Keeping the night shift healthy (and happy ) Danielle Livelsberger RPSGT OSU Sleep Lab Manager

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1 Keeping the night shift healthy (and happy ) Danielle Livelsberger RPSGT OSU Sleep Lab Manager

2 Objectives Identify good sleep practices Identify actions to help manage sleep when working night shift

3 Sleep Hygiene Good advice for everyone Part of a healthy lifestyle

4 Sleep Hygiene Lifestyle Bedtime routines Environmental factors Can be changed to improve sleep

5 Sleep-Wake Pattern Same wake up time every day Same bedtime every night Avoid naps

6 Caffeine Caffeine is a stimulant Products with caffeine Coffee, tea, soda Cocoa, chocolate Energy drinks OTC pain medications OTC weight control medications

7 Caffeine Read labels Stop caffeine 4 hours before bedtime May need to stop after lunch

8 Nicotine Nicotine is a stimulant Nervous system arousal despite feeling relaxed

9 Nicotine No smoking before bedtime No smoking during the night Stop smoking

10 Alcohol Alcohol is a depressant Helps initial sleep onset Alcohol metabolites cause restlessness More awakenings in 2 nd half of the night Alcohol causes dehydration Wake up due to thirst and need to urinate Alcohol causes dependence

11 Alcohol Stop alcohol 4 hours before bedtime Do not use alcohol to manage sleep

12 Diet Food metabolism & sleep active processes Hunger & fullness wakefulness Dieting & rapid weight loss can cause broken sleep

13 Diet Eat light snack before bedtime Eat small amount or nothing if awake during night Avoid foods causing indigestion Avoid too much fluid 1 cup = ½ can within 4 hours of bedtime? warm milk

14 Exercise Physically fit better sleep quality Physical activity stimulation

15 Exercise Time of exercise can help sleep Late afternoon Early evening 5 to 6 hrs before bedtime

16 Environmental Noise Sudden, unexpected noise wake up or lighter level of sleep Can desensitize to noise: train, plane, cars Continuous sounds soothing vs irritating:? Clock ticking? Fan? ear plugs only block certain decibels

17 Environmental Noise Quiet the environment Learn what works for you

18 Room Temperature Temperature > 75 F too hot Temperature < 55 F too cold Suggested temperature is 65 F

19 Air Quality Fresh air promotes sleep Stuffy room impairs sleep

20 Body Temperature Warm bath promotes relaxation 2 hours before bedtime best

21 Light Light encourages wakefulness Bright white lights most problematic Dark curtains or shades for room

22 Clock Don t be a clock watcher!

23 Bed Mattress and pillow Personal preference You get what you pay for

24 Pre-sleep Routine Start minutes before bedtime Wind down from daytime activities Complete work of primary importance Complete other activities Relax read, TV, relaxation therapy

25 Pre-sleep Routine Pre-bed sequence: lock up house change clothes wash medication Go to bed... Relax... Sleep

26 Go To Bed Make sleep a priority Schedule your bedtime Same time every night weekend days off

27 Stimulus Control 2 Basic Principles Standardize the sleep wake schedule Eliminate behaviors: Incompatible with sleep Occur in bedroom Occur in bed

28 Stimulus Control Same bedtime every night Same wake time every morning Avoid naps

29 Stimulus Control Go to bed only when sleepy or tired

30 Stimulus Control If you do not go to sleep: Get out of bed Go to separate room Do non-stimulating activity Go back to bed when you feel sleepy or tired again

31 Stimulus Control Use the bedroom ONLY for: Sleep Intimacy

32 Stimulus Control No TV No work No computer No...

33 But I work night shift...

34 Sleep Hygiene Sleep - wake pattern Caffeine Nicotine Alcohol Diet Exercise Environmental factors....

35 Sleep Hygiene Environmental factors Noise Room temperature Body temperature Air quality Light Mattress & pillows

36 Special Concerns: Night Shift Workers Can t keep same schedule 7 days a week Social demands of life Reason for working night shift Circadian rhythm

37 Special Concerns: Night Shift Workers Sleep deprived 1.5 hours less sleep than non-shift workers

38 Special Concerns: Night Shift Workers Drowsy Driving More likely to nod off while driving Increased incidence of MVA & near misses

39 Special Concerns: Night Shift Workers Health issues Metabolism - weight, adiposity Immune response - cancer Mood - depression

40 The Opponent Process Model of Sleep Regulation Homeostatic drive for sleep Awake Sleep Circadian drive for wakefulness 9 AM 3 PM 9 PM 3 AM 9 AM Awake Sleep Adapted from Moore RY. Current Perspectives in Insomnia, Vol 3,

41 Circadian Rhythm 24 hour biological clock Light Melatonin Body Temperature

42 Melatonin Levels increase at night, low during day Bell shaped curve Dim light melatonin onset (DLMO) Causes sleepiness Antioxidant & anti-inflammatory properties

43 Body Temperature Decrease in temperature sleepiness Tmin most sleepy Lowest temp about about 4 AM

44 Light at Night Suppress melatonin levels Decreases inflammatory responses Body mass, adiposity and glucose elevated Depressed affective responses

45 Goal: Recommendations for Night Shift Workers Circadian adaptation Phase delay Get the Tmin into your sleep!

46 Recommendations for Night Shift Workers Nap Before your night shift minutes

47 The Opponent Process Model of Sleep Regulation Homeostatic drive for sleep Awake Sleep Circadian drive for wakefulness 9 AM 3 PM 9 PM 3 AM 9 AM Awake Sleep Adapted from Moore RY. Current Perspectives in Insomnia, Vol 3,

48 Recommendations for Night Shift Workers Caffeine mg During first 2 hours of shift

49 Recommendations for Night Shift Workers Wear Sunglasses Use on drive home from work Bandit frames top and side shields Expresso lenses transmit 12% light Approved for driving

50 The Opponent Process Model of Sleep Regulation Homeostatic drive for sleep Awake Sleep Circadian drive for wakefulness 9 AM 3 PM 9 PM 3 AM 9 AM Awake Sleep Adapted from Moore RY. Current Perspectives in Insomnia, Vol 3,

51 Recommendations for Night Shift Workers Take precautions to drive safely Pull off the road in a safe place if you feel very drowsy Car pool if possible so someone else is awake in the vehicle

52 Recommendations for Night Shift Workers Go to bed Early in the morning after your night shift

53 Recommendations for Night Shift Workers Keep environment conducive to sleep Dark room Turn off phone Tell others not to call / visit during sleep time

54 Recommendations for Night Shift Workers Sleep in late on nights off

55 Goal: Recommendations for Night Shift Workers Circadian adaptation Get the Tmin into your sleep!

56 Have a good sleep

57

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