Improving Sleep Quality for Shift Workers

Speaker 1 0:00

In the last episode of the podcast , I discussed why do we wake during sleep . It was episode one of what is going to be a three-part episode around sleep . In today's episode , I talk about how to wake up less frequency frequently at night . So let's get on with part two of this three-part series . Shift work can be brutal , but it doesn't have to be . Welcome to a healthy shift . My name is Roger Sutherland , certified Nutritionist , veteran Law Enforcement Officer and 24-7 Shift Worker for almost four decades . Through this podcast , I aim to educate shift workers , using evidence-based methods , to not only survive the rigors of shift work , but thrive . My goal is to empower shift workers to improve their health and well-being so they have more energy to do the things they love . Enjoy today's show and welcome to a healthy shift podcast where we explore evidence-based strategies for improving your sleep quality as a shift worker .

Speaker 1 1:16

Now I'm your host , roger Sutherland , and today we're diving into the topic of waking up less frequently while we should be sleeping . Now , whether you're struggling with insomnia , restless legs or simply too many late-night bathroom trips , I've got you covered with some practical tips which will help you to sleep through the night . So let's just start off from the outset with my top five tips to sleep through the night , and these are all important because these are the key reasons why we do tend to suffer with wake-ups and not being able to go back to sleep during the periods that we have allocated for our sleep . Now , one of the most important things is we should be limiting our exercise into an earlier part of the day . All right , one of the most important things and one of the biggest mistakes that I see shift workers making is coming home from night shift and going straight to the gym and training , and this is literally suicidal for your sleep . It is death to sleep when this happens . Now I know some people will say oh no , but it really helps me . You run the risk of injury . You run the risk of absolutely wasting that training session because your body has elevated cortisol at that time . It's not going to cash in on the adaptations of that training . People , please , I need you to understand . The completion of night shift should be signaling yay , let's get to bed . That's the most important thing that we must be thinking about when we finish night shift . It is not clever , it is not smart and your coach is not proud if you are heading to the gym and going to train on the way home from your night shift . I'm sure I've just made that point .

Speaker 1 3:02

So we do not do that . We also don't do any exercise other than maybe just going for a very gentle walk prior to sleep . One of the things that exercise does for us is it actually stimulates our central nervous system . It puts us into a sympathetic state . Now that's what we want . This is good stress . This is called eustress and this is the stress that we actually want when we exercise , because it teaches our body to adapt to the stressor . So therefore we grow muscle or we improve our cardiovascular health . So it's really important that we do that .

Speaker 1 3:39

But that sympathetic state is poor for our sleep . We need to be getting ourselves back into a parasympathetic state beforehand . So that's the first one , that's my first tip . And also we need to be making sure that if we are having a nap and when I say nap , I mean 20 to 30 minute nap If you do not climb into bed , grab your teddy bear and have a sleep for four hours , that's not a nap , that is a sleep , and some shift workers would call that a marathon sleep for hours . So let's just be clear that our naps need to be earlier in the day , like 12 to 2 o'clock at the late 2 o'clock at the latest for a nap . I wouldn't be napping any later than that or you will start to impact on your sleep overnight and we'll go into that more later .

Speaker 1 4:28

We need to drink less fluids before bedtime , dar . Does that not make sense ? But how many people are sitting around drinking at night and then they go to bed , go to sleep , go really well , and then they're waking up and going to the bathroom all the time because our body is processing that . We're eating our chickens and salads , we're eating our food . It's sucking the water out of everything . It's got to go somewhere . Our body needs to get rid of it and that's why we end up having to wake up and urinate while we're sleeping , or we should be sleeping , and it's waking us up . Then the brain ticks over because we're shift workers and we're reticent . Then the stresses it causes us all sorts of problems .

Speaker 1 5:04

Now the other thing that we need to focus on , the other tip , is time , light exposure , which is according to your sleep weight schedule . We need to optimize this . This is something that we need to do . It's very important . We need to be getting that daylight exposure upon waking . If you're in a regular run of nights , you still need to be getting that daylight exposure when you wake up . We don't crawl out of bed , crawl to the couch and just lay on the couch and nap and watch TV . That is going to cause us more problems .

Speaker 1 5:36

Get up , get outside , take yourself for a stroll , go for a little walk , just , gentle , walk out in the daylight . That daylight will trigger that circadian rhythm into okay , we're up and about its movement time and you will feel so much better . If you're on day shift , you need to be getting that daylight as soon as you possibly can . Get outside , go for a walk , go and sit outside and have your coffee in the morning , go and do whatever , but just get outside into that light . We need to optimize the bedroom to be cool , dark and quiet and I'll do more on that one later as well and avoid alcohol , caffeine and large meals before bed and we will cover off on that as well . That's my five major tips in relation to sleeping through the night . Those five things are almost six . There's light exercise and nap . Light exercise , naps Both of those need to be earlier in the day . Drink less fluids before bedtime , nighttime exposure according to your time , light exposure according to your sleep , weight schedule , and optimizing the bathroom to be cool , dark and quiet , and avoiding alcohol , caffeine and large meals before bed . That's really , really important and generally when I speak to clients and talk to clients about their sleep issues , it will be one , two or more of those that is actually impacting on their sleep .

Speaker 1 7:00

Most shift workers can go to sleep . There's no problems with them going to sleep . It's staying asleep and this is the problem and this is what causes us to wake up those things there . So why do we keep waking up at night ? Now , I covered this in the last episode , but just to quickly recap , we can have shift work sleep disorder , which is a diagnosable condition , and it's something that well , you might have to reconsider whether shift work is the thing for you if you've got something like that . But that gets diagnosed by a physician and it gets dealt with . You would have heard about this on the last episode .

Speaker 1 7:33

Insomnia , mental health conditions , sleep apnea , restless legs you know we can have all sorts of problems with that and it can be incredibly annoying and wake us up . We can have poor sleep hygiene . We don't have any sleep hygiene , that can be a massive problem . We've got no productive habits to help our poor body to go to sleep . And then the famous words of Tom Coleman If you create the environment , your body will take care of the rest . And I keep on repeating this . But it is such a good expression because I know from my own experience that if you do create the environment , your body will sleep and continue to sleep . But there's so many other outside environmental factors that we compromise this with and then we say I can't sleep , we're causing it , it's a problem . We have odd sleeping schedules night shift , day shift , afternoon shift , swing shift , disco shifts All of those shifts are all causing us all sleep disruption and circadian rhythm disruption , which can be massive problems for us , our age , and we also talk about physical conditions with chronic pain , acid reflux and neurological disorders as well . And also I want to make this point as well , which is really really important If you seem to be suffering from sleep and you go and see your physician and you end up on a medication for sleep , you're probably even further compromising your sleep .

Speaker 1 8:59

And I'm not someone here that's to argue with a doctor , but I'm telling you what science tells us around a sleep medication . A sleep medication is a very quick fix for a doctor to prescribe a sleep medication . They would be much better off prescribing you to go and see a sleep expert to talk back through all of these environmental factors to help you to create this environment for sleep . When you take a sleep medication , you are not asleep , you are unconscious . That person that comes into your work that tells you oh , I had eight hours sleep today and it's fantastic , you know , I slept from this time to this time , but they look like death warmed up . They weren't asleep . The body hasn't gone through all of the natural cycles of sleep that it needs to go through every single cycle of the ultradian rhythm every 90 minutes .

Speaker 1 9:51

Very , very important that people understand this those medications that you take , those nurses , friends or and I'm excluding melatonin here I'm not including melatonin . Melatonin is something that can be very good for us to use on night shift , and I'll do another podcast on melatonin because I think it's something that's really important but that doesn't mean go out and buy the strongest dose of melatonin . We only need enough to put us to sleep . But the efficacy of melatonin is also extremely questionable , so we don't just get it off the shelf . Really important , all right , so we've covered off on those things . So the tips on how to stay asleep through the night , and that's what the podcast is about We've covered the rest .

Speaker 1 10:35

So what we need to do to start off with is we need to condition ourselves and we need to aim for seven to nine hours of sleep each night . Stop laughing . All right , I know , remember . I've done shift work for nearly 40 years . I know how difficult it is . So don't come at me and say what would you know ? Because I do know and I'm here to help you with this . I'm going on what I have learned , with what I've experienced myself , so I'm in a position to actually help you Psychologically .

Speaker 1 11:10

When we are aiming for that time and , of course , we all go to bed and we don't think , oh , I only want to sleep for three hours we don't do that . We go to bed because we want to sleep as long as we can . But what we do need to do is condition our brain that we are out of action for seven hours minimum . That's what we need to do . And when we condition our brain to that and that's the root same we set up , what do you think the body does , the body gets used to that . But if you have got things on your mind of I've got that work to do , or that patient really upset me , or this happened , or that happened , or I normally wake up at 10 o'clock when I'm on night shift , so that's what I'll do today . You are actually conditioning your brain to do that . Be careful . How many times have you woken up before the alarm when you're on a day shift or whatever ? That's for those that can go to sleep before a day shift , but anyway , that's another story . But how many times have you woken up just before the alarm ? And the reason for that is that circadian rhythm , that clock internally , psychologically , mentally , subconsciously . Your brain is actually thinking that and that's why we wake up as well . So we need to aim condition , get ourselves ready for that . Seven hours of sleep minimum every time . We also need to improve our sleep hygiene . We can all benefit from our sleep hygiene . We must minimize our electronic device use in bed .

Speaker 1 13:24

If you've got a TV in your bedroom , get rid of it . Honestly , seriously , why have you got a TV in bed ? There's only three things that we

Optimizing Sleep Habits for Better Rest

Speaker 1 13:31

should be doing in the bedroom . There's only three things that we should be doing in bed . All three of them start with S One sleep , the other one is sick and the other one starts with S , and we perform it as a couple , and I'll just leave your imagination to do that . There is nothing else that we should be doing in bed .

Speaker 1 13:49

If you have sleep issues and you are lying in bed watching TV , you have no one else to blame but yourself , because you are conditioning your brain that this is where we go online , think and watch TV . That's exactly what we're doing . So we need to remove that TV from the bedroom . We need to put that phone out on the kitchen bench and charge it out on the kitchen bench . These are the key things that sleep experts will work with you on . Why ? Because it works , and that's something that is really , really important .

Speaker 1 14:21

So what we have to do is we have to minimise those electronic devices . It's not just the blue light , it's literally what we're absorbing as content , and I talked about that in the last podcast . So just remember that content is causing you psychological damage all the time , watching your friends away on holidays in different countries while you're in the middle of a night shift . Well , it's miserable . People are off laying on beaches around the world and it's sunny . People have got fantastic bodies in bikinis and you're looking at them , feeling miserable in yourself . These things all impact greatly on us and when we go to sleep we wake up , things happen , these things start ticking over in our mind and it doesn't support good sleep .

Speaker 1 15:04

Now we also need to exercise earlier in the day to avoid interfering with the sleep , and I covered off on that just before in relation to stimulating our central nervous system and putting us into a sympathetic state , which is less than ideal for sleep . It elevates our heart rate . It gets the glucose pumping through our system . We don't want that . When we're trying to go to sleep , what we want to do is we want to be calm and we want to be relaxed . We need to reduce alcohol . That's another thing .

Speaker 1 15:31

Having alcohol before sleep , a lot of people will say , oh , I need alcohol to relax . And yep , alcohol can be something that relaxes us , there's no doubt about it but it also severely impacts on our sleep cycles and we do not get the deep , restorative sleep that we need by alcohol . It also causes our body to park any nutrients that we've had and store them as body fat while it deals with the toxin of the alcohol in our bloodstream . Our body sees alcohol as a toxin and what it does is it shelves everything else to work really hard on the alcohol before we go , before it can deal with the nutrients . So what happens to the nutrients ? They get park just body fat . This is a problem . It's a massive problem for us .

Speaker 1 16:16

So what we want to do is we need to avoid alcohol before sleep , and when I say before sleep , I'm talking four or five hours before sleep , really , really important . I know I'm only laying it out , all right , I'm just telling you what could be impacting on your sleep . I'm not giving you the Dear John or mum or dad lecture , I'm just saying caffeine . It's important to note this recent research around caffeine that shows that even just 120 milligrams of caffeine which is around about your normal two shots which is in your latte up to 8.8 hours prior to sleep , will impact on subsequent sleep . The best thing to do is to avoid caffeine eight hours before sleep , full stop .

Speaker 1 17:03

Now you might think having that caffeine at five , four or five o'clock in the morning is absolutely fine and it doesn't impact on your sleep . I'm going to call bullshit and I'll tell you why . You might get home and go to sleep , no problems whatsoever . But the problem is you then release the sleep pressure and then what happens is you wake up and that caffeine molecule floating around in your bloodstream then blocks the adenosine receptor and you cannot go back to sleep . There's another reason why . So if you think you can go to sleep , so caffeine is not impacting on it , then you can go to sleep . That might be true , but the problem that you have is , once you've released that sleep pressure because you've gone to sleep , you're in a world I heard after that , and that's one of the reasons why we wake up . So keep that in mind as well . It is really , really important . Okay now , avoid drinking large amounts of fluids before bedtime to minimize nighttime bathroom trips , like you know . Really seriously , we know that .

Speaker 1 17:57

Adjust your nap schedule to avoid late afternoon naps or naps that last too long and I've spoken about naps at length a number of times 20 to 30 minutes maximum . You've got to take that and get up Straight away . The reason being is you won't go into that first sleep cycle and you will wake up Quicker than you would if you wake yourself up mid-cycle after an hour or so , because you will have chronic sleep Immersion and that is going to cause you massive problems and also it will Get rid of that sleep pressure , and it will . It takes a long time to build that sleep pressure to go back to sleep at night Again , alright , so we've got to get rid of that Now , when it's a developer regular bedtime routine which will signal to your body that it's time to wind down . Okay , I'll cover it off on that earlier , but I need to make it very clear to you regular sleep routines , as Close to regular as you can , and that doesn't mean on your days off that you have a late night , go out all night and then sleep in half the day . You are actually compromising yourself really badly , and I will also make it quite clear for you as well .

Speaker 1 19:07

Sleep catch ups yeah , you can't catch up on sleep . It doesn't work that way . You've got a sleep debt . You won't catch up on it . What will happen is you will throw your circadian rhythm further out . You need to get up , get on with it and , if you feel tired , have yourself a nap for 20 to 30 minutes between 12 and 2 , and then you will Be fine to go to continue on and it won't impact on your Subsequent sleep . Now we need to limit our awake time in bed by only going to bed when you're feeling sleepy .

Speaker 1 19:39

One of the worst problems that we can actually have , particularly as shift workers with a de-synchronous circadian rhythm it's just going to bed because we feel like we should . We have all these impacts the caffeine , the alcohol , the poor sleep hygiene , everything . Once again , if you create the environment , your body will take care of the rest of it . But don't go to bed and lie there in bed for half an hour thinking I'm not really tired , so I'll just grab my phone and scroll on your phone until you get tired and go to sleep . It's going to put you'll still go to sleep , but it's going to impact on the quality of your sleep . That's the biggest problem that we have . So make sure that you're tired when you do go to bed , and that's the most important thing that you can do .

Speaker 1 20:20

Or one of the most important things and the next thing is the most important is you've got to manage that light exposure by spending time outside in daylight during the day and Optimizing that bright light in the evening . Our circadian rhythm counts on it . We ask a lot of our bodies , but the one thing that it will respond to is that blue light from outside daylight Earlier in the day to reset the circadian rhythm , to tell it that it's daytime . If you think about it , if you get up and you actually wander around the house all day and you don't get any daylight , no wonder you can't sleep , no wonder you can't function , no wonder you've got brain fog and headaches and you feel chronically fatigued Because you haven't reset your circadian rhythm and your body has absolutely no idea where it is at in time and space and Lights inside the house are simply not bright enough during the day to stimulate us . There are only around about 500 lux of light . We need 10,000 lux . 10,000 lux is daylight outside . Even on an overcast day , you're still getting somewhere between 6,000 to 10,000 lux of daylight , which is what we need to actually Stimulate and reset our circadian rhythm . This going around inside with our lights on yet doesn't work . The lights are simply not bright enough and it's insufficient blue light during the day , too much at night you , but it's not enough during the day to stimulate us and we're learning more and more about that current times . There's a lot of evidence and information that's going to come out in relation to our internal lighting in houses . So watch this space .

Speaker 1 22:09

So when should we be concerned about waking up frequently ? Other than the obvious ? We're trying to sleep during the day when we're on night shift , but occasional nighttime awakenings or occasional wakings during shift work are normal . But frequent disruptions and feeling unrested when you do wake up could actually indicate a sleep disorder or another health issue which I covered off in the last episode . So what we need to do is we need to speak to our health care provider as a matter of course . This is not a conversation to have around the table with Jenny and Karen and everybody at work . This is a conversation to have with your physician , because your physician can have a look at a whole range of things and refer you on to a sleep specialist who can help you to create the optimal environment for you to go to sleep All right . So in the next episode , what I will do is I will discuss the key , and that is what to do when we wake up overnight .

Speaker 1 23:09

So thank you for tuning in for this episode of a healthy shift . By understanding the reasons behind nighttime awakenings or shift work awakenings and implementing these practical tips , you can take steps towards achieving a more restful night sleep , but remember prioritizing your sleep health is essential for overall well-being . So don't hesitate to seek support if you're struggling with sleep . And until next time , sleep well and take care . Thank you for listening . If you enjoyed this episode , be sure to subscribe so you get notified whenever a new episode is released . It would also be ever so helpful if you could leave a rating and review on the app you're currently listening on . If you want to know more about me or work with me , you can go to ahealthyshiftcom . I'll catch you on the next one .