Nightlag

I spent most of yesterday sitting on my sofa, trying to convince myself to stay awake.

Just before my first set of nights, in December, I asked Twitter for advice on how best to switch from day shift body clock to night shift body clock. I had three nights in medical receiving, in the middle of a six week or so period when I had been working a lot. There had been a lot of on calls, a lot of long days, a long time since my last bit of annual leave, and, just a few days before I was due to go on to nights, the bed crisis to end all bed crises, with a fourteen hour ward round and a consultant who asked out loud in the middle of it whether we would be seeing patients in the car park before the day was over. Thus, on the day before my first night shift, I was very pleased to shuffle off back to bed after lunch and I got a decent sleep in before heading into work that evening. Afterwards, switching back to day shift body clock was even easier. Possibly because I only had twenty three and a half hours between the end of my night shift and the start of my day shift, and I had Midnight Mass to force me to wake up for a bit in the middle.

But the consensus from everyone I’ve talked to has been that when they aren’t immediately followed by a middle-of-the-night liturgical celebration, I am better advised post-nights to stay awake until what might be considered a reasonable(ish) bedtime. A little like the rule about setting watches to destination local time when boarding flights. After all, night shifts are basically just a very peculiar sort of jetlag. And as I imagine that the Church as a whole would grumble at the idea of inventing liturgical celebrations for no better reason than to ease my days-to-nights-and-back-again transitions — although I will note that by happy coincidence, Easter this year will be very much doing exactly that — I was stuck this time with resisting the lure of my duvet through sheer force of will.

I’ve quite enjoyed my nights this week. I spent half of one of them in the emergency department, on account of a complete lack of beds anywhere else in the hospital, but, for the most part, things have been manageable rather than stupid. It’s been a good team, fuelled mostly by Haribos and potato scone sandwiches and giggling. I’ve seen some things that I haven’t before, felt just a little bit smug about a far-too-early-in-the-morning hunch that was proven right, and even got some bits of ePortfolio done during one of the quieter spells. The end of a working night, falling asleep in handover with rumpled scrubs and undone hair, feels like an accomplishment in a different way than getting to the end of a working day. It feels like an enormous achievement to clear ED in time to batter down the canteen doors for a Team Nightshift breakfast and a relief to finally get rid of the arrest page — a particular highlight of my week was the look on the face of the medical student who almost found herself with the SHO arrest page in her hands, such was the eagerness of my SHO to get to his bed.

I could do without being back on nights next weekend, mind, but I’ve given up on figuring out my rota.

In the end, yesterday, I made it to quarter past four in the afternoon before I conked out on my sofa in front of Lewis. And but for a brief period of consciousness to shuffle bedwards, I was dead to the world until after eight this morning. Mission accomplished.

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11 comments

  1. I find that the shift from night to days is one of the hardest transitions for me. It usually takes me a full week until I can reliably sleep through the night and not fall asleep during daytime lectures, although I may still do the latter anyway due to generalized sleep deprivation. I personally sleep for a few hours after my night shift and then stay up until it’s my usual bedtime, but I have no idea whether this works better or worse than any of the other methods. The one thing that does help me is taking some sort of sleep aid (melatonin or diphenhydramine) for the first few nights back on days, as it helps me to avoid the 2-4 am stare at the ceiling phase.

    1. Have only just learned that WordPress thought that you were spam, despite your comments having been accepted multiple times before. I have no idea, but I’m sorry about that.

      I’ve had a little time off after my nights and I’m back on nights on Friday, with no day shifts in the middle, which is weird, but whatever. I’ve had no trouble actually sleeping this week, but I have noticed that my bedtime has yet to switch back to its usual time. I need to get that sorted before I have a couple of day shifts to do next weekend.

  2. The thing I find works best is to sleep for a couple of hours when I come home because I can’t not do that, and then get up and stay up until normal bedtime. I forgot last time and slept all day and then all night and then the following night I woke up at 3.30 and couldn’t get back to sleep at all. I loathe nightlag. Glad your nights went okay though.

        1. Yeah, the cats just curl up in their warm spot on my legs and go to sleep with me. That wouldn’t help. They did wake me up this morning by patting me on the face at 4am — I think just to make sure that I was still alive.

    1. After online Evening Prayer before a Saturday nightshift. I ate cornflakes and then went out to work. That was weird.

      If I were to choose between the two, it would be Compline, because of the prayer in Rite 2 that I often say before I start nights: “Keep watch, dear Lord, with those who work, or watch, or weep this night, and give your angels charge over those who sleep.”

  3. Hi Beth, I have read on the web (a good few years back) about night shift worker’s paralysis. I experienced it once when at a break, well on in the middle of the night, I fell into what must have been a deep sleep sitting in a very comfortable chair in a small office with an auxillary. At one point I woke up ‘on the inside’ so to speak and couldn’t move or make a sound. Very scarey but eventually (can’t say how long but still within the break period) I woke up fully. When ‘paralyzed’ I was trying to shout out! Not everyone gets it. I worked on nights at that time 2 nights a week for a few years – looking after 2 small children in the daytime after a morning sleep.

    I agree with advice you’ve been given, work through that first day and go to bed at a reasonable hour.

    1. I feel quite lucky, Jackie, in that I seem to have no trouble at all sleeping properly during the day when I’m on nights, which I think helps a lot. By Thursday morning, being wide awake at 4am seemed like a perfectly reasonable thing to be. It’s the switching back and forth that’s hell.

    2. I get the paralysis when I am waking up sometimes and it is HORRIBLE. Also feelings like a stabbing finger in the back. I know that if I can move a muscle then I will wake up, but am awake a little before the links to the muscles are switched on.

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