MEDICATED SLEEP AND WAKEFULNESS: A Social Scien9fic Inves9ga9on of Stakeholder Interests, Policies and Prac9ces
AMY is an AMBULANCE TECHNICIAN. She works a 12 hour rota9ng shiE paUern. She is 39 years old and of White Bri9sh ethnicity. “I have worked shi/s for 17 years. I find nights hard. I find the days hard as well! I’ve done every shi/ pa=ern, start ?me and finish ?me that there is. ShiE work makes it difficult to get enough sleep and then throw in if you’ve got a family, other commitments, a really busy life, then all those issues, hinder geNng enough sleep. I am very, very aware of how a lack of sleep affects me and, in turn, my husband. I’ve got to have a minimum of 8 hours or else I’m just really crabby. If I only have 5.5 to 6 hours I will then func?on at 80% for the rest of the day and be short tempered. Things that we can do without thinking about during a day shi/ become quite taxing during a night shi/. Everything is five ?mes as hard, even just basic coordina?on, using our equipment. Nothing works, this is too heavy, that doesn’t fit, and everything becomes so short fused. Even being able to stay awake while driving is phenomenally difficult. Some?mes, I am convinced I’ve had about 10 micro sleeps on the way from one standby point to another. I would nap at every available opportunity if I could. You could be disciplined for it, if you’re caught sleeping, but now, there is nowhere, really, for us to sleep. My crew mate happily sleeps in between going from one job to the next. But I can’t sleep siTng upright like that. I need to lie down. I struggle to sleep during the day too and I live on a quiet street, I sleep at the back of the house, wear ear plugs, have black out curtains. I usually feel sick by the ?me I come in, in the morning because the 12 hours shi/ doesn’t usually end on 12 hours, it runs into 13 or 13.5. I’m ready to just collapse in the bed, I will go off within a second. First night I sleep like a log. It will be the second night that I will be awake at 3am. So, I have a delayed night shi/ sort of awakeness. And then once the mind is awake it’s hard to switch off from daily stuff. I relive the shi/ I’ve just had, probably, all the ?me. If you are being constantly exposed to trauma?c events, those experiences build up and get put somewhere. Add that to a rolling shi/ pa=ern where you are depriving yourself of sleep you then might find that something then happens which will bring all those things back to the surface. If I’m on a run of nights I’ll get perhaps 3.5 hours of dead sleep, where the duvet won’t have moved. My body, or my liver wakes up four hours later and decides I need a wee, and I desperately try not to wake up properly. I try and sit there with my eyes s?ll desperately closed because I know that if I do wake up I’ve got no chance of geTng back to sleep properly. I will try so hard to go back to sleep un?l I just give up and think “well, there’s no point in lying here anymore”. I go and do some cleaning or walk the dog. If I’ve been desperate to sleep and I haven’t been sleeping off nights for that run, I may try diazepam, Night Nurse is a good one. I’ve always got diazepam at home for chronic back problems. I’ll have a half, it just relaxes everything right down. I have taken diazepam for sleep issues as well, as directed by a doctor. I was more than happy to take it because I wasn’t geTng any rest in the day or the night so I needed something to close off from what was going on. And it worked. I took them for about three weeks, every night. I don’t take anything now. My sleep is fine now. I will be ready to go to my first night shi/ but I won’t have been able to get any sleep in the a/ernoon before I go to work for 7pm, so I will go through for that 24 hour period without any sleep. We can’t ever get that sleep back, we can’t say ”oh I’ll make up for it, I’ll sleep tonight”. That doesn’t replace the sleep that you’ve lost and we are all shortening our life expectancy. On the first night shi/ when I really am sort of asleep behind the wheel, I may some9mes resort to a boUle of something like Power Aid just to get me through that last end bit. I would have it in the fridge ready because I know I’ve got a run of nights coming up, because I just know. But, I don’t really like puTng that inside my body, I don’t think it’s par?cularly healthy. I drink coffee anyway, caffeine doesn’t have massive effects. I’ve never heard of this drug modafinil, so it’s knowing about what’s in it, what is the long term effect of using it, if I’m puTng it into my body. I wouldn’t take something that I didn’t really know a bit about.” Project Team: Professor Jonathan Gabe, Royal Holloway, University of London Professor Simon Williams, University of Warwick Professor John Abraham, King’s College, London Dr. Catherine Coveney, University of Warwick/ University of Sussex Research funded by The Economic and Social Research Council UK