Handling tiredness

[OttawaURookie]

So how do you guys do it?

 

I've never handled tiredness that well. The issue for me is that I'm one of those people that when I don't sleep, I don't look like I kinda didn't sleep, I look like a totally different person.(huge difference in my looks) So for me, its really hard to handle mentally. (though I've slowly gotten over it) Does anyone else have similar issues?

 

I don't think I'm that vain either but its one of those things..

[aaronjw]

Good luck with residency lol

[OttawaURookie]

haha well gee thanks

 

I'm just lucky that my biggest interests actually happen to be correlated with the specialities that have reasonable hours (family medicine, psychiatry)

[astrogirl]

These are a few tricks I've picked up from my days of working at observatories all night long and then having to go to school all day the day after. Modify as appropriate for your own situation, but hopefully some of them are helpful.

 

-Make it as dark as possible when you actually are sleeping, even if it's during the day. Close your blinds and wear an eye mask. When I was in undergrad, there was one I had to spend the night at the observatory every Wednesday to TA a telescope lab, then I had a meeting for a class I was grading for at 7:30 AM on Thursday morning, and then nothing until 11 AM. So I slept under a table in the astronomy library with earplugs and an eye mask for a few hours, and it was surprisingly good sleep.

 

-If you ever sleep at the right hours to do this, go to sleep when it's dark and leave your blinds open to let the sun wake you up. It's not always possible, but I think it's the easiest way to get up.

 

-If you have to stay up all night then still be awake the next day, drink at least as much cold water as you do caffeinated things. You'll have to pee more, but you'll be less twitchy in the morning. I find that the higher the cold water to caffeine ratio, the less twitchy and unfocused I am.

 

-Unless you're a really heavy sleeper, don't set your alarm sound to be something loud and jarring. Soft music is much nicer to wake up to.

 

-If you have an iphone, ipad, or ipod touch, try downloading this app: http://itunes.apple.com/ca/app/sleep-cycle-alarm-clock/id320606217?mt=8. I've only had it for a couple of weeks, and I haven't tested it out under extreme sleep craziness conditions, but there have been a couple of nights that I was only going to get 4 hours of sleep, and it really does seem to work well. You set a window of time you want to wake up in (can be from 15-90 minutes), and it tracks your motion so that it wakes you up when you're in a light sleep rather than a deep sleep. It's not perfect, but it's only 99 cents and it really does seem to work well.

 

-If you're sitting through a class or a meeting and you're falling asleep, pull on your earlobes. I don't remember where I first heard this, but it wakes you up. You may have to repeat it every 5 minutes if you're really tired, but it works.

 

-If you're trying to do stuff on your own (studying in the library, working at home, etc) and you're falling asleep but you can't go to bed yet, get up and run around the block/run around the room/run in place for a few minutes. You'll be more awake after that.

 

-Eat healthy food. Don't be up all night eating vending machine stuff to stay awake. It doesn't have to be complicated healthy food. Just bring a bag of carrots and a bag of little tangerines or something along those lines. It'll help cut down on some of the twitchy/unfocused feeling the next day.

 

Like I said, modify as appropriate for your situation, but hopefully something I said will help a bit!

[preppy038]

Coffee + donut

[psychoswim]

I agree with many of Astrogirl's points.

 

I'm the opposite.. I can get by very normally with 5-6 hours of sleep per night. Having trained (and woken up at 5am) for 20+ years, I still wake up before 6am on my own on most days, especially when the sun is already up.

 

I've never tried the pulling on your earlobes trick, will have to try it for sure! Exercising a little or just walking around helps you wake up when studying. It's better to take more short breaks. Sometimes cold drinks are better than coffee (or hot chocolate in my case), even cold water, juicy fruits...

[EoE]

I totally agree with astrogirl. Although her post did make me sleepy... very sleepy...

 

One thing I do to wake up is think about a time that got me really really worked up. Med school results day, big presentations, defences, when I said that stupid thing in high school and almost lost all my friends, when I was in a plane that lost an engine, etc. Focusing on one of those super-intense memories gets my heart pounding, adrenaline flowing and wakes me up quick. Also, maybe that makes me crazy!

 

For me and long term tiredness, its coffee coffee coffee.

[xyandfc]

Thanks for the tips! I seem to be the type of person who needs more sleep than average. One thing that I've found to make a big difference is the bed I sleep on! If you're anticipating times of little sleep, it might be worthwhile to invest in a bed that gives you better rest.

[Hockey_whiz]

I totally agree with astrogirl. Although her post did make me sleepy... very sleepy...

 

One thing I do to wake up is think about a time that got me really really worked up. Med school results day, big presentations, defences, when I said that stupid thing in high school and almost lost all my friends, when I was in a plane that lost an engine, etc. Focusing on one of those super-intense memories gets my heart pounding, adrenaline flowing and wakes me up quick. Also, maybe that makes me crazy!

 

For me and long term tiredness, its coffee coffee coffee.

 

your post reminded me of this

http://www.youtube.com/watch?v=IFYGx1KgKE8

[Georgia_Stars]

I totally agree with astrogirl. Although her post did make me sleepy... very sleepy...

 

One thing I do to wake up is think about a time that got me really really worked up. Med school results day, big presentations, defences, when I said that stupid thing in high school and almost lost all my friends, when I was in a plane that lost an engine, etc. Focusing on one of those super-intense memories gets my heart pounding, adrenaline flowing and wakes me up quick. Also, maybe that makes me crazy!

 

For me and long term tiredness, its coffee coffee coffee.

 

You were on a plane that Lost. An. ENGINE. !!!!! Well that's INTENSE alright.

[RaVen777]

In my experience, you learn to deal with the sleep deprivation, no matter how impossible it seems at first.

 

While not in residency, or even med school quite yet, I worked for two years in an on-call 24/7 sometimes stressful field. I would often work a Day shift, followed by a graveyard shift, followed by an afternoon shift. Rinse repeat.

 

I think people don't quite realize just how much their body can take until they put it to the test. You may look like hell, but you'll figure something out.

 

 

I don't necessarily agree that sleep deprived docs are the best thing for patients though:p

[Georgia_Stars]

When I'm feeling sleepy in class, I can't really just stand up and run around the lecture hall or slap myself to stay awake. My friend and I wake each other up if one of us falls asleep during lecture. But you know, that doesn't work out so well when both of us doze off. Thankfully it doesn't happen very often.

Oh and you might wanna try washing your face with cold water - that always makes me feel more alert and refreshed.

[Renin]

Melatonin.

 

And eat breakfast.

[EoE]

Plane losing engine over the atlantic = intense fear = memory able to keep me awake. It was not so bad once the plane stopped dipping and doodling. The captain came on and explained the situation and said we would be making an emergency landing in Labrador and that we would be fine, we could fly fine just as before, the danger was that if we lost the other engine we would be in trouble.

 

Another thing I do when I am really tired is pinch myself, gives me bruises but it works!

 

There is a great book called No More Sleepless Nights that I read in undergrad when I was really having trouble sleeping.

[Nobodycirclesthewagons]

These are a few tricks I've picked up from my days of working at observatories all night long and then having to go to school all day the day after. Modify as appropriate for your own situation, but hopefully some of them are helpful.

 

-Make it as dark as possible when you actually are sleeping, even if it's during the day. Close your blinds and wear an eye mask. When I was in undergrad, there was one I had to spend the night at the observatory every Wednesday to TA a telescope lab, then I had a meeting for a class I was grading for at 7:30 AM on Thursday morning, and then nothing until 11 AM. So I slept under a table in the astronomy library with earplugs and an eye mask for a few hours, and it was surprisingly good sleep.

 

-If you ever sleep at the right hours to do this, go to sleep when it's dark and leave your blinds open to let the sun wake you up. It's not always possible, but I think it's the easiest way to get up.

 

-If you have to stay up all night then still be awake the next day, drink at least as much cold water as you do caffeinated things. You'll have to pee more, but you'll be less twitchy in the morning. I find that the higher the cold water to caffeine ratio, the less twitchy and unfocused I am.

 

-Unless you're a really heavy sleeper, don't set your alarm sound to be something loud and jarring. Soft music is much nicer to wake up to.

 

-If you have an iphone, ipad, or ipod touch, try downloading this app: http://itunes.apple.com/ca/app/sleep-cycle-alarm-clock/id320606217?mt=8. I've only had it for a couple of weeks, and I haven't tested it out under extreme sleep craziness conditions, but there have been a couple of nights that I was only going to get 4 hours of sleep, and it really does seem to work well. You set a window of time you want to wake up in (can be from 15-90 minutes), and it tracks your motion so that it wakes you up when you're in a light sleep rather than a deep sleep. It's not perfect, but it's only 99 cents and it really does seem to work well.

 

-If you're sitting through a class or a meeting and you're falling asleep, pull on your earlobes. I don't remember where I first heard this, but it wakes you up. You may have to repeat it every 5 minutes if you're really tired, but it works.

 

-If you're trying to do stuff on your own (studying in the library, working at home, etc) and you're falling asleep but you can't go to bed yet, get up and run around the block/run around the room/run in place for a few minutes. You'll be more awake after that.

 

-Eat healthy food. Don't be up all night eating vending machine stuff to stay awake. It doesn't have to be complicated healthy food. Just bring a bag of carrots and a bag of little tangerines or something along those lines. It'll help cut down on some of the twitchy/unfocused feeling the next day.

 

Like I said, modify as appropriate for your situation, but hopefully something I said will help a bit!

 

Wow, great tips. Thanks. I'll use them during clerkship!

[OttawaURookie]

Thanks for the tips guys.

 

One thing I struggle with is when I know somebody may need me very soon or at any time. If I know there is something tomorrow, that's easy. But sleeping when you can be called at any time..now that, I don't know how people can do it.

[larva]

Thanks for the tips guys.

 

One thing I struggle with is when I know somebody may need me very soon or at any time. If I know there is something tomorrow, that's easy. But sleeping when you can be called at any time..now that, I don't know how people can do it.

 

I'm on call about 3-4 times a week (from home) and go to sleep with the pager next to me. At first, it was a bit unnerving, but I'm totally used to it now. Once you've been woken up in the middle of the night a few times you realize that adrenaline will kick in enough to get you going, and the severity of the situation will allow you to focus when you need to.

 

I'll also echo what paraD said about getting any amount of sleep, whenever you can. Last week I got called out at 1am, after two hours of sleep, but it was incredible how alert I was compared to nights when I get no sleep at all.

[bidiboom]

Isnt it dangerous to take shift sleepless? I have always wondered how the doctors, especially the newbies who have a harder work load, can handle this and come to their senses during a 36 hour shift and after an hour of sleep for instance.

 

and for waking up, my suggestion is whole-body-streching.. it works very well on feet, bow to your feet, your arms paralel and stretched to the front, slowly get your waist straight (by counting to 8).. and when your arms gets the upward position, keep stretching as if you try to catch something hanging on you.

[Renin]

Isnt it dangerous to take shift sleepless? I have always wondered how the doctors, especially the newbies who have a harder work load, can handle this and come to their senses during a 36 hour shift and after an hour of sleep for instance.

 

and for waking up, my suggestion is whole-body-streching.. it works very well on feet, bow to your feet, your arms paralel and stretched to the front, slowly get your waist straight (by counting to 8).. and when your arms gets the upward position, keep stretching as if you try to catch something hanging on you.

 

Adrenaline. When that pager goes off; you're in hypervigilant mode. Like when superman emerges from his phone booth. LOL. Except you look more tired. Don't glow. And are less heroic.

[Cerena]

Adrenaline. When that pager goes off; you're in hypervigilant mode. Like when superman emerges from his phone booth. LOL. Except you look more tired. Don't glow. And are less heroic.

 

Love the visual Haha.

[apache]

ok, since no one tossed this out here, ill finally mention it... shift-work sleep disorder, indictation: modafinil. it's more or less non-dopaminergic, though to work as a histamine, norepi agonist, so it keeps you awake without the crazy ass **** coffee does to you such as high heart rate, withdrawal headaches etc (i asked my gp to try it for two weeks when i tried, unsuccessfully, on my like, 15th attempt to quit coffee)

 

the stuff works great, you can stay really alert for like hours on end without the edginess of coffee, i know they prescribe it to pilots and what not... but that's just always my pervasive pharmacological alternative... anyhoo proceed back to meditation and what not

[Renin]

Love the visual Haha.

 

HAHA; I used to have this "doctor persona" which was all serious and stuff; and it was on with the coat, on with the seriousness. If you know me, I'm not serious and stuffy.

 

Now I'm the same. I think I've pretty much become a tad more serious in my real life and a tad more fun as a doc-in-training (DIT).

[Cerena]

HAHA; I used to have this "doctor persona" which was all serious and stuff; and it was on with the coat, on with the seriousness. If you know me, I'm not serious and stuffy.

 

Now I'm the same. I think I've pretty much become a tad more serious in my real life and a tad more fun as a doc-in-training (DIT).

 

Can you imagine going through life every single day being serious and stuffy?

Girl, I would cringe.

[Renin]

Can you imagine going through life every single day being serious and stuffy?

I cringe.

 

HAHAHA. It was hard. I am more serious and stuffy if I don't know my stuff, though. I will be very serious and stuffy in surgery

[Cerena]

HAHAHA. It was hard. I am more serious and stuffy if I don't know my stuff, though. I will be very serious and stuffy in surgery

 

As you should be!