Podcast #26

owl face
As veterinary medicine continues to progress, more and more clients are not OK with their fur-babies being ‘left alone’ all night. This has pushed the demand for 24 hour centres.

Shiftwork has been shown to cause increased incidence of mental and physical illness, cancers, infertility, pregnancy complications, and a whole slew of other negative impacts.

As we work these night shifts, there are ways that we can approach and manage our sleeping, eating, schedule, turn-around days and attitude so that they are much more manageable.

This blog focuses on KICK ASS Tips for surviving the dreaded night shifts.
Chipmunk stuffing mouth with peanuts
Instead of just randomly stuffing your face with anything you can find, having a plan for your meals and eating habits can improve how you feel and function on night shift!
A huge part of our hormone day-night cycle is related to when we eat. By managing WHAT, WHERE and WHEN we eat, we can help our bodies manage these shifts.
EATING- What To Eat:
SUGAR: Anyone that works night shift is no stranger to the giant bowls of lollies, cookies, candies, bottles of coke, energy drinks, etc. that are lying around. As much as a sugar hit is helpful when you are crashing, it actually makes your overall energy much worse. Try to avoid the giant sugar spikes! In fact, eliminating simple sugars all together is most beneficial.

CAFFEINE: Caffeine is important, and let’s not even start to pretend like we are surviving the night without some. Plan the timing of your caffeine however so that it is conducive to working, and not to keeping you awake so you can’t sleep the next day. Try to have your last caffeinated beverage BEFORE midnight!

plate of dinner with nicely cooked meat, asparagus, tomatoes.
Meal-prepping and having healthy, vegetable and protein based meals, is important! Meal-prep companies can help with this.
Try to have healthy, hearty meals prepared so that your night shift is fuelled by a good source, instead of just holding on with little sugar hits. Lots of vegetables and nuts are recommended. If you are having trouble making healthy meals, consider meal prep programs such as Hello Fresh, Marley Spoon, etc.

SNACKS: Snacks are important to not only get through those early morning hours when you body is screaming at you to sleep, but is also important when it is so busy that heating up your meal is just impossible. Nuts, fresh/dried fruit, a protein/granola bar, anything to give you energy without a giant sugar spike.

Harry Potter Waterbottle
Water Bottles that help encourage you to drink more water are helpful, and FUN!!
By keeping hydrated your tolerance to combatting all of the various mental and physical aspects of night shift will be easier. Try to drink 2 Litres of water each day. Getting a water bottle that has the hours marked on it is helpful to keep you on track!

Another way to increase your water intake, and to give yourself a 'treat' and a boost, and a little extra warmth when your body has turned off producing heat at 4am, is a fruity (non-sugar, non-caffienated) tea! My favourites are Red Seal Teas . They are also great cold as a sugar-free drink substitute!
EATING- When To Eat:
clock made out of vegetables
Having an eating routine will help train your stomach, and brain, when to feel hungry, and when to feel sleepy.
BEFORE SHIFT: Try to have a ‘breakfast’ before you start your shift. This is a healthy, hearty meal so that when you go into your overnight you are fuelled up and ready to go, and more able to resist the temptation of grabbing candy as soon as you get to work. This will start your shift of right!

MIDNIGHT MEAL: Try to have a meal sometime between 10pm-1am. This will help fill you up and give you the energy to go through that 2-3am lull where you just want to lie down. Having your last coffee after this meal is a good time-frame.

FAST: Having a bit of a fast for your stomach for 5-6 hours between midnight and the end of your shift may help you sleep a bit better the next day. If you do eat in this time, try to make it a small healthy snack.

BREAKFAST: About 1hour-30min before the end of your shift, try to have a SMALL breakfast. Enough to take the edge off of your hunger so you aren’t woken up, but not enough to keep you awake. A small bowl of cereal or some yogurt with fruit/granola works well. Try to avoid a caffeinated beverage at this point, as you will want to be able to sleep.
EATING- Where To Eat:
Taking a break and going to a low stress environment that isn’t at the work place, whether it is a separate room or ideally a different location away from work, helps to have a healthier and less stressful meal. It also helps promote having a more complete, well-balanced meal. If you can, get away from the work space to have a meal.
Everyone’s body works differently, so you will need to trial what works best for you. Also, some people have a long drive home and require a coffee to stay awake for the drive. Having a quick power nap before driving, or having a coffee, if it is the only safe way to get home, is important!
TIME BETWEEN SHIFTS: It is important to have enough time between shifts to allow for a good sleep, meal prep, and ideally a quick work-out. Try to plan 7-9 hours dedicated to sleeping.

STRINGS OF SHIFTS: Avoiding long strings of work in a row is important. Sleep deprivation (or ‘sleep debt’) accumulates and mental and physical problems compound as the number of night shifts in a row increases. Most people start to suffer after 3 shifts in a row.

ROTATING SHIFTS: When rotating between shifts move FORWARD, not backwards. Ex: Transition from an afternoon shift to an overnight shift vs an afternoon to a day shift or a night shift to an afternoon shift.

Bulldog asleep on a muskoka chair
Having a 15-30min nap in the middle of the nigth can combat fatigue and improve cognition.
Scheduling a nap. Talk to your employer about scheduling a nap time in your shift for ~15-30min. This helps you regenerate and have better cognitive function.

EASIER WORK AT NIGHT: Having your clinic schedule the hardest work requiring the most concentration during the day is important, as it is much harder to think and function overnight than during the day.

ROUTINE: Having a consistent reliable shift routine helps the formation of a sleeping schedule that you and your body can plan around and get used to.
TIME: Ideally try to get 7-9 hours of sleep. Remember, the quality of this sleep won’t be as good as normal night-time sleep so you will need more, and will accumulate ‘sleep debt’ even if you are getting normal hours worth of sleep.

SLEEP DEBT: Any sleep lost will result in ‘sleep debt’ that will need to be repaid as soon as possible. Having ‘recovery days’ where you plan to have more sleep to make up for the poor quality/lack of sleep is important.

LIGHT (or Lack of...):
Black out and noise reducing curtains.
Black out and noise reducing curtains are imperative to helping you sleep during the day.
To enhance your ability to sleep make your room as dark as possible. Get black out and noise reducing curtains and cover up edges of windows/doors where light spills in to make your room as dark as possible. Wearing sunglasses on your way home can help you transition to sleep-time by decreasing the amount of light. Avoid screens (tablets, phones, computers, TV) before bed as the light from the screens will ramp you into ‘day mode’.

NOISE: Inform family/friends of your work-schedule so you aren’t disturbed and turn your phone off or on silent to decrease chances of you being woken up. Also, having a fan or other ambient noise maker to drown out small sounds from the day will help.

NAPPING: Having a 15-30min nap while at work mid-shift can restore brain-power and combat fatigue. Avoid long naps where you get into a sleep cycle, you just want a quick power-nap.
Lack of sleep can make you CRAZY. Everything seems hard, everything seems stressful, and everything is more upsetting than it should be. If you are in a string of nights and aren’t sleeping well, and are upset/stressed, try as best as you can to just ‘put a pin’ in that stressful event until you have had a good sleep. Everything is easier, happier and better when you have had sleep. Rely on your friends and family in these times to just give you a hug and take care of you until you can get a good night’s rest.
Sloth hanging upsidedown.
The world can seen upside down on your ‘Turn-Around’ Days. Just go slow and steady, but constantly moving forwards!
This is the day after your last overnight shift. It begins when you get home in the morning from your shift and includes the sleep, awake and then sleeping at ‘normal’ night-time cycle.

SHORT SLEEP: Having a short sleep for 3-5 hours on your turn-around day allows you to get enough sleep to work through the day, but still be tired enough to sleep that evening.

GET OUTSIDE/ACTIVE: Organize an activity or event on your turn-around day to try to get you up and active.

EASY DAY: Take this day as an easy one. Don’t do important or difficult tasks. Consider this as another ‘work day’ but one where you recover. Pamper yourself, take it easy, but try to get outside and doing something (go for a walk, wander the mall, meet a friend for coffee, anything).

NIGHT-TIME ROUTINE: Having a consistent night-time routine that is calming can help you switch back into normal night-time sleep. Follow this while on day and night schedule to help train your brain that ‘it’s time for bed’.

Kermit the frog passed out on a bench with bottles of liquor around him.
Although alcohol and drugs (prescription or otherwise) may help reset your time-clock and help you sleep, it isn't recommended in the long run.
Overall, alcohol, smoking and other drugs are not helpful at getting a consistent, good sleep and not one that is recommended. That being said, I personally will use some wine, or an anti-histamine (I use Promethazine- Trade Name Phenergan) in the times that I am having trouble falling asleep at night.
Let's Get Personal

Working night shift and rotating shifts for over 5 years now, I have found that some weeks I can transition very well from my nights back to day schedule. Other weeks it is a struggle and a fight where night after night I lay in bed awake, unable to sleep, until I eventually just go back into night schedule. Those weeks are very hard, and result in night after night of lack of sleep that build on one another. Those are the times when I rely on Phenergan or a couple glasses of wine to jolt my system into a different time-zone. These 'bad weeks' usually happen when I fall off the the healthy eating/exercise/routine habits wagon.
Having a positive and go with the flow attitude is important to working night shift. You have to be understanding that your day before and after a string of night shifts is a ‘working day’, and that you will need to allow yourself time to recover, and time to sleep, in order to succeed.

Being disciplined to stick to a healthy diet, and remaining active and healthy on both your working and non-working days, is also important to help make your night shifts easier, and to combat the negative side effects of working shift-work. Have a tailored work-out plan that fits your life and schedule can be helpful, so sometimes having a personal trainer even to just create a plan for you can help!

The attitudes of your family and friends are important as well. Having a supportive and understanding network that allows and encourages healthy sleep and diet routines is incredibly important. Talk to your family, your spouse, your kids, etc. about not disrupting you during your sleep, and have meal prep together with your family so that you are all eating well together.
Let's Get Personal
I am incredibly lucky to have an amazing and supportive husband in regards to my night shifts. He is supportive in many ways through my career, but in terms of to night shift he does 3 main things:

1. He always ensures that our bedroom can be blacked out. It is one of the first things he organizes when we move houses.
2. He doesn’t have any expectations of me on ‘turn-around’ days. He makes all major decisions, does all the driving, allows me to pamper myself and recover, and encourages me to get outside.
3. He helps me ‘wake up naturally’ on turn-around days, at the 4-5hr mark, by steadily opening the blinds so that my body thinks that the sun is rising. (You can buy a 'husband substitute' alarm clock .)

I am very thankful.
By creating a schedule and a plan for your night shifts, and controlling your eating habits and improving your sleep environment, you can drastically improve how you feel and tolerate these night shifts!

Remember that you will need to repay the ‘sleep debt’ and by thinking of the day before starting nights shifts and your recovery day as ‘work days’, this will help you prioritize the repayment of this debt. If your employer/family/friends don’t appreciate this point, kindly remind them that even though you may only ‘work 3 days’, that doesn’t mean you have ‘4 days off a week’.
Written by Dr. Ann Herbst BSc, DVM

Published January 29th, 2020

Advocate for yourself, you are the only one that will!

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