Whether I’m getting home at 8AM or 8PM, all I want to do after a shift at the hospital is snuggle into bed and pass out. As soon as I walk in the door, I slide out of my dirty scrubs – ain’t nobody got time for tracking C dif. through the house. I give my family a semi-intelligible greeting, hop in the shower for a quick scrub down, and then collapse into my sheets.
At this point, my body has been ready for sleep for the past six to twelve hours. I was barely able to keep my eyes open on the drive home, so sweet slumber should come in a matter of seconds. I close my eyes, and then BAM!
My mind starts scrutinizing every single decision I made during my last shift. As I race through every med pass, patient interaction, vital sign, and documentation I start to question everything.
Did I remember to document that my patient used their incentive spirometer or record their intake and output every four hours? Was that slight drop in blood pressure the beginning of decompensation? Was there something I missed or could have done to prevent that code? Do I suck at being a nurse? All of these questions and so many more have all spun around in my head as I try to fall asleep.
At this point, I start to get frustrated because I can’t sleep – despite being ridiculously exhausted and knowing I have to wake up in a few hours to get ready for a whole ‘nother shift.
It’s really important to remember that we can learn from mistakes and move forward, but at some point it’s also not beneficial to dissect every small detail. This is especially true when this over analyzation leads to self-doubt and anxiety. This is not productive for you nor your patients.
A good night’s sleep is vital for your mind and body to recharge and prepare to kick butt during your next shift. Sleep keeps us happy, healthy, and resilient. I don’t know about you but I definitely get a little cranky when I am tired – this doesn’t lend well to keeping those HCAHPS high. Sleep is also when our brain moves newly learned information into our long term-memory bank.
Over the years I have tried out many strategies for trying to quiet my mind so I can fall asleep. I am an occasional exogenous melatonin user and that can be good in a pinch, but I prefer to not use any medications if I can avoid it. Studies have shown that using Benadryl (diphenhydramine) can help you fall asleep, but can actually cause decreased quality of sleep.
Here are my top 5 techniques for quieting my mind so that I can get a good night’s sleep.
You can also read about how to Feel Less Exhausted During Your Shift.
1. Practice Good Sleep Hygiene
Sleep hygiene just means good sleep habits. One of the most important aspects of this is being consistent. A good way to do this is by setting an alarm for the time you should start getting ready to sleep.
Have a consistent set of tasks that you do every single night (or morning if you’re a night shifter) that help signal to your body that it is almost time to fall asleep. For me, this means brushing my teeth, washing my face, and making sure my dogs’ water bowl is full for the next day. This also means turning the TV off and stopping whatever I might be working on to allow my brain to slow back down. I like to keep my routine short and sweet, because I don’t have the patience to be messing around before bed.
Basically, you are trying to create a Pavlovian response when getting ready for bed. If you are consistent enough, your body will get so used to your nightly routine that you will notice yourself getting more tired when you start your routine. Create a strong habit so that your body can recognize instantly when it’s about time to sleep. As soon as I start putting on my facial moisturizer, my eyes get a little bit heavier.
“Be consistent with when you get ready for bed. “
Try to be consistent with what you do before bed, but really make sure you are consistent with when you get ready for bed. Having a consistent bedtime and wake time also helps prime your body to knowing when it’s time to fall asleep. Yes, this even means on your days off.
If you are a night shifter or switch between days and nights, the consistent sleep/wake times can be difficult. Try to figure out what the best routine is for you on your days off. For me, I like to clump my shifts together as much as possible. After my last night shift, I sleep just a few hours and try to wake up around 1300 or 1400 – a little earlier than I would wake up for another night shift. I would then work out or run, do a few errands maybe, watch some netflix, eat, do whatever. Then I would still be tired enough to fall asleep at a reasonable time that night. This is the most efficient way I figured out to switch from night shift back to a regular human schedule.
Some other good sleep hygiene techniques to practice are:
- Get some exercise. Avoid exercising within 30 minutes of getting into bed.
- Create a good environment for sleep. Quiet, dark, low stimulus.
- Don’t eat big meals before bed, and obviously avoid caffeine too close to bedtime.
Read my other post about Maintaining Healthy Habits.
Another thing you might try is using one of these amazing eye masks to black out your room if you can’t get black out curtains.
2. Ditch the Technology
I had my phone charger on my bedside table for most of my life. I never paid it much thought and would lie in bed for a while mindlessly watching Youtube videos or scrolling through Instagram. Soon, what I thought was only a few minutes on my phone turned into 20 minutes and then an hour and then it was way past my bedtime.
It was a really hard habit to break, but eventually I removed my phone from the situation by just moving my charge to the other side of the room on my dresser. This has helped me tremendously in not wasting a bunch of time diddling around on my phone before bed.
Another issue with using your phone or whatever electronic device before bed is that it keeps your brain in alert mode. The constant influx of information, news, emails, and social media likes keeps our brain switched on. Refer to technique #1 about creating a good sleep hygiene environment – and this means ditching your technology before bed.
Studies have been coming out lately that the blue light that is emitted from our electronic screens actually suppresses our body’s ability to produce melatonin. Now I know you all know about melatonin from anatomy and physiology. But basically if our brain isn’t producing the proper amounts of melatonin, then our entire circadian rhythm and sleep/wake cycle gets thrown off. You could read a review about it in this Harvard Health article.
This blue light effect is amplified and even more detrimental to night shift workers who are already dealing with busted circadian rhythms. Honestly, we have to give ourselves the best chance we can. One way that we can decrease our exposure to blue light while charting on night shift is to wear glasses with lenses that filter out the blue light. My prescription glasses have a mild blue-blocking coating on them, otherwise I have seen glasses specifically made for filtering out blue light. Ok, yes, a lot of those glasses look pretty lame.
The simplest thing you can do is decrease your electronic use leading up to when you’re trying to go to bed. Also move your phone, tablet, computer, TV, whatever away from your bed, and preferably out of your bedroom!
3. Create a Distraction
I know this is in direct opposition to technique #2, but sometimes desperate times call for desperate measures. For a really long time I had such a hard time falling asleep because I felt like my internal dialogue would just not shut up. Sometimes this dialogue was positive – rife with ideas for new blog posts or new ideas I wanted to discuss with my nurse coworkers.
Unfortunately though, a lot of times the chatter in my head was pretty negative. As the distractions of my life slowed down and I didn’t have a checklist to work through, my thoughts turned to bully me.
The negative thoughts could be about anything from convincing myself that my new coworkers hated me, or that I forgot to tell the oncoming nurse something during handoff, or if my patients were ok after I left. Because of this insistent chatter, my sleep really was being negatively impacted.
I found that sometimes, I just needed something to distract my brain to drown out my inner dialogue. What works best for me is having a funny and light tv show play in the background. It’s important that it’s something that I have seen before so I am not keeping myself up following the plot. For me, the perfect distraction is Bob’s Burgers. It’s silly, not serious, and I really don’t have to pay attention to what’s going on. Just focusing on the characters’ voices in the background versus my own thoughts helps me fall asleep. I usually fall asleep shortly into one episode.
The show you watch as a distraction could be something totally different, Bob’s Burgers is just one that works for me.
Other ways you could distract your internal voice are:
- Calming music
- A podcast of someone who has a soothing voice.
- There are actually podcasts specifically targeted to helping people sleep like “Sleep With Me”
- A sound machine
There are so many benefits that meditation can bring. Meditation can help reduce stress, relieve anxiety, improve self-awareness, and so many other benefits. You can begin your meditation practice during your bedtime routine to prepare yourself for bed. You can also practice meditation while you’re lying in bed pleading with your brain to fall asleep.
So many people are put off by meditation because they think it is “hard.” They think that if they get distracted or their mind wanders then they have failed at meditiaton. In fact, this is actually the point of meditation. It is a practice of your mind wandering and then gently bringing your attention back to the meditation. There is no “failure.”
There are currently loads of apps and resources to help you start a meditation practice. As your practice develops and you know the basics you won’t need any assistance. Literally all you need is your breath! But if you want some help getting started there are apps like Headspace.
There are many different meditation techniques and almost infinite ways to practice meditation. For me, the technique that has helped me to fall asleep is one I learned from renowned Buddhist monk Thich Nhat Hanh. It is a beginner technique that he describes in his book The Miracle of Mindfulness.
The technique is simple. You just count your breaths. This is probably similar in premise to counting sheep, but I like this one better! Breathe in – one. Breathe out – one. Breathe in – two. Breathe out – two. Get it? Count for as long as you can, and if you get distracted and forget which number you were on, you simply start over.
Meditation is only hard when you create the narrative of being bad at it. Like I said, meditation is a practice. The more you do it, the more you understand that there is no such thing as failing at meditation.
5. Visualization Techniques
Visualization is often used to achieve your goals. The basic principle is you create an image in your mind of what you want and are trying to achieve. This is a technique to help you see yourself succeeding and can boost your confidence. In this particular context, you can visualize yourself being calm, relaxed, and ready to fall asleep.
Slow your breathing down and visualize yourself sitting on a beach or at the top of a mountain. Whatever you find to be the most comforting environment, you can picture yourself in this place. This can help slow down your thoughts and help you drift to sleep by creating a strong image in your mind.
Make the image bright and as real and detailed as you possibly can. Next, instead of just picturing the scenery, step into it. Imagine yourself in whatever place you have conjured. Breathe slowly.
The visualization that works best for me is plotting a familiar course. It sounds mundane, but that’s exactly why it works to put me to sleep. I generally have two courses that I visualize in my mind.
The first course: I visualize myself getting in my car, pulling out of my garage and driving to work. It’s nice because there are no other drivers on the road!
The second course: I visualize myself doing my usual running route through my neighborhood.
During this visualization I try to take notice of my surroundings. I try to remember what the different houses look like as I run past them. I try to make it as far as I can without my mind wandering and getting distracted.
I run this route so often, that I am able to replicate it pretty well in my mind. This helps quiet my inner dialogue as I imagine myself running down the sidewalk.
Read my post about positive personal mantras and you might find that having a mantra to repeat when trying to fall asleep might help as well.
What techniques do you use to fall asleep?
Falling asleep after a hard shift can be so difficult despite feeling absolutely exhausted. I’ve been in that position many times. Just lying in bed, eyes closed, trying to bargain with your brain to let you fall asleep. Over the years I developed these 5 techniques to help me quiet my mind to fall asleep. Use these 3 other techniques for Reconnecting to your WHY.
Let me know if you use any of these techniques or if you have some other techniques you use. Subscribe to my newsletter to stay up to date on all of my future posts!
As always, I would love to connect with you on social.
Read Past Posts