Understanding the Brain: Neurobiology of Everyday Life final class project July 22 2018 Professor Peggy Mason

1. S L E E P L E S S N I G H T S
M A N A G I N G S L E E P
P R E S S U R E & C I R C A D I A N
R H Y T H M S
A S A N I G H T S H I F T
H O S P I TA L N U R S E
Cynthia Davenport-Herbst, RN
San Angelo, Texas
U N D E R S TA N D I N G T H E B R A I N : T H E
N E U R O B I O L O G Y O F E V E RY D AY L I F E

2. Professor Mason explained that healthy sleep is
controlled by two things in the hypothalamus.
T H E F I R S T I S T H E U R G E T O S L E E P.
S H E C A L L E D I T S L E E P P R E S S U R E .

3. C I R C A D I A N R H Y T H M I S C O N T R O L L E D B Y T H E P E R C E P T I O N O F
L I G H T A N D D A R K . T H E I N F O R M AT I O N G O E S F R O M T H E E Y E S
I N T O A N A R E A O F T H E H Y P O T H A L A M U S C A L L E D T H E
S U P R A C H I A S M AT I C N U C L E U S .
T H E S E C O N D I S
C I R C A D I A N
R H Y T H M ,
W H I C H W O R K S
A G A I N S T S L E E P
P R E S S U R E . I T
T E L L S Y O U T O
G E T U P A N D
G O E AT W H E N
I T ’ S L I G H T
O U T S I D E .

4. Healthy people get sleepy at the same time that it’s getting dark
outside. Prof. Mason called it a push-pull mechanism, where
sleep pressure pushes you to sleep when you’ve been awake for
a while, and your circadian rhythms pull you to get up and go eat
when it’s light outside and pull you to go to sleep when it’s dark.
I ’ M A N I G H T S H I F T
N U R S E . I W O R K
7 P M T O 7 A M .
C I R C A D I A N R H Y T H M S
P U L L M E T O S L E E P
W H E N I T ’ S G E T T I N G
D A R K , B U T T H AT ’ S
W H E N I N E E D T O WA K E
U P. I T ’ S D A N G E R O U S
T O B E S L E E P Y —
O N E O F M Y PAT I E N T S
M I G H T B E Y O U !

5. Fortunately, many
people have
researched ways to
manage this problem.
This is a strategy from
an article in the British
Medical Journal called
Optimizing sleep for
night shifts by Helen
McKenna and Matt
Wilkes. Attempt 90 or 180-minute nap
immediately following the shift
Go outside after
waking
Avoid daytime napping
in the subsequent days
Aim to go to bed close
to the normal time
zzz zzz
Try to get to sleep as
early as possible
Sleep in a quiet,
darkened, room
Accept that any sleep is
better than none (even
fragmented or shortened
sleep episodes) and
maximise sleep time
Before trying sleep, avoid:
Stay active Take naps of 10-20
minutes during the
early part of the shift
Take caffeine before
napping but make
that the last caffeine
of the night
Avoid caffeine and nicotine
Prescription
wakefulness agents
are likely effective
but associated with
side-effects
Eat lightly and to
comfort
Build in checks
during critical tasks
to mitigate against
reduced alertness
performance
During night shift Last few hours and way home
Days between night shifts
Resetting after night shifts
z
zz
Try to avoid
exposure to
bright light (wear
sunglasses even
on a cloudy day)
Consider public
transport rather
than driving
?
zzz
Bright lights
Screens Alcohol
Take a 90-minute nap
to complete one sleep
cycle, between 2–6pm
zzz
Avoid a morning
coffee
Sleep until you wake
naturally (don’t set
an alarm)
Day of first night shift Goal: minimise sleep debt
Goal: improve performance
discussions with experts in the field, although they note that quality of evidence is low.
They offer this as a starting point from which to develop your own sleep strategy.
Goal: minimise sleep debt
Goal: re-establish normal sleep rhythm
© 2018 BMJ Publishing group Ltd.
Read the full
article online http://bit.ly/BMJsleep
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6. I H AV E P R E S B Y O P I A * , S O I N E E D T H AT I N F O R M AT I O N T O B E L A R G E R .
* Presbycusis is age-related hearing loss due to the slow and gradual death of outer hair
cells in response to loud sounds over time. Prof Mason talked about it in Week 5.
Presbyopia is age-related farsightedness caused by loss of elasticity in the lens of the eye.
I’m 48. I don’t have presbycusis yet, but I have presbyopia. I need larger print.
The day before your first night shift, you should reduce
sleep pressure as much as possible.
1 ) S L E E P A S L AT E A S
Y O U C A N . D O N ’ T
U S E A N A L A R M .
2 ) N O M O R N I N G
C O F F E E .
3 ) TA K E A 9 0 M I N U T E
N A P B E T W E E N 2 - 6 P M

7. During the night shift you should be
up and get going as much as you can.
1 ) S TAY A C T I V E .
2 ) D R I N K
C O F F E E
E A R LY I N
T H E S H I F T. 3 ) E AT L I G H T
T H R O U G H O U T T H E
S H I F T.

8. After your night shift, it’s getting light outside. Your
circadian rhythms will be pulling you to wake up. You
have to trick them to get as much sleep as you can.
1 ) W E A R S U N G L A S S E S O N
T H E D R I V E H O M E .
3 ) C O M P L E T E Y O U R R E G U L A R B E D T I M E
R I T U A L S A N D G O T O B E D I N A Q U I E T,
D A R K E N E D , C O O L R O O M .
2 ) AV O I D B R I G H T L I G H T S ,
S C R E E N S A N D B I G M E A L S .

9. 1 ) G O T O B E D F O R A
G O O D N A P A S S O O N
A S Y O U C A N .
2 ) I N T H E A F T E R N O O N , G O O U T S I D E ,
E AT W E L L A N D TA L K T O P E O P L E T O
M A K E S U R E Y O U TA K E A D VA N TA G E O F
T H E R E D U C E D U R G E T O S L E E P A N D T H E
P U L L O F S U N L I G H T T O G E T U P A N D E AT.
To reset your clock if you don’t have to
go to work the next night,

10. Many thanks to the British Medical Journal for
making the article Optimizing sleep for night
shifts by Helen McKenna and Matt Wilkes public
access, without a copyright.