Coming off nights: a three day plan for your gut and sleep

Day one, nap for one to two hours, ideally before midday, then stay up and eat at normal times. Day two, a normal bedtime, regular meals, plenty of water, a walk, and go to the toilet when you need to. Day three, wake at your usual time. Expect about two normal nights before your sleep is back.

How long does it take to recover from a run of nights?

Expect about two normal nights before your sleep is back where it was. The Sleep Charity’s advice after a final night shift is specific: a short morning nap of one to two hours, ideally before midday, then get up and keep the day as normal as you can, eating at your usual times and aiming for your usual bedtime. Its own estimate is that you are likely to need two normal nights to settle back into a usual pattern.

That nap is the part most people get wrong. After the last night you want a fry up and ten hours in bed, and a long day sleep pushes your first normal night further away. Dr Chiara Dall’Ora, writing for the Royal College of Nursing, makes the point that time off can be eaten into by the need to recover properly, especially after a set of 12 hour nights. Recovery is part of the time off, so plan it rather than hoping it happens.

Why does my gut go off after nights?

Because nights stack up the things a gut likes least. Changing your diet or daily routine, not drinking enough fluids, sitting still for long spells and ignoring the urge to go are all among the most common causes of constipation, and a run of nights can hand you most of them at once. Meals move around the clock, the water bottle goes untouched, and the toilet waits until there is a gap.

I know most of these from the inside. On thirteen hour shifts I learned to put off going to the toilet, and my water bottle sat untouched on the nurses’ station for hours. Two long days went straight into three nights.

There is also a longer term picture. A large UK study found that people who always worked nights were more likely to be diagnosed with IBS, though it could not show nights were the cause; I’ve gone through it in night shifts and IBS. A few days of recovery won’t change that picture, but they are the part you control.

The three day plan

What should I eat on my first day off?

Ordinary meals at ordinary times, which is harder than it sounds when your stomach thinks lunch is at 2am. The advice after a run of nights is to eat at your normal times from the first day, so have breakfast, lunch and dinner on the clock even if you are not hungry for the first one.

If you come off nights constipated, the NHS advice is to drink plenty of water and other fluids, avoid alcohol, and gradually increase the fibre in your diet. Gradually is the important word. Most UK adults eat about 20g of fibre a day against the 30g they should be getting, and the gap is closed in small steps, not in one weekend: porridge, a wholemeal sandwich, a tin of beans in a stew, a piece of fruit with lunch.

On the toilet itself, keep to a regular time and place, give yourself plenty of time, and do not delay when you feel the urge. After a run of nights, that last one takes a conscious effort.

Leave a big night out for later in the week. Alcohol might help you drop off, but after a drink you sleep less deeply and wake tired, which is the opposite of what the first two nights are for.

Why am I so tired in the afternoon on my days off?

Partly because you are still catching up, and partly because the afternoon dip is built in. It happens even in people who have had no lunch at all, a high carbohydrate lunch makes it worse, and a disturbed night’s sleep deepens it. In the first two days off, you have the disturbed sleep covered.

A glucose dip after a meal is often blamed, but the research links it to hunger and eating more later, not to sleepiness. So a sensible lunch is aimed at the 4pm raid on the cupboard, and an early night at the heavy eyes. A walk after lunch is free, and even a single 15 minute walk can give you an energy boost. If the slump hangs around long after your sleep has recovered, the afternoon crash quiz is a good next step.

For the next run, the recovery starts on the first night: the main meal before you leave, a snack rather than a meal in the small hours, and a light breakfast before bed. Those are in what to eat on a night shift and breakfast after nights.

When is it more than coming off nights?

If you have diabetes, or take medication timed to meals, speak to your own diabetes team or GP before changing when you eat around your shifts.

The NHS says to see a GP if you:

• are regularly constipated
• are regularly bloated
• have blood in your poo
• have lost weight without trying
• are constipated and feel tired all the time
• notice sudden changes in how you poo (your bowel habits)
• have tummy pain

And for tiredness, see a GP if you’ve been feeling tired for a few weeks and you’re not sure why, or your tiredness affects your daily life. Don’t put either off until after the next set of nights.