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Well-being Investment: Restorative Sleep - Foundation of Self-Care

(NEW) TLDR at the bottom*

Welcome back to our series on physical well-being investments. Today, we’re diving into perhaps the most critical supporter of self-care, the very foundation - restorative sleep. How challenging that can be in this line of work!

If you’re already waking up refreshed and energized throughout the day—keep doing what works for you. However, most physicians will admit they’re running low on sleep, whether it’s due to intrinsic or external factors, or choices within their control.


Why Restorative Sleep Matters

Let's review a few of the proven benefits of getting adequate, high-quality sleep:

  • Improves memory and learning
  • Enhances safety (fewer accidents and errors)
  • Boosts mood
  • Supports healthy metabolism
  • Protects cardiovascular health
  • Strengthens immunity
  • Increases efficiency and productivity
  • Improves overall quality of life

Sleep Hygiene: Through your Lens

As healthcare professionals, we often give patients great advice—yet we don’t always follow it ourselves. Let’s apply these proven sleep hygiene tips to our own lives.

1. Consistency:

  • Stick to 7–9 hours of sleep each night when it is within your control.
  • Maintain consistent temperature of the sleep environment.
  • Maintain a regular bedtime and wake time, even on days off. Use that sleep feature on your smart watch that reminds you to winddown 15 minutes prior to bed and that wakes you up with a gentle sound in the morning with incremental increase in volume. .
  • Establish bedtime routines like slipping on your favorite PJ's, stretching, dimming lights, brushing teeth, or journaling.
  • Get bright morning light (100,000 lux) within the first 2–4 hours each morning after waking. Natural sunlight is great but not alwayas available. A lightmeter app can tell you what lux you're getting. 
  • Keep exercise and mealtimes as consistent as you can for your circadian rhythm.

2. Optimize Your Sleep Environment:

  • Temperature: Aim for around 65°F or a little cooler.
  • Darkness: Use blackout blinds or an eye mask.
  • Quiet: Consider earplugs or white noise when needed.
  • Comfort: Invest in good pillows, linens, and a supportive mattress.
  • Limit bed activities to sleep and intimacy—no screens, books, or work in bed to signal your brain it's time to sleep.
  • Some find calming scents of lavender, etc helpful
  • Taking a warm shower or bath a little before bedtime can be helpful as your body temp falling signals the brain to sleep. 

3. Avoid Sleep Disruptors:

  • Caffeine: Avoid within 8 hours of bedtime.
  • Alcohol: It may help you fall asleep but disrupts sleep quality and often leads to nighttime awakenings.
  • Screen time: Limit 1–2 hours before bed.
  • Heavy, spicy, or greasy meals: Limit to earlier in the evening - remote from bedtime.
  • Intense exercise: Limit for 2-4 hours prior to bed.
  • Lying awake for prolonged periods in bed (more than 30 min):  Trial 10 rounds of 4-7-8 breathing right when you recognize you've awoken in the middle of the night. If you remain awake for more than 30 ish minutes - Get up, go to dim room and do something boring.
  • Naps: If you are on a routine schedule or you have chronic insomnia, naps can deplete your sleep drive.

Navigating Float/Swing/Call Shifts

Adjusting Circadian Rhythms:

  • For short-term schedule changes (under 2 days), stick to your usual routines.
  • For long-term shifts (2+ weeks), pre-adjust by 1–2 hours per day, focusing on light exposure in your "new morning."
  • For the in-between - well, it's the gray zone, figure out which approach is best for you.
  • Adjusting your internal clock forward is easier than back (similar to easier to travel West than East - especially to wake up in the morning).
  • To adjust circadian rhythm: 
    • Pre-adjust sleep time, meals, exercise, and other routines by up to 2 hours max per day.
    • Begin to concentrate light exposure in your "new morning" hourse - natural or 10,000 Lux SADD lamp. 

Coping With Sleep Loss:

  • Use moderate caffeine strategically - 4-8 oz of coffee or equivalent spread out every 1-2 hours over the shift.  (300-400mg of caffeine). Avoid caffeine in the 6-8 hours before your new bedtime. 
  • Take 10–20 minute power naps, potentially pre-dosed with caffeine for a boost. Power naps have been shown to improve cognitive performance, mood, and alertness. If you're on call with a team, cover for one another. 
    (Pro-tip – if you’re experiencing chronic insomnia, the power nap likely isn’t for you as it robs you of your sleep drive).

Improving Sleep:

  • Consider supplements like melatonin, magnesium, or ashwagandha to improve sleep quality.
  • Melatonin is the most well-studied. 0.5-3mg 30-60 min before bedtime improved sleep for shift workers, though its nightime alertness is inconsistent. 
  • Other studies need more higher quality and reproducible studies, yet the most promising are:
    • Ashwagandha 120mg of extract to 600mg/day for 6-8 weeks has been shown to improve sleep quality, sleep latency, total sleep time, wake after sleep onset, and sleep efficiency in some studies.
    •  Magnesium supplements (200-400mg) was demonstrated in some studies to improve sleep quality, total time, and latency. The form in many of the studies were citrate or oxide, though the bioavailability is better with glycinate so it may be better – and because of the easier absorption, there are less side effects on the bowel.  
    •  L-Threonine (200mg) before bed can improve sleep quality in lower quality studies  

Safety First:

  • Avoid driving if you’re drowsy. Call a ride or sleep in the call room.
  • Seek help if you notice impaired thinking or alertness.

Readjust: 

  • Lessen the sleep deficit and reset the times of your sleep/light/routines by up to 2 hours a day max. (Meaning okay to "sleep in" up to 2 hours past your normal wake up time when making up time.) 

Overcoming Common Sleep Barriers with Mindset

  • Overwhelming To-Do Lists: Remind yourself that sleep boosts productivity tomorrow. The work is never done and it will still be there tomorrow. 
  • The Clock has Nothing Useful to Say: As long as you know you have adequate alarm(s) set, don't bother looking at the clock once you go to bed. Your brain will likely turn whatever time it is into an "Oh no... " and raise your stress levels further impairing sleep. 
  • FOMO and Screen Time: The "I deserve to (blank) mindset can be counter productive." Decide how much Netflix, social media, gaming, etc truly serve your overall needs—and when sleep would serve you better. It's good to give yourself what your body really needs. 
  • Journal: This can be helpful to get out all the things swirling in your head and to have a place to write the new "to do's" that come up that may impair your sleep as you try not to forget. 
  • CBT: The most evidence based interaction we have.
  • Find Your Useful Thoughts: When you find yourself awake, figure out the calming thoughts that may be more helpful. A couple of example
    • “At least I’m resting.” “My mind is so amazing to offer me all these thoughts trying to keep me safe and/or be so creative. I’m so grateful." (Judgement about all the thoughts doesn't help calm the brain – it's like yelling, "Stop crying!" to a crying kid).  “Where do I feel any tension? I'm now releasing it” (Relax your jaw, shoulder, legs, etc.) 
    • “It feels good to relax. I am so grateful to have a bed and roof over my head in a safe place.” 
    • “Even if I only doze another 10 minutes, there’s evidence powernaps are helpful.” 
  •  

Final Thoughts, Resource, and Reflection

If you have medial or pscyhological issues impairing sleep - work with your own health professional or see a sleep specialist. Prioritize what your body truly needs—restorative sleep. It’s not a luxury but a necessity, and you deserve it just by being you!

Remember the 3 R's: Rest & Recover Regularly.

Resource: Dr. Funke Brown, one of our previous guest coaches in the JoyFM Community, is a sleep medicine specialist (with lots of expertise for parents too!) offers this short video which includes her 5 favorite sleep tips to start off 2025 well.

Reflection Question:
What small change can you make today to prioritize your sleep and improve your restorative sleep as an investment for your physical well-being?


Preview of Next Week

Stay tuned as we explore how to fuel your body with nutritious food to further enhance your physical well-being!

 

Have a joy-filled and rested week! Tonya 

Check out my Individual Physician Coaching Course on Enjoying Life and Thriving in your Career here 

 

TLDR:

  • Restorative sleep is the cornerstone of self-care, improving memory, mood, immunity, and overall well-being.
  • Consistency is key: Stick to regular sleep schedules, routines, and light exposure.
  • Create an optimal sleep environment: Cool, dark, quiet, and comfortable.
  • Avoid disruptors: Caffeine, alcohol, screens, and heavy meals close to bedtime.
  • Shift work requires strategic planning, like pre-adjusting routines and using light exposure.
  • Supplements like melatonin, magnesium, or ashwagandha may enhance sleep quality.
  • Prioritize sleep as a fundamental need—you’ll be more productive, efficient, and happier.

Next week: Nutrition

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