Sleep health management for healthcare workers

The intervention for poor shift work responsiveness has two components. Firstly, the participant will receive a group education session (approx 20 minutes) about the impact of shift work on sleep, health and other factors. The education sessions will be delivered by the trial co-coordinator/Phd in sleep, ICU nurse/PhD for this study, researcher/PhD for this study, The education will also outline some general principles that will help the participant to adapt their sleep cycle to shift work. The education will be based on the following general recommendations: 1. Nap approximately 8 to 9 hours after wake time in the afternoon prior to the first night shift. Ideally, nap for approximately 2 hours (or as long as possible), but the earlier the awakening the longer the nap required. For example, those who awake at 6am should nap for 2 hours, whereas those who awake at 10am may only require a 30 minute nap. For subsequent night shifts that nap time would be in the late afternoon to early evening. 2. Bright light during all work hours; 3. Caffeine use (excluding those with contraindications to caffeine use): Recommend caffeine use of 60 mg (approximately one 250ml cup of instant coffee OR one 55ml latte/cappuccino) up to every 2 hours until 6 hours before you plan to sleep when working night shifts and 9 hours before you plan to sleep on day shifts; 4. Exercise during breaks on the overnight shift for approximately 20 minutes (low to moderate intensity, e.g., go for a short walk); 5. Go home and attempt to sleep as soon as possible after ending work, and sleep in as long as possible; 6. Use eye mask, ear plugs and turning off phones and pagers. Tell others in your house that you are not to be disturbed; 7. Melatonin (1-3 mg), no additives, taken as soon as arrive home (note that melatonin will not be provided as a part of the study to the participants; if the participant decides they want melatonin they will be told to see their GP and obtain a referral); 8. Limit exposure to light and remain indoors immediately upon arrival at home. Secondly, the participant will be coached by the researcher who conduct the education session on how to develop a more individualised schedule that helps plan the undertaking of necessary measures to adapt to shift work. The individualised schedule will be based on the participants’ rostered sequence of shift type (e.g., night) and are therefore likely to differ across participants. Each schedule will consider the following factors: scheduling sleep/nap times; sleep hygiene; melatonin; dietary factors such as meal planning and caffeine intake; timed bright light exposure; and exercise. The researcher will receive the participants roster before the meeting so they can plan the schedule before the meeting, with the assistance of the rest of the research team (included in the researcher team are experts on circadian rhythm and sleep, sleep physician, experts on sleep in shift workers). The intervention will last for 8 to 12 weeks, and consist of four meetings (20 minutes each meeting) approximately every fortnight between the researcher and the participant to discuss the participant’s response to the schedule. The meetings will also serve to improve compliance, resolve issues they may have encountered. Participants who are at-risk for OSA or insomnia will Receive a referral to a sleep physician (OSA) or sleep psychologist (Insomnia)