Doctors, nurses, paramedics, police officers, emergency dispatchers, firefighters, retail workers, and home health aids all have one thing in common — shift work. Shift work includes jobs where individuals are needed around the clock, generally consisting of hours outside of 9:00am-5:00pm. Approximately one in five individuals hold a job with rotating shifts, often including overnights.
3 weeks ago, Lindsay discussed the importance of getting adequate sleep, and Sheela addressed the implications of pulling an all nighter. But what about those individuals who have rotating sleep schedules and have to stay up all night? Are night shifts dangerous to health?
The Journal of Neural Transmission published an article which reviewed studies that looked at the implications of rotating between work schedules and more specifically, working night shifts. Major findings include:
- Small likelihood of developing a depressive mood in shift work over 10 years, most often seen in men over 45 years of age.
- Nurses working night shifts were significantly more apt to report symptoms of somatization, obsessive-compulsiveness, interpersonal sensitivity, anxiety, and paranoia compared to day shift workers.
- Poorer mental health was associated with shift work, however, it is unclear whether this has to do with long shifts (11-12 hours) or actual shift work.
- Difficulty maintaining a social life, due to free time that is misaligned with others working 9:00am-5:00pm.
- Reduced spouse satisfaction and an increase in divorce was found in 2 studies reviewed.
- Chronic effects included moderately increased prevalence of intestinal, metabolic, and cardiovascular diseases.
- Gastrointestinal problems, such as ulcers were found widely inconsistent between studies.
- Increased risk of breast cancer in women and increased risk of prostate cancer in men, however, studies show low correlation between cancer and shift work.
- Possible increase in fatal effects on unborn children.
- Increased risk of traffic accidents after night shifts.
So, what are the possible reasons for seeing these potential health effects in shift and night workers? One reason may be due to offsetting the body’s circadian rhythm, the control of psychological and physiological functions, such as sleep, temperature, and digestion.
Humans are programmed to sleep when it’s dark out and be awake and alert when it is light out. This cycle is what makes it difficult to flip the switch and be alert at night, and have quality sleep during the day. An article published in Clinical Medicine describes the cumulative loss of sleep resulting from night shifts as, “sleep debt” and is also associated with:
- fatigue which may lead to reduced performance
- sleep deprivation
- low levels of alertness, vigilance, and cognitive reasoning
- decreased judgement on performance
- impaired knowledge that has recently been acquired
The circadian rhythm releases melatonin at night in order to assist with sleeping. Offsetting the processes of the circadian rhythm due to irregular sleep and activity may be associated with the above findings. However, keeping sleep debt to a minimum and receiving social support from family, friends and co-workers may assist in making shift work more bearable and less harmful to health.
Additional tips from the article in Clinical Medicine for shift work and balancing circadian rhythm include:
In order to ease transitioning to a night shift…
- Repay as much sleep debt as possible before switching to a night shift.
- Sleep in later the morning before your first night shift.
- Take at least a 2 hour late afternoon nap to benefit from deep sleep.
- In your bedroom, avoid watching TV, using a computer or playing video games.
- Sleep in your bed and not on the couch or in a chair.
- Try not to worry about the previous or upcoming shift.
- If after 30 minutes, you still cannot fall asleep, try getting up and listening to relaxing music or take a bath. Don’t stress about not being able to fall asleep in bed.
- If possible, take a 20-45 minute nap in a quiet and dark place to improve alertness.
- Try to nap before feeling tired.
- Maximize bright light, even if its from a desk or overhead lamp.
- Try to maintain a similar eating schedule to the one you have during day shifts.
- If you consume caffeine, have it in small doses and not within 4 hours before your shift is over to allow for being able to sleep during the day.
- Wear dark sunglasses driving home so the light doesn’t trigger alertness.
- Keep sleep debt under control.
- Avoid distractions and try going to bed right when getting home.
- If you are hungry, have something easy to digest before laying down.