all night. I did not allow myself a nap and I made myself stay awake until 6 p.m., then I crashed. I got up at 2 a.m.
The 2nd night, I was tired early but I stayed up an hour later, until 7. I got up at 3.
Third night, stayed up until 8. Slept til 4.
After that, I tried to settle into sleeping from 9-5. I wasn't always successful, but that first night of exhaustion did help me get things turned around. I would definitely recommend that you stay up all night before a day off though. Don't want to be a zombie at work.
Good luck!
Neveranurseagain, RN
866 Posts
You may need to learn to shut your mind to the off position. Try meditation followed by a progressive relaxation technique. It takes some practice but I was able to "train" my self to go to sleep right when I wanted to.
GrumpyRN63, ADN, RN
833 Posts
My body always worked very well in 2nd shift mode, never able to sleep early even when on days , up til midnite at least, always exhausted. Even when not working days I would never get tired before 1-2 am @ the earliest. My solution for about 9 yrs has been the doxylamine succinate (Unisom) NEVER FAILS, and really you only need 1/3 to 1/2 max for it to work well, head on pillow, nite nite. If you use a whole
dose, it will leave you feeling grogged out the next day. It is truly the best OTC sleep aid !!
BradleyRN
520 Posts
I certainly do not recommend sleeping pills, because they reduce the amount of REM sleep, which is what we need the most in the first place. Also, taking pills carry a risk of addiction and can lead to liver damage. Since you are in California, they now prescribe marijuana for insomnia. There are few side effects, not including sleep-walking or sleep-driving, no risk of kidney or liver damage, and it is not physically addictive. :)
Speed Freak
81 Posts
Because of PTSD issues, I have not slept more than 3 or 4 hours a night for 15 years. I am starting a new CNA job and will probably wind up on nights after training and certification (the LTC is taking care of that). I may have to **** my negligible sleep paterns then. Right now I go to bed at 10-10:30 and stay in bed until my wife goes to sleep. Then I get up and watch a movie or surf the internet until 1 or 2 in the morning and then I get up at 5 to take my dog for our 4 mile run/walk.
I have been like this for 15 years. Should I sleep more than 4 hours, bad things will play themselves out on the inside of my eyelids. Once that happens, they won't go away for months. They will show up the minute I go to sleep. So I deal with the hand I have been dealt.
Jaybird310
116 Posts
I feel your pain about the insomnia. Especially yours Speed Freak. I've suffered with horrible insomnia since I was about 12 years old and have recently been exploring the fact that it could be due to PTSD from childhood issues. I've tried everything under the sun to help with it but thus far my search has turned up empty. I'm naturally a night person so I work nights, however I rarely sleep more than 3-4 hours a night, maybe 6-8 hours if I've gone out and had too much alcohol. It's actually caused me relationships problem as my first serious girlfriend after a while wouldn't even attempt to sleep in the bed with me. I've had my doctor go as far as to have me try anti depressants to see if maybe my insomnia was a manic depressive issue. However I'm not manic depressive so it didn't help. One day I'd like to be able to sleep like a normal human being but I don't ever foresee that happening. But if anyone stumbles across a for sure cure send it along my way.
I know exactly what my PTSD issues arose from. I was taken out into the desert in Mexico by some thugs to be executed. I was shot out there but I survived. I really regret what happened out there. I keep it hidden away and it rarely gets out anymore, unless I unwillingly sleep too much.
Wow that's intense I can see where that would keep you from sleeping at night. Like I've said I just recently started exploring the idea that PTSD might be the cause of my insomnia. I know I've serious abandonment issues. Too make the whole long story short I had a complicated childhood and when I was 5 my mother shipped me off to live with my father whom I barely knew. I would see her during the summer. The last summer I spent with her I was 10 and suffered physical abuse at the hands of her boyfriend all summer, which included 2 trips to the hospital. Every year after that I would get phone calls from her and she was dying of some new uncurable illness. It was a complicated mess and I haven't spoken to her in years now. I've sworn to myself I will protect my children from anything like that at all costs. And I'm pretty sure all of that mess has something to do with the cause of my insomnia. Now fixing the insomnia is the difficult part.
I would love to use marijuana as a sleep aid (I'm in CA) but am afraid I will fail a urine drug screen. And now that they shut down all the clinics in Kern County, I would have to travel almost 3 hrs one way to a clinic in LA. So the Federal Government has decided to deny me access to a safe, effective inexpensive drug that works! I will never work as an RN again (see my first post) but other jobs require drug screens.
I would love to use marijuana as a sleep aid (I'm in CA) but am afraid I will fail a urine drug screen. And now that they shut down all the clinics in Kern County, I would have to travel almost 3 hrs one way to a clinic in LA. So the Federal Government has decided to deny me access to a safe, effective inexpensive drug that works! I will never work as an RN again (see my first thread) but other jobs require drug screens.
Thanks for the advice I've gotten so far. My insomnia is generally only caused by having to get up early as I'm naturally a night person, and I hadn't had to get to work before 10AM in many years.
Sorry to hear of the problems others have had which led to insomnia problems.