Podcast 509: Circadian Rhythm and Shift Work, From Z to Z
Show: Emergency Medical Minute
Contributor: Jared Scott, MD
Educational Pearls:
- Sleep deprivation and disturbed sleep cycles increases the risk of many acute and chronic medical issues such as motor vehicle accidents, diabetes, cardiovascular disease, psychiatric disease, and shift work sleep disorder (difficulty sleeping, fatigue, interference with daily activities)
- Stages of sleep
- Stage 1: 5-10 minutes (light sleep, may not recognize).
- Stage 2: Spindle waves, mostly unstudied
- Stage 3: Restorative sleep
- Stage 4 (REM): Paralysis, memory consolidation
- One sleep cycle takes about 120 minutes
- Light is critical for regulating sleep cycles. Exposure to light (especially blue light) inhibits melatonin release from the pineal gland, which influences the suprachiasmatic nucleus (master sleep controller in the brain)
- How can you optimize sleep before your night shifts? On the day of your first night shift, sleep until you wake naturally, then take a 90min nap between 2-6pm before you start your shift
- Sleepy on shift? A 5 minute nap is helpful to increase your attention span and thinking. A 30 minute nap is good for achieving more restorative sleep. Naps between 30 and 60 minutes are not recommended due to increased sleep inertia
- How do I optimize myself on shift? Keep active and take a 5 minute nap if needed. Do not use caffeine within the last 4 hours of your shift (it will interfere with your sleep!). More than 200-300mg a caffeine are not recommended, if you do use it.Use built in checks to reduce errors, as errors are increased during night shifts!
- Leaving your shift, reduce exposure to light by wearing sunglasses, avoid screens and alcohol, and get to sleep ASAP
- Got things to do? Remember that some sleep is better than none!
References
Kuhn G et al. Circadian rhythm, shift work, and emergency medicine. Ann Emerg Med. (2001) 37:1, 88-98.
McKenna Helen, Wilkes Matt. Optimising sleep for night shifts BMJ (2018). 360:j5637
Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD
Music credit: "Smooth Lovin" by Kevin MacLoed (incompetech.com). Licensed under Creative Commons By Attribution 3.0 License. http://creativecommons.org/licenses/by/3.0/
More From Current Show
Podcast 1025: Post intubation Sedation Contributor: Aaron Lessen, MD Educational Pearls: Experts suggest that anyone who is...
Listen Now Contributor: Taylor Lynch, MD Educational Pearls: Excessive caffeine intake can be dangerous. For normal adults, the toxicity level...
Listen Now Contributor: Aaron Lessen, MD Educational Pearls: Case review of a patient with recurrent episodes of syncope and shortness...
Listen Now Contributor: Taylor Lynch, MD Educational Pearls: When a patient who missed dialysis presents to the emergency department, our...
Listen Now Contributor: Travis Barlock, MD Educational Pearls: What is pulmonary edema? Pulmonary edema is the accumulation of fluid initially...
Listen Now Contributor: Alec Coston, MD Educational Pearls: Benign Paroxysmal Positional Vertigo (BPPV) Common inner ear condition that can cause...
Listen Now Contributor: Aaron Lessen, MD Educational Pearls: Blunt cerebrovascular injury (BCVI) BCVI is a traumatic injury to the carotid...
Listen Now Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation...
Listen Now Related Episodes
No related episodes found.
