To nap or not to nap is often the question. Limiting it to these binary conditions means we often ignore all the grey areas in-between; like when to nap? How to nap? What to do if you are unsuccessfully trying to nap?
Following on from our last piece on why you should nap on nightshifts we will dive into tips on how to nap on a night time shift and how you can improve your sleep.
What does napping help with
The list of what napping helps with is endless, but in short, napping IS sleep, so its benefits are related to the benefits you receive from sleep, just a few of which:
Makes you more alert
Improves heart health
Keeps off the pounds
Improves your mood
Boosts your immune system
Refines physical performance
Sharpens sensory perception
How best to approach napping on shift work?
When in the shift to nap?
The best time to nap on a shift depends on your internal circadian rhythm. A good indication based on sleep deprivation research on airline pilots suggests that preventing the onset of tiredness is more effective in treating it. Therefore, to nap earlier on on your shift before the fatigue hits you would be much more effective than spending that same amount of time napping after it has hit you.
For people with a late circadian rhythm, your natural dip will be later in the shift, potentially 3 am - 6 am. For early types, your natural dip may be as early as 11 pm-12 am and you may struggle even more with night shifts compared to late types. Try to get your rest in before your dip.
If you drive home, think about taking a short nap towards or at the end of your shift; the occurrence of fatal accidents for night shift workers is significantly higher. When you are sleep deprived, your brain goes into micro-sleeps lasting a couple of seconds at the most but we don't always realise it is happening. When you are driving these split seconds of unconsciousness are the most dangerous.
How long should you nap for?
If you have the luxury of choosing how long you can nap; I’d base it on the amount of sleep you achieved before your shift. If you were lucky and got your ~8 hours, a shorter nap of 15 mins - 30 mins may be enough to hold off the effects of fatigue later in your shift.
If your sleep is heavily disrupted I would consider taking longer naps of 40 mins to 90 mins if possible, this will take you through more of the sleep cycle, increasing the recovery benefits.
Where to nap
Time is precious, so make the most of it by having a good environment to nap. If you don’t have access to a Rest Space or other forms of sleeping areas or sleeping pods then think quiet, dark, and cool. If you can get away from your work area your brain may find it a bit easier to switch off. Our sleep quality is impacted by the psychological arousal caused by our work environments. Studies on patients found their sleep quality was reduced in hospital environments with the noise of monitors and machines compared to the same environments with music to mask this noise.
Laying down also improves your sleep quality as opposed to sleeping on a chair
When we sleep our temperature drops, so having a cosy but cool environment can help with the time it takes to fall asleep
Light is a key signal to our bodies that it's daytime and we need to be awake, getting somewhere dark, or covering your face will improve the quality of your nap
What other factors can help to adjust to night shifts
On top of napping, you can help your body adjust slightly better to nightshifts, by understanding your own body clock and find out when it is tuned to being awake and active. Knowing this can help you adjust your mealtimes, light exposure and sleep patterns to make the adjustment a bit smoother.
If you are an early type and like to go to bed early and wake up early you may find it more beneficial to have your main sleep period just before your night shift. If you are a late-type and tend to go to bed a bit later and wake up a bit later you would probably adjust a bit better if you had your main sleep period straight after your nightshift. Limiting the light you are exposed to a few hours before you sleep can help with the adjustment and improve the quality of sleep you are able to get. Closing the curtains in your home, wearing sunglasses if you are outside, or on your way home from work, dimming your indoor lighting, and avoiding devices are some of the ways you can do this.
Increasing the light when you wake up will also help your body adjust to your new rhythm slightly better. If it is still daylight, spend at least 10 min outside in the first couple hours of you waking up, a great time to have your ‘morning’ cuppa.
Optimal eating times vary for all of us, here are some things to think about:
Large high protein meals close to our bedtime generally interfere with our sleep as our body is spending time and energy digesting food instead of getting you ready to switch off
Caffeine has a quarter-life of 12 hours so try to avoid it in the second half of your shift. Caffeine blocks your adenosine receptors, which is a key hormone for getting you ready to sleep
More research needs to be done on this but one case study by Dr Amy M. Bender found one of her athletes was waking up to 22 times an hour when he drank caffeine before bed without realising. Like many of us, he had no trouble falling asleep after a coffee and didn’t think it impacted his sleep.
Alcohol and sleeping pills also impact the quality of your sleep so reconsider using these as sleeping aides. Your brain is very active during sleep with brain waves looking similar to waking levels, sleeping pills sedate you and are suspected to minimize the brain's activity levels that are generally seen in sleep.
The last thing I would mention is don’t let the stigma of napping on the job stop you from getting the rest you need. From our research, we have found that most health care workers think they are being judged by colleagues for napping at work, but in fact, most of the people we surveyed said napping on the job makes them better at their work. In the case of nightshifts, your work directly impacts your sleep so your work should be supportive of your efforts to counteract this and improve your wellbeing and performance.
How to transform UK healthcare environments to support doctors and medical students to care for patients - Professor Michael West and Dame Denise Coia on behalf of General Medical Council