The Well-Rested Nurse

A crucial cornerstone in maintaining personal wellness is obtaining optimal sleep every 24 hours. Fatigue occurs when we toss and turn, have trouble falling asleep, can’t stay asleep or experience a combination of all three. Fatigue can lead to lack of energy, a decrease in motivation and even more serious health conditions, such as depression, obesity, diabetes and thyroid problems.

Poor sleeping habits can be doubly hard on nurses because we juggle not only long shifts, but swing shifts. An inconsistency with our bodies’ normal circadian system creates even more havoc when trying to get a good night’s rest. Fortunately, there are some simple ways to get a better night’s rest.

14 tips for sound sleep

Cleveland Clinic developed its Go!® to Sleep online program, which provides six weeks of effective sleep therapy for use at home. Here are some sleep hygiene tips from the program and other sources to improve your sleep:

1. Develop a bedtime routine. Following a nightly routine prepares our bodies and minds for sleep. Unfortunately, many of us are glued to late-night TV shows, catching up on emails or working through to-do lists rather than settling down. Stick to this routine instead: Brush your teeth, dim the bedroom lights, read a chapter of your favorite book and use the following techniques as they fit your lifestyle.
2. Get comfortable. You don’t need the most expensive mattress or comforter, just a cozy place to rest your head. Use a fan to block out unwanted noise, black out the room (see below) and keep the temperature between 65 and 70 degrees Fahrenheit. If your room becomes too hot or cold, you may awaken frequently.
3. Turn off electronics. Put down your smart phone, turn off the TV and close the laptop. Studies reveal that the blue light from our electronic devices causes suppression of the hormone melatonin, thus shifting our circadian rhythms and interrupting our sleep. Designate the bedroom for two things only – sleep and sex.
4. Try progressive muscle relaxation. While in bed, focus on each muscle group in your body. Tense selected muscles for a few seconds, then slowly relax them over the course of 20 to 30 seconds. There are many free apps that can guide you through this on your smartphone. (Yes, I said no phones in the bedroom, but until you learn how to complete this technique on your own you might need some assistance! Once you have mastered the practice, ditch the phone.)
5. Black out the room. If you work night shift, you know how hard it is to sleep with the morning sun beaming through your windows. Melatonin is the hormone responsible for sending us off to sleep. The darker the room, the more melatonin we produce and the better we sleep. Purchase black-out shades for every window in your bedroom so it’s completely dark even on the sunniest days.
6. Use blue–light blocking sunglasses. Night shift nurses may also consider purchasing blue-light blocking glasses. Wearing them after work before you step into the bright morning light will help increase your chances of producing more melatonin, thus enhancing your ability to sleep. The glasses’ light blocking abilities also will help keep your cortisol levels low, which can contribute to improved sleep.
7. Invest in ear plugs. Sleeping during the day is not easy, especially when the rest of the world is hard at work. The sounds of lawn mowers or kids playing on the street can easily awaken you. Ear plugs will help minimize the disruptions you cannot control.
8. Drink chamomile tea. Your new bedtime routine might include a cup of chamomile tea to help reduce your anxiety. The soothing herbal effects of this warm drink could be the answer on stressful days.
9. Get a whiff of lavender. Lavender scents produce a calming effect on the body. Try lavender essential oils or candles in the bedroom to help decrease insomnia.
10. Listen to soothing music. Classical, smooth jazz or sounds of the ocean might help calm your mind and body, even bringing you back to your last vacation.
11. Warm yourself. Just like drinking a hot cup of chamomile tea, try a hot shower or bath before bed. Warming up the body prepares your mind and body for the relaxation phase of your day.
12. Aim for consistent sleep. Ideally, try to get seven hours of sleep a night. Attempt to maintain homeostasis by going to bed and waking up at the same time every day. Admittedly, this is hard if you rotate day and night shifts, but do your best.
13. Boost your magnesium intake. Magnesium helps keep us asleep through the night. Try eating pumpkin seeds or spinach to help boost levels naturally. Over-the-counter supplements might also be beneficial if you suffer from hypomagnesemia (deficiency of magnesium in the blood), but check with your healthcare provider before starting any new supplements or medications.
14. Take a melatonin supplement. If you still have trouble after using the other sleep hygiene tips, check with your healthcare provider about using over-the-counter melatonin supplementation.

Good sleep is essential. We only live once, so why not feel good every day – and night?

Mallory Hatmaker, MSN, BSN, CNP, is a regular contributor to Consult QD—Nursing. She is an Adult/Gerontology Certified Nurse Practitioner who has been a staff nurse at Cleveland Clinic since 2009. She currently works in the Employee Wellness and Internal Medicine Departments at Cleveland Clinic, where she spearheads an initiative on Nursing Wellness.