Reflective accounts

Healthy sleep

As a nurse who works permanently on night shifts, I read with interest the CPD article on promoting healthy sleep.

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The article examined what is known about the process and purpose of sleep. Although much is known about the basic mechanisms that sustain and induce sleep, scientific information about how and why we sleep is incomplete.

Research has emphasised the health implications of sleep deprivation. This is particularly relevant for nurses, because changing shift patterns can prevent a regular sleep-wake cycle from being achieved. I am now aware that shift work, especially night duty, is associated with significant health risks. These risks to health include heart disease, diabetes and obesity.

There is also an increased risk of malpractice if healthcare practitioners do not address their sleep deficits. This is because tired staff are more likely to make mistakes that may harm patients. Repeated exposure to sleep deprivation may result in musculoskeletal problems and fatigue, and is associated with impaired memory, judgement, reaction time and concentration.

The article also examined the relationship between eating, sleep and long-term metabolic risks. It discussed the hormones ghrelin and leptin, which help to control appetite and weight. The balance of these hormones is disrupted when sleep patterns are altered, making weight control difficult. Cortisol, a stress hormone that responds to physical and emotional demands, increases the appetite of night workers in response to abnormal wakefulness. Additionally, the body is not as adept at processing glucose during the night. I will now be more conscious of what I consume during a night shift, and I intend to disseminate this information to my colleagues.

The CPD article has increased my understanding of what constitutes good sleep. It suggested that people should have a regular sleep pattern: asleep at night, awake in daytime hours, and aiming to get between seven and nine hours of good quality sleep every 24 hours. This is especially important because disruption to sleep is not easily compensated for by ‘catching up’ later. The maximum effective sleep reclamation is no more than one hour in any 24-hour period.

Improving sleep patterns

The article acknowledged it is often unrealistic for individuals to go to bed by 10pm. In particular, this might not be possible in nursing. However, there is a need to examine sleep patterns and acknowledge the importance of sleep. The article provided some suggestions to help achieve healthy sleep, such as completing a two-week sleep diary. I used this to identify nights when I slept better. As a result, I have stopped drinking coffee after 5pm, which has already improved my sleep.

Having worked permanent night shifts for 12 years, this article raised some issues pertinent to my circumstances and encouraged me to read further. This article emphasised that the importance of sleep cannot be over estimated, and that adjustments can be made to improve sleep patterns.

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