In this episode, Nathan talks about sleep again: part three of his mini-series about sleep difficulties, problems, and insomnia and how to improve those for nurses and midwives.

In the previous episodes, Nathan provided an overview of effective evidence-based ways to optimize sleep and overcome sleep problems. Today's episode focused on shift work sleep disorder and the issues it creates for nurses and midwives.

Here is a summary of key points from the episode:

• Shift work is when someone works outside of traditional working hours in Western society. As we all know, many nurses and midwives are also required to do this shift work as part of their roles.
• Essentially our circadian rhythm—that biological clock that our bodies follow, and all of the cells in our body, follow this rhythm that is triggered by the rising of the sun and exposure to light through our eyes, and then darkness.
• When you are working a night shift, you are essentially fighting against the body's natural desire to sleep at night.
• Circadian misalignment is when your body gets used to a natural thing on the day shifts. An unnatural something on the night shift, and then keeps switching back and forth.
• One of the other big problems with working the night shift is it disrupts your social life.
• Shift work sleep disorder is characterized by insomnia problems: difficulty falling asleep or staying asleep, difficulties with impaired concentration, and sleepiness when the person is awake.

Nathan shares several strategies and techniques for overcoming these difficulties and helping optimize sleep for people rotating shifts.

1. A helpful place to start is talking about the differences between those who work rotating shifts and people who are on permanent changes and what we know from the research about the differences between those.
2. Start by considering the day of your first night shift; then, it is essential to sleep in as long as possible before that first night shift. Then in the afternoon, it will be excellent if you can take a nap as well.
3. Having the opportunity to take a nap while on a shift is helpful, and then not drinking caffeine later into your shift, indeed not napping later into your shift.
4. When you leave work, avoid light exposure. The light exposure will trigger all of those mechanisms in your brain and body that will keep you awake.
5. Having a dark, quiet, cool room in your home is super important.
6. We know that alcohol is not helpful for sleep. Alcohol, as are caffeine and other stimulants, is something to avoid right before you go to sleep.
7. The strategy to use after the final night shift
8. You want to sleep a little bit, to begin with. Sleep between 90 minutes and a couple of hours, and set yourself an alarm to wake up.
9. In the afternoon, avoid caffeine and anything that will affect your sleep later that night. Try to stay awake as close as possible to what your regular bedtime would be.

People might put a lot of pressure on themselves to sleep and fall asleep during the day. This psychological pressure we put on ourselves can create a lot of stress and lead to that arousal, making sleep very difficult. So remind yourself that getting rest is essential, and if you are struggling with sleeping, seeking help is really important.

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