Laura Vater remembers sneaking into her home after 12-hour night shifts during medical training while her husband distracted their toddler. The stealthy tag-teaming effort helped her get enough undisturbed sleep before returning to an Indiana University hospital the following night to repeat the pattern.<\/p>\n
\u201cHe would pretend to take out the trash when I pulled in,\u201d said Vater, MD, now a gastrointestinal oncologist and assistant professor of medicine at IU Health Simon Cancer Center in Indianapolis. \u201cI would sneak in so she [their daughter] wouldn\u2019t see me, and then he would go back in.\u201d<\/p>\n For Vater, prioritizing sleep during the day to combat sleep deprivation common among doctors-in-training on night shifts required enlisting a supportive spouse. It\u2019s just one of the tips she and a few chief residents shared with Medscape Medical News<\/em> for staying sharp and healthy during overnight rotations.<\/p>\n While the pace of patient rounds may slow from the frenetic daytime rush, training as a doctor after the sun goes down can be quite challenging for residents, they told Medscape Medical News<\/em>. From sleep deprivation working while the rest of us slumbers to the after-effects of late-night caffeine, learning to manage night rotations requires a balance of preparation and attention to personal health while caring for others, the residents and adviser said.<\/p>\n Compromised sleep<\/a> is one of the biggest hurdles residents have to overcome. Sleep loss comes with risks to cardiovascular disease and type 2 diabetes, among other heath conditions, according to Medscape<\/em> Medical News<\/em> reports. And night shift workers\u00a0<\/a> who sleep 6 or fewer hours a night have at least one sleep disorder.<\/p>\n Sleep deprivation associated with overnight call schedules also can worsen a resident\u2019s mood and motivation while impairing their judgment, leading to medical errors, according to a new study<\/a> published in JAMA Open Network<\/em>. The study proposed shorter consecutive night shifts and naps as ways to offset the results of sleep loss, especially for interns or first-year residents.\u00a0<\/p>\n Residency programs recently have been experimenting with shorter call schedules<\/a>.<\/p>\n Working the night shift demands a disciplined sleep schedule, said Nat deQuillfeldt, MD, a Denver Health chief resident in the University of Colorado\u2019s internal medicine residency program.<\/p>\n \u201cWhen I was on night admissions, I was very strict about going to sleep at 8 AM and waking at 3 PM every single day. It can be very tempting to try to stay up and spend time with loved ones, but my husband and I both prioritized my physical well-being for those weeks,\u201d said deQuillfeldt, a PGY-4 resident. \u201cIt was especially challenging for me because I had to commute about 50 minutes each way and without such a rigid schedule I would have struggled to be on time.\u201d<\/p>\n deQuillfeldt doesn\u2019t have young children at home, a noisy community, or other distractions to interrupt sleep during the day. But it was still difficult for her to sleep while the sun was out. \u201cI used an eye mask and ear plugs but definitely woke up more often than I would at night.\u201d<\/p>\n Blackout curtains may have helped, she added.<\/p>\n \u201cWithout adequate sleep, your clinical thinking is not as sharp. When emergencies happen overnight, you\u2019re often the first person to arrive and need to be able to make rapid, accurate assessments and decisions.\u201d<\/p>\n As a chief resident, she chooses never to sleep during night shifts.<\/p>\n \u201cI personally didn\u2019t want to leave my interns alone or make them feel like they were waking me up or bothering me if they needed help, and I also didn\u2019t want to be groggy in case of a rapid response or code blue.\u201d<\/p>\n But napping on night shift is definitely possible, deQuillfeldt said. Between following up on overnight lab results, answering nurses\u2019 questions, and responding to emergencies, she found downtime on night shift to eat and hydrate. She believes others can catch an hour or 2 of shut eye, even if they work in the intensive care unit, or 3-4 hours on rare quiet nights.<\/p>\n Vater suggests residents transitioning from daytime work to night shift prepare by trying to catch an afternoon nap, staying up later the night before the change, and banking sleep hours in advance.<\/p>\n When he knows he\u2019s starting night shifts, Apurva Popat, MD, said he tries to go to sleep an hour or so later nights before to avoid becoming sleep deprived. The chief resident of internal medicine at Marshfield Clinic Health System in Marshfield, Wisconsin, doesn\u2019t recommend sleeping during the night shift.<\/p>\n \u201cI typically try not to sleep, even if I have time, so I can go home and sleep later in the morning,\u201d said Popat, a PGY-3 resident.<\/p>\n To help him snooze, he uses blackout curtains and a fan to block out noise. His wife, a first-year internal medicine intern, often works a different shift, so she helps set up his sleeping environment and he reciprocates when it\u2019s her turn for night shifts.<\/p>\n Some interns may need to catch a 20- to 30-minute nap on the first night shift, he said.<\/p>\n Popat also seeks out brighter areas of the hospital, such as the emergency department, where there are more people and colleagues to keep him alert.<\/p>\n Lack of sleep makes it even more difficult to eat healthy on night shift, said Vater, who advises residents about wellness issues at IU and on social media.<\/p>\n \u201cWhen you are sleep deprived, when you do not get enough sleep, you eat but you don\u2019t feel full,\u201d she said. \u201cIt\u2019s hard to eat well on night shift. It\u2019s harder if you go to the break room and there\u2019s candy and junk food.\u201d<\/p>\n Vater said that, as a resident, she brought a lunch bag to the hospital during night shifts. \u201cI never had time to prep food, so I\u2019d bring a whole apple, a whole orange, a whole avocado or nuts. It allowed me to eat more fruits and vegetables than I normally would.\u201d<\/p>\n She advises caution when considering coffee to stay awake, especially after about 9 PM, which could interfere with sleep residents need later when they finish their shifts. Caffeine may help in the moment, but it prevents deep sleep, Vater said. So when residents finally get sleep after their shifts, they may wake up feeling tired, she said.<\/p>\n To avoid sleepiness, Popat brings protein shakes with him to night shifts. They stave off sugar spikes and keep his energy level high, he said. He might have a protein shake and fruit before he leaves home and carry his vegetarian dinner with him to eat in the early morning hours when the hospital is calm.<\/p>\n Eating small and frequent meals also helps ward off sleepiness, deQuillfeldt said.<\/p>\n Trying to stay healthy on night shifts, Vater also checked on patients by taking the stairs. \u201cI\u2019d set the timer on my phone for 30 minutes and if I got paged at 15, I\u2019d pause the timer and reset it if I had a moment later. I\u2019d get at least 30 minutes in, although not always continuous. I think some activity is better than none.\u201d<\/p>\n Vater said her hospital had a gym, but it wasn\u2019t practical for her because it was further away from where she worked. \u201cSometimes my coresidents would be more creative, and we would do squats.\u201d<\/p>\n Popat tries to lift weights 2 hours before his night shift, but he also takes short walks between patients\u2019 rooms in the early morning hours when it\u2019s quietest. He also promotes deep breathing to stay alert.<\/p>\n Vater urges those coming off night shifts, especially those transitioning for the first time from daytime rotations, not to drive if they\u2019re exhausted. \u201cGet an Uber. \u2026 Make sure you get a ride home.\u201d<\/p>\n The CU residency program covers the cost of a ridesharing service when doctors-in-training are too tired to drive home, deQuillfeldt said. \u201cWe really try to encourage people to use this to reduce the risk of car accidents.\u201d<\/p>\n The residency program also links residents with primary care and mental health services. People who really struggle with shift work sleep disorder may qualify for medications to help them stay awake overnight, in addition to sleep hygiene apps and sleep aides.<\/p>\n \u201cNight shifts can put a strain on mental health, especially when you\u2019re only working, eating, and sleeping and not spending any time with family and friends,\u201d deQuillfeldt said. \u201cMy husband works late afternoons, so we often would go weeks seeing each other for 15-20 minutes a day.\u201d<\/p>\n \u201cSleeping when the sun is out often leads to a lack of light exposure and, possibly, which can compound the problem. Seeking mental health support early is really important to avoiding burnout,\u201d she said.<\/p>\n She also recommended planning a fun weekend activity, trip, or celebration with friends or family after night shifts end \u201cso you have something to look forward to. \u2026 It\u2019s so important to have a light at the end of the tunnel, which will allow you to enjoy the sense of accomplishment even more.\u201d<\/p>\n For more advice on the subject, consider the American Medical Association<\/a> guide to managing sleep deprivation in residency or Laura Vater\u2019s tips for night shifts<\/a>.\u00a0<\/em><\/p>\n Roni Robbins is a freelance journalist and former editor for Medscape Business of Medicine. She\u2019s also a freelance health reporter for The Atlanta Journal-Constitution. Her writing has appeared in WebMD, HuffPost,\u00a0Forbes,\u00a0New York Daily News, BioPharma Dive, MNN,\u00a0Adweek, Healthline, and others. She\u2019s also the author of the multi-award\u2013winning Hands of Gold: One Man\u2019s Quest to Find the Silver Lining in Misfortune.<\/em><\/p>\n<\/div>\n![\"Business](\"https:\/\/img.medscapestatic.com\/vim\/live\/professional_assets\/medscape\/images\/thumbnail_library\/ht_241219_laura_vater_120x156.jpg\")
Business News Catching Zzs<\/strong><\/h2>\n
![\"Business](\"https:\/\/img.medscapestatic.com\/vim\/live\/professional_assets\/medscape\/images\/thumbnail_library\/ht_241219_nat_dequillfeldt_120x156.jpg\")
Business News Bypass Vending Machines<\/strong><\/h2>\n
![\"Business](\"https:\/\/img.medscapestatic.com\/vim\/live\/professional_assets\/medscape\/images\/thumbnail_library\/ht_241219_apurva_popat_120x156.jpg\")
Business News Take the Stairs<\/strong><\/h2>\n
Business News Ask for a Ride<\/strong><\/h2>\n
Business News Promoting Mental Health<\/strong><\/h2>\n