Stay sharp overnight

In emergency medicine and critical care medicine, acute resuscitation is a 24/7 activity.  Night shifts can either be hurried throughout or long stretches of boredom punctuated by episodes of sheer adrenaline.  How can you make your resuscitations at night as on point as those during the day when you’re fresh?  A recent practice review covering the top 10 EBM interventions to help promote night shift alertness might help. Here are their findings:


  1. Schedule changes in a forward circadian rhythm - Day to afternoon to night.
  2. Nap prior to your night shift
  3. Maximize bright lights while on shift
  4. Take a nap during your shift if you can - 20 minutes is enough to promote alertness without causing sleep inertia.
  5. If you use caffeine, front load it into your shift to prevent lingering effects when you get home.
  6. Avoid large meals during the shift
  7. Reduce your exposure to bright light on your way home
  8. If you have trouble sleeping, melatonin may be worth a shot
  9. Maximize the darkness when you’re sleeping at home
  10. Turn down the temperature in your sleeping environment


Be sure to check out the article for their full references and evaluate the evidence for yourself!

Wallace PJ, Haber JJ.  “Top 10 evidence-based countermeasures for night shift workers.” Emerg Med J. Epub ahead of print. 2020.