Working nights, you may eat your main meal at work in the small hours and go to sleep as the day starts, while everyday advice such as avoiding large meals late at night and naps after 3 p.m. assumes you sleep at night. Shift work has diet guidelines of its own, offered for shift workers by the researchers Lowden and colleagues, and nurses on nights have a federal training course with steps for day sleep and the drive home. Use them to fit your meals around the shift, get more of your day sleep, and tell when drowsiness on the way home means pulling off the road.
Whether you can eat in the middle of a night shift
Between midnight and 6 a.m., the middle of a night shift, avoid eating or reduce food intake. So a meal at work in those hours is either skipped or kept small.
If your circadian rhythms, the body's daily cycles, have not adjusted to being active at night, you may eat at times when your digestive tract is prepared for sleep and not for eating and digesting food. Eating at those times raises your risk of gastrointestinal symptoms, obesity, cardiovascular disease, diabetes and metabolic syndrome.
Where the three meals go when your working day starts in the evening
When your working day starts in the evening, fit the three meals to the normal day and night pattern of meal timing as much as possible, and divide your eating into three meals per 24-hour period. Apart from the midnight-to-6 a.m. limit, no clock time is set for any of them, so you choose where each falls around your shift. Before your day sleep:
- Eat a small breakfast before your day sleep so hunger does not wake you. If you have not eaten much for several hours and expect to feel hungry when you are trying to sleep, make it a small meal with a protein and a carbohydrate, like cereal and milk.
- Avoid large meals in the 1 to 2 hours before the main sleep episode, which on nights is your day sleep.
For the meal on the shift, eat high-quality foods such as vegetables, salads, vegetable soups, fruits, whole-grain sandwiches, yogurt, cheese, eggs, nuts and green tea. Avoid sugar-rich products and low-fiber carbohydrate foods. They can increase sleepiness, so keep them off your plate when you feel sleepy or need to stay alert. When you need to boost your energy, eat more frequently. Where you can, eat with colleagues in a pleasant place away from the work site.
Avoid alcohol and foods with added sugar, as well as heavy, fatty or spicy foods, and try to have only light caffeine during your shift (see How much caffeine is in a day of coffee instead of meals?).
Why the sleep you get in the daytime is so short, and what changes it
Daylight will trigger waking from sleep in the daytime, and if your circadian rhythms have not adjusted to sleeping during the day, your body's own alerting mechanism soon kicks in and tries to keep you awake. Night shift workers usually get less sleep overall than day shift workers, and poorer-quality sleep, so spend as much time in bed as possible to keep from becoming chronically sleep deprived. For adults aged 18 to 60, the recommended amount is 7 or more hours of sleep a day; from 61 to 64 it is 7 to 9 hours, and from 65, 7 to 8 hours.
What changes it starts the moment you get home from the shift:
- Go directly to bed. The more sleep you get before 2 p.m., the better rested you will be. Keep chores and errands out of the early morning, because that is prime sleep time after a night shift.
- Make the bedroom so dark you cannot see your hand in front of your eyes, or wear an eye mask, since you will sleep better and longer in darkness. Fit blackout shades or drapes to the windows of the bedroom, the bathroom and the path between them, block the light under the doors, and use a dim red nightlight if you have to get up.
- Block noise with earplugs or a white noise machine, and stop the phone from waking you.
- Ask family and friends not to disturb you while you sleep.
- If you can take a nap before you return to work, take it: a nap can increase your overall sleep time and may help you stay alert during the night.
Which standard sleep habits still apply on a night schedule
On nights, the general sleep habits tied to your bedtime may still help, with bedtime meaning the start of your day sleep. Those include keeping your bedroom cool, dark and quiet, exercising regularly but not too close to bedtime, and getting rid of distractions such as TVs, computers and phones. If you cannot fall asleep for 20 minutes, get up and do something relaxing.
Other general habits are set by the clock: avoiding caffeine in the afternoon and evening, no nap after 3 p.m., and enough sunlight during the day. On nights those hours are your shift, the time before it and your day sleep. If you work shifts, you may also want to:
- limit caffeine to the first part of the shift
- take naps and extend your total sleep time
- keep the lights bright at work
If you have continued trouble sleeping, see a health care provider. You may have a sleep disorder such as insomnia or sleep apnea, and in some cases your provider may suggest a sleep study or other treatments (see Do you need a sleep study if you stop breathing at night?). Your provider may have you keep a sleep diary of when you go to bed, wake up during your sleep, wake up at the end of it, take naps, exercise, drink alcohol or caffeinated drinks and take medications. On nights, the sleep it records is your day sleep.
When drowsiness on the drive home means pulling off the road
Drowsiness on the drive home from a shift needs action at the wheel, the moment you notice it. Watch for the warning signs of drowsy driving:
- difficulty focusing, frequent blinking or heavy eyelids
- daydreaming, or wandering, disconnected thoughts
- trouble remembering the last few miles driven, or missing exits or traffic signs
- yawning repeatedly or rubbing your eyes
- trouble keeping your head up
- drifting from your lane, tailgating, or hitting a shoulder rumble strip
- feeling restless and irritable
If you feel drowsy, pull off at the next exit or rest area, stop driving, and get sleep, caffeine or both. If you cannot stop for long, a nap of even 15 to 20 minutes can help, so find a safe place to stop and take one. For an added boost, you can try caffeine before a short nap to get the benefit of both; it is a temporary aid and not a replacement for getting enough sleep. Caffeine at the roadside is there to prevent a crash, so it is an exception to keeping caffeine to the first part of your shift. Avoid even small amounts of alcohol when you are short of sleep and planning to drive, because even a low dose of alcohol on top of long hours awake reduces your performance further.
Some medicines and chronic diseases can increase daytime sleepiness. Check the labels of the medicines you take for side effects that include sleepiness, or ask your doctor. There may be alternatives that do not have sedating effects.
When you get your weight care through NicoCares and think a medicine is making you sleepy, tell your care team promptly in Spruce, where they answer messages, as the terms ask you to do for side effects and new medications. If the physician who wrote the prescription treats you through NicoCares, the clinical decision belongs to that physician, so any change to it is theirs to make. The site sets no time for an answer in Spruce, so if drowsiness comes on at the wheel, pull off the road first, without waiting for a reply.
