We owe them a debt of gratitude. The past few years have been particularly tough for our frontline healthcare workers.
Increased demand for health services, additional compliance and WHS regulations, long shifts, and worsening workforce shortages have led our nurses, doctors, healthcare, disability, and aged care workers down the road of overwork, overwhelm, and burnout. What we’ve learned is that burnout is prevalent and self-care isn’t just a ‘nice-to-have’, its necessary.
A simple Google search will reveal no shortage of advice about how to look after ourselves. But how do we sort through all the noise? Luckily, there’s one self-care hack that’s known to have a significantly positive impact on our health, and it’s free!
Sleep - the elixir of life!
Sleep truly is the foundation of health and wellness. How rested we are has a direct impact on our resilience, and how effective and productive we are at work.
Worryingly, a 2019 federal inquiry into how Australians are sleeping uncovered that almost 60% of Australians experience symptoms of disordered sleep and only 45% of people report being satisfied with the amount and quality of their sleep. The report indicates that just 20% of people get to sleep through the night uninterrupted and that 2 out of every 5 people fall short of getting the recommended 7-9 hours of sleep on a daily basis. Not surprisingly, almost 50% of people complain that their erratic daily routine negatively impacts their sleep.
Healthcare workers are no exception.
A 2016 multi-study review of sleep habits among healthcare workers found that 30%-70% of nurses report getting fewer than six hours of sleep per night. Another study found that the prevalence of impaired sleep among physicians is high and that physicians with poor sleep were more likely to experience burnout, and decreased professional fulfillment, and noted a major spike in self-reported medical errors.
So, we’ve established that sleep is important, but what’s the key to getting better sleep? How can healthcare workers improve the quality and duration of their sleep? The answer lies in our circadian rhythm.
What’s the deal with your circadian rhythm?
Your circadian rhythm, also known as your internal clock, helps to regulate important functions in your body, including your metabolism, blood pressure, blood glucose, and wake and sleep cycles. It does this by governing the timing of a number of biological events, such as body temperature, digestion, and hormone release.
There is a strong correlation between the health of your circadian rhythm and your overall health. The better job you do at keeping your circadian rhythm in check, the better overall health you’re able to achieve.
Your circadian rhythm is easily impacted by your behaviours and external environment and can be disrupted by the lights in your home, when and how you sleep, your work schedule, what and when you eat, and time-zone changes, for example.
But, just as these events can negatively impact your circadian rhythm, proper management of your environment can help you keep your circadian rhythm in check.
Here are a few simple shifts you can make to your behaviours and environment to help you maintain a healthy circadian rhythm, get better sleep and be your best at work.
Get some sunlight upon waking
Natural light is critical for triggering your circadian rhythm’s wake cycle. As soon as you can, open the blinds and a window, or get outside. Even ten minutes of early morning sunlight can help you feel more awake, set your metabolism up for the day, help you to be more focused and productive, and help you get better sleep later that night.
Now, as a healthcare worker, we know that you aren’t always waking when the sun is coming up. Maybe you’re on night shift, and you’re actually waking when the sun is going down. Well, the same rule applies. Prioritise getting any kind of bright light as soon as you can after waking. This could be a bright lamp, the fluorescent light in your kitchen, or you can just turn on all the lights in your house.
Exercise early in the day
Physical activity is another great way to promote wakefulness. Exercising early in the day, be it in the morning or early afternoon, advances your internal clock, and can make you more alert, improve concentration, and help you to be more focused.
The benefits of exercise include better sleep, so whether you catch those Z’s through the night or through the day because of your roster, exercise is a really important element in your daily routine.
Avoid caffeine 6 hours before sleep
Coffee and other caffeinated beverages can affect your sleep even up to 6 hours after consumption. And, since the timing of your sleep is such an important factor in maintaining a good circadian rhythm, drinking your caffeine earlier in the day is highly advisable. In saying that, everyone is different. Some people metabolise caffeine quickly. If you rely on caffeine to keep you going, it's worth experimenting with the timing of your consumption, to make sure you're optimising for productivity throughout the day, and sleep at night (or vice-versa).
Keep a consistent sleep schedule
Your circadian rhythm works hard to regulate your wake and sleep cycles. Keeping an irregular sleep schedule can really throw it out of whack. For example, if you’re staying up late one night, then getting up early the next morning, then going to bed early the next night, and then sleeping in the next morning, your body will struggle to know how to regulate the hormones that control your immune system, hunger, and stress. This can lead to overeating, a lack of focus, and even anxiety and depression. So, pick a regular sleep and wake time that’s sustainable at least 90% of the time, and try your best to stick to it. A good rule of thumb is to give yourself an 8-hour sleep window. So for example, if you're planning on waking up at 5 am, you'll need to hit the hay by 9 pm.
This rule applies even if you’re working the late shift. For example, if you’re planning on waking up at 5pm for your 7pm shift, make sure you get to bed by 9am, and stick to this rhythm as consistently as you can.
Don’t eat too close to bedtime
To ensure you can get a good sleep, you need your body to enter into a parasympathetic or ‘rest-and-digest’ state. It’s in this state that your nervous system promotes relaxation and sleep by lowering your heart rate, slowing your respiratory rate by tightening the bronchi in your lungs, and enacting digestive processes in the gut. If you continue to eat right up to bed time, your body will need to keep managing your consumption of food, and cannot fully embrace a parasympathetic state. This can lead to disturbed and less restful sleep and can affect your circadian rhythm’s sleep and wake cycles.
Turn your lights down low
In the same way that exposing yourself to natural light upon waking promotes wakefulness, reducing exposure to light and particularly blue light, in the evening or before bed, promotes sleepfulness. It’s become fairly common knowledge that staring at our mobile phones and tablets hinders good sleep. But, avoiding your devices for an hour or two before bed, as good of practice as this is, just isn’t enough. Once you’ve had your last meal for the day, turn off or turn down the lights in all areas of the house. If possible, avoid bright and LED light bulbs during your wind-down period, and instead, use low wattage, warm or yellowish coloured bulbs, or even candlelight instead.
Getting better sleep sounds easy, but it can be a challenge, especially for those of us that work in the health and social support sector. In saying that, investing in your sleep will give you amazing benefits, and can set the stage for all your other self-care efforts. In many ways, sleep is the glue that binds all the elements of your health together, and is key to enabling you to be the best healthcare worker you can be.