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Sleep is a key component of Wellness, and good, restorative sleep can be elusive for emergency physicians. Some tips to optimize:

  • Consider using a sleep tracker to see how much sleep you are really getting
  • Set an alarm for bedtime to remind yourself to take a nap before a night shift or to go to bed at a reasonable hour
  • Try to do only 1 night shift at a time, or if that is not possible, no more than 2 in a row
    • After 3 nights, one’s circadian rhythm is reset
    • Alternative potential schedules include: all evening and night shifts, or the Thomas schedule (one or two physicians work all nights for that month, covering most of the night shifts, while the others fill in single nights to give those physicians time off; each physician does one month as the night person per year)
  • Nap before a night shift and don’t schedule meetings for after night shifts
  • Try to schedule shifts so they rotate clockwise, ie from day to swing to night shift
  • Use apps or built-in Apple functions on screens (mobile phone, computer) to reduce blue light exposure from screens before bedtime
  • Avoid sunlight when coming off a night-shift to go home – use blue light blocking sunglasses, keep your home dim, use blackout shades in the bedroom
  • Keep your bedroom dark, quiet (use ear plugs, mute phones), and cool for sleeping
  • Don’t be a “clock-starer” – avoid a bright LCD clock on your bedside table
  • Avoid caffeine for several hours, exercise or alcohol for 3 hours, prior to when you plan to sleep
  • Avoid screens for an hour before you plan to sleep
  • If you find yourself getting up to go to the bathroom a lot, limit excess liquids before sleep
  • White noise may help, or pink or brown noise may be even more helpful – try them out here
  • If you’re having trouble falling asleep, after 15 minutes, get up and read or do something mindless (no screens) for a bit, then try again

Helpful links:

BMJ Optimising sleep for night shifts and infographic

EMRA Sleep better chapter

General sleep hygiene tips

Tuck advancing better sleep

Shift work sleep disorder