Getting through a night without a minute of sleep is what I find the hardest about being a doctor. Lack of sleep will make me unconcentrated,  irritable,  and more error-prone. And during a night shift, it’s not your only task to stay awake: you are supposed to work, make good decisions,  and save lives.

During my first years of my residency I tested several strategies not only  to stay awake, but also alert and concentrated during a night shift.

Here I share what worked, and what didn’t .

1. Don’t sleep ahead of time.

   You shouldn’t start your shift tired, that’s obvious but trying to fill your “sleep account” doesn’t work for me.
   I’ve tried that a couple of times, and it made me even more tired.

   Spend the day of your first night shift normally. Don’t run a marathon, but don’t stay in bed all day long either.

2. Watch your diet during the shift.

   When I am on night shifts, I tend to reward myself, because I am on night shifts: Chocolate, Chips and Pizza are supposed to cheer me up. Turns out that doesn’t work out well:

   A) That makes you fat, especially in combination with stress-related elevation of cortisol levels.
   B) Twenty minutes after your glucose kick you are going to be really tired and wishing for a nap.

   So what do I eat during the night?
   I snack all the time: especially raw vegetables of all kinds (carrots, cucumbers, peppers) some nuts, maybe some cottage cheese and yoghurt.

   If you want a real meal, I’d go with a soup, because it can be prepared ahead of time and can be easily reheated and it keeps you hydrated.

3. Caffeine:

   Coffee, red bull and Coke is fine for a night shift.
   We are not establishing nutrition guidelines here, we wanna make it through the night. So two cans of diet coke or two cups of coffee are fine.

   If you want it a bit healthier you can drink green tea, but it takes a scientist to prepare that, because if you let it brew a minute to long it’s going to make you tired and tastes bitter.

   My deal: I go with 2 cans of Coke zero.

4. Drink lots of water.

   Sleepiness is often related to dehydration.

5. Keep yourself busy.

   In most of my shifts, that’s not a big concern: mostly there is lots of work to do. If not, I try to round on my patients especially thoroughly, that takes some time.

   Review the reports of the last day, try to find problems you can solve. If all that is done, writing report files also can kill some time. You can even do some work of the morning shift.

   I definitely wouldn’t read more than necessary and too much time in front of the PC also will make you tired.

6. After the shift:

   Be aware that you are tired! You are highly irritable and your motor skills are comparable to drunk people. So when you get home, don’t start any arguments with family or friends, it’ll likely end in a fight.

   If you have to drive, do so carefully! I’ve had numerous close-to-accidents while trying to operate a car after a night shift.As soon as you end your shift, the preparation for your next night shifts begins.

   If you have another shift on the same night, preparation begins as soon as you leave the hospital. I’ll write another blogpost on that soon!

Question: What’s your best trick to get through the night without falling asleep? Leave a comment below!