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Laura Vater, MD, vividly recalls sneaking into her home after grueling 12-hour night shifts during her medical training. Her husband would distract their toddler, enabling her to slip inside unnoticed and catch much-needed sleep before another overnight at Indiana University hospital. “He would pretend to take out the trash when I pulled in,” said Vater, now a gastrointestinal oncologist and assistant professor at IU Health Simon Cancer Center. “I would sneak in so she [their daughter] wouldn’t see me, and then he would go back in.”
This tag-team effort highlights a universal challenge for medical residents: balancing professional demands with personal health. Night shifts disrupt normal routines, requiring intentional strategies to combat sleep deprivation and maintain performance.
The Challenges of Night Shifts
Medical residents working overnight rotations face unique hurdles, from disrupted sleep patterns to the aftereffects of late-night caffeine. Sleep deprivation—a common issue—can lead to serious health problems, including cardiovascular disease and type 2 diabetes. Studies, such as one recently published in JAMA Open Network, link inadequate sleep to impaired judgment, worsened mood, and increased medical errors. Suggestions like shorter shifts and strategic naps aim to mitigate these risks.
Prioritizing Sleep
Effective sleep management is critical. Nat deQuillfeldt, MD, a chief resident at Denver Health in Colorado, adheres to a strict sleep schedule when on night duty. “I went to sleep at 8 AM and woke at 3 PM every day,” said deQuillfeldt, emphasizing the importance of routine. She relied on eye masks and ear plugs but acknowledged that daytime sleep remains challenging. Blackout curtains, she added, could further improve rest.
For deQuillfeldt, maintaining sharp clinical thinking—essential for emergencies—requires prioritizing her well-being. She chooses not to nap during shifts to remain available to interns and avoid grogginess during critical moments.
Vater suggests preparing for night shifts by “banking” sleep, staying up later the night before, and taking afternoon naps. Similarly, Apurva Popat, MD, chief resident at Marshfield Clinic in Wisconsin, gradually shifts his bedtime later in preparation. He emphasizes creating a sleep-friendly environment, using blackout curtains and white noise to maximize rest.
Eating Smart
Night shifts challenge healthy eating habits. Sleep deprivation can intensify cravings and hinder satiety, making it easy to reach for unhealthy snacks. Vater recalls bringing simple, nutritious foods like whole fruits, avocados, and nuts to the hospital. “It’s hard to eat well on night shift,” she said.
Popat relies on protein shakes and small, frequent meals to stabilize energy levels. Avoiding caffeine after 9 PM helps ensure better post-shift sleep, according to Vater.
Staying Active
Physical activity boosts alertness. Vater set timers to ensure at least 30 minutes of movement during her shifts, often taking the stairs while checking on patients. Popat incorporates short walks and weightlifting before his shifts to maintain energy and focus. Deep breathing exercises are another strategy to stay alert during lulls.
Safety and Mental Health
Driving home after a night shift can be risky for exhausted residents. Vater advises using ridesharing services if needed. Programs like deQuillfeldt’s provide reimbursement for such services to reduce the risk of accidents.
Mental health is another critical consideration. Shift work can strain relationships and lead to feelings of isolation. “Night shifts can put a strain on mental health, especially when you’re only working, eating, and sleeping and not spending any time with family and friends,” deQuillfeldt said. Planning post-shift activities and seeking support early can help prevent burnout.
Final Takeaways
Night shifts are a rite of passage for medical residents, but they don’t have to come at the expense of health and performance. From strategic sleep management to balanced meals and mental health resources, small adjustments can make a big difference. For more tips, resources like the American Medical Association’s guide to sleep deprivation can provide additional support.
By embracing proactive strategies, residents like Vater, deQuillfeldt, and Popat show that staying sharp and healthy during overnight rotations is possible—one shift at a time.
