A common problem that emergency physicians share and struggle over is the circadian “dysrhythmia” of working random morning, afternoon, and night shifts. Shift work is the blessing and curse of our profession. I have yet to figure out the best way to adjust back to the daytime world after night shifts. Do you have any tricks?

Also, does anyone else find it disturbing to be writing the same date on the chart as your last shift, as you start your night shift? You went home at 7 am and are now back at 10 pm!

I encountered an interesting concept of a “caffeine nap”, which arose out of the sleep literature in the UK. The pilot study focused on assessing ways to combat driver sleepiness, using a driving simulator. The drivers reported their drowsiness on a 9-point Karolinska Sleepiness Scale and also underwent EEG monitoring.

What is the Caffeine Nap?
The caffeine nap involves drinking 1 cup of coffee and then immediately napping for only 15 minutes. The coffee apparently helps to eliminate adenosine stores, which contribute to fatigue. After your 15 minutes, the wakeful effects of caffeine will kick you off to a running start. The caffeine nap kept drivers more alert than caffeine or napping alone.

I’m going to try this the next time I’m having a hard time switching back from my night-owl to normal daytime hours. I recently tried Philz Coffee, a local favorite in San Francisco. I’m not a coffee snob, but this could be my new favorite coffee place.

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD