Skip to content
Epomedicine

Mnemonics, Simplified Concepts & Thoughts

Epomedicine

Mnemonics, Simplified Concepts & Thoughts

psychiatry symbol

How to Come Down After a Long Shift When Your Head Is Still Running

Epomedicine, Sep 23, 2026Sep 23, 2026

If you are lying in bed at one in the morning rehearsing a handover you already gave, the fix is not more discipline. It is a short, fixed routine that you do not have to think about, ideally the same one every night, small enough that you will still do it when you are too tired to decide anything. Ten or twelve minutes is enough. Below is a routine that asks nothing of your judgement, only your body.

A word before that. I am not a doctor and not a clinician. You know far more about physiology than I do, and I am not going to tell you what any of this does inside you, because I do not know. What I can describe is what to do and what it feels like from the inside. I spent about two years waking at three in the morning most nights, not from shift work but from a head that would not stop sorting things, and I tried a lot of apps that handed me a library of recordings and let me choose. I never chose. That part is the reason I ended up building something, and it is the part I think transfers to your nights.

Why the drive home does not count

Most people who work long shifts already have a wind down. It is the commute, the scroll, the reheated food at midnight, the episode you have seen before. None of that is a moral failure. It is genuinely the only stretch of the day that belongs to you, and you are not going to give it up.

The trouble is that it does not change what your attention is doing. You finish the episode and your head picks up exactly where it left off, because nothing in that hour asked your attention to move somewhere simpler. So the useful addition is not a longer wind down. It is something short and deliberately boring, placed after all of that, at the point where you are already lying down.

A routine that does not depend on willpower

Do it in bed, lights off, phone face down. Nothing here needs sitting upright or a mat on the floor.

One. A slightly longer out-breath, about two minutes. Breathe in through the nose for about four seconds, out for about six. No holds. Do not push the last of the air out. If six feels long, make it five. Aim for the out-breath to be unhurried rather than big. You are not trying to breathe deeply. You are trying to breathe slowly and stop counting eventually.

Two. Gently tense, then let go, about two minutes. Take one area at a time. Both feet, mild effort, a few seconds, then release and leave them alone. Then calves. Then hands into a soft fist. Then shoulders lifted slightly towards the ears. Then jaw, very lightly, and this one matters if you have been talking all day. Keep breathing normally through the tensing. Never hold your breath. The interesting part is the second after the release, not the squeeze.

Three. A slow pass through contact points, three or four minutes. Move attention through the places where your body meets the bed. Heels. Backs of the legs. Lower back. Upper back. The hands wherever they have landed. The back of the head. The jaw again. You are not scanning for problems and you are not trying to relax anything you find. If your shoulder is tight, notice it is tight and move on. Doctors and students find this one hard, because you have been trained all day to find the abnormality and act on it. Here there is nothing to find and nothing to act on.

Four. A resting hand, and then nothing, two or three minutes. Let one hand rest lightly on the opposite upper arm, supported so the arm is not held up by muscle. Then stop working. Do not check whether you feel calmer. Do not check whether sleep is coming. Give up the goal entirely and just lie there with the hand where it is. Sleep, if it arrives, arrives while you are not monitoring for it.

Two optional swaps. If your chest feels tight rather than your thoughts busy, use an easy even breath instead of step one, a comfortable five seconds in and five out, not bigger breaths than usual. If you are wired from talking or handover, try a quiet hum on three or four comfortable out-breaths before step three. Low, soft, nothing performed.

If anything here feels uncomfortable, stop and rest in your usual way. There is no version of this that is worth pushing through.

The three in the morning version

Waking in the middle of a sleep, whether it is a night off or the second day of nights, has a different problem. You are not trying to come down. You are trying not to start a project. The move is to do less than you think. One long out-breath pattern, the resting hand, and then the giving up part, lying there without checking. Lights stay off. Phone stays where it is. I wrote up the longer version of what to do when you wake at 3am separately, because it took me a long time to work out that the aim at that hour is not to get back to sleep but to stop trying to.

When the choosing is the step that fails

Here is the honest bit. The routine above is not the hard part. The hard part is that at eleven at night, after twelve hours, the act of deciding what to do is the thing that does not happen. You lie down, you think you should probably do something, and instead you scroll.

You can remove that decision without an app. Write the four steps on paper by your bed. Save one single YouTube recording and use only that one, never the sidebar. Use a free timer app and set twelve minutes. Any of that works, as long as the choosing is already done.

If you would rather it be done for you, that is what I built Wind Down Daily for. You tap three things before bed, how you slept, how tense you are, how much energy is left, and it opens one practice for that evening, around twelve minutes, with one line saying why that one. Voice guided, made for a dark room with the screen off. iOS and Android.

When this is not enough

This is a small routine for a busy head, nothing more. If you are waking most nights over weeks, falling asleep at the wheel or nodding off in handover, waking gasping or told you stop breathing, feeling low or flat in a way that is not lifting, or drinking to get to sleep, that is worth taking to your own GP or occupational health rather than managing alone. You would tell a patient the same. It is harder to hear on your own behalf, and it still applies.

  • Facebook
  • Twitter
Blog

Post navigation

Previous post

Related Posts

Blog

How Medicine May Change In A Post Covid-19 World

Jul 23, 2020Jul 23, 2020

There is no doubt that we will start thinking in terms of the world pre and post Covid-19. The entire globe has been turned upside down to the point that daily life from before is completely unrecognizable.  How we deal with our personal lives, our professions and society as a…

Read More
Blog

5 Ways to Gain Professional Nursing Experience

Mar 8, 2023Mar 8, 2023

Being in school and studying hard is essential as is getting practical experience. Learning from real-life scenarios can help make future tasks more accessible and comfortable. Here are ways to gain realistic nursing skills while gaining the academic education you need for long-term career success.  Volunteering at a hospital or…

Read More
Blog weight loss

What hormones make it difficult to lose weight?

Oct 4, 2021Oct 4, 2021

Many people want to lose weight for various reasons, whether it is to have more energy, obtain a specific look, or live a healthier lifestyle. Most pay attention to only numbers on a scale, nutritional values, and calorie averages, yet do not see the results they want. Sometimes, the hormonal…

Read More

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Epomedicine. How to Come Down After a Long Shift When Your Head Is Still Running [Internet]. Epomedicine; 2026 Sep 23 [cited 2026 Sep 23]. Available from: https://epomedicine.com/blog/coming-down-after-a-long-shift/.

Pre-clinical (Basic Sciences)

Anatomy

Biochemistry

Community medicine (PSM)

Embryology

Microbiology

Pathology

Pharmacology

Physiology

Clinical Sciences

Anesthesia

Dermatology

Emergency medicine

Forensic

Internal medicine

Gynecology & Obstetrics

Oncology

Ophthalmology

Orthopedics

Otorhinolaryngology (ENT)

Pediatrics

Psychiatry

Radiology

Surgery

RSS feed: Ask Epomedicine Ask Epomedicine

  • What to study for Clinical examination in Orthopedics?
  • What is the mechanism of AVNRT?

Epomedicine weekly

  • About Epomedicine
  • Contact Us
  • Author Guidelines
  • Submit Article
  • Editorial Board
  • USMLE
  • MRCS
  • Thesis
©2026 Epomedicine | WordPress Theme by SuperbThemes