More than at any other time in history, life operates on a 24/7 schedule. Made up in large part of a combination of globalization and accessibility provided by the internet, there's no longer any reason to shut down for the day. The downside to this 24/7 culture is that it has erased many of the old boundaries about work schedules. The medical community is particularly affected by this change because someone has to be available to tend to the medical emergencies of people who may work at any hours of the day or night.
Signs of Shift Work Sleep Disorder
Some people adapt moderately well to working different shifts. However, many people are driven by circadian rhythms which more or less follow the sun: we wake up at dawn and get sleepy at night. The problem occurs when people living with normal circadian rhythms have to adapt to working during the hours when they would normally be inclined to sleep. This is the cause of the shift work sleep disorder. Signs that you have this sleep disorder include the following:
Risks of Shift Work Sleep Disorder
Shift work is a major public health problem. When considering the fact that many people working non-traditional or fluctuating shifts include doctors and nurses, it's easy to understand the serious consequences of being tired and accident-prone. Unfortunately, it's not possible to serve the emergency medical needs of people working 24/7 unless health professionals themselves are working around the clock.
In addition to presenting safety risks to patients, healthcare workers are themselves negatively affected by working long hours.
In addition to presenting safety risks to patients, healthcare workers are themselves negatively affected by working these hours. Being awake at a time that our bodies are telling us to rest eventually takes its toll on individual health. One 2007 study found that shift work was more likely to be associated with cancer. Other research papers have found a link between shift work and heart disease, menstrual irregularities, and digestive disorders.
How to Reduce the Impact of Shift Work
Shift work is just a fact of life for many people, especially those who work in the healthcare field. Shift work sleep disorder is a common result of working these biologically unnatural schedules. However, there are ways to reduce the amount of impact on one's health from shift work.
Make sleep a priority. Many shift workers short-change their own sleep because they try to be too available during standard daylight hours. Those lucky enough to have predictable work hours that just happen to be at non-traditional times should set aside a regular wake/sleep schedule every day. Sleep still needs to be the highest priority even when work hours are unpredictable, so avoid falling into the common shift-worker trap of having daily sleep amount to little more than a nap.
Create the right environment. It can be very difficult to sleep during the day because it goes against what is biologically natural for most people. However, making the bedroom dark, cool, and quiet during the day is most likely to promote sleep. Make sure to ask family members to limit noise and distractions as well.
Take advantage of light. Getting more exposure to light, especially in a non-standard work shift, can make it easier to stay alert and awake. Those who have to work during night hours can try to recreate circadian rhythms with artificial exposure to light during the hours they need to be awake and making sure things are dark after their work shift. Many third-shift workers use sunglasses that filter out the blue rays of the sun on the drive home from work to make sure the bright morning light doesn't signal their brain that it's time to be alert.
Use caffeine with caution. Caffeine fuels any workplace, but this is even more true in environments that require workers to stay alert around the clock. The problem with relying too much on caffeine to stay awake is that it can make shift work sleep disorder worse. Caffeine may help you stay awake but can make it harder to fall asleep, especially if you go to bed as soon as your shift ends.
Take medications as a last resort. Medications to help with sleep are not an ideal solution for every day, but sometimes they're an important option. However, make sure to keep medication use as a last resort to avoid developing a dependency.
Shift work sleep disorder is a very real condition with massive consequences.
Shift work sleep disorder is a very real condition with massive consequences. Some some health experts recommend changes to improve safety and health for such workers include reducing the number of 12-hour shifts in a row or limiting back-to-back shifts with less than 12 hours' break. Until these proposals result in changes, shift workers can focus on sleep hygiene to improve the odds of getting a good night's rest -- even if that doesn't actually happen at night.
Dr. Pushpa Chandra is a Vancouver-based Naturopathic Physician. She worked for over 27 years as a registered nurse and 22 years at BC's Children's Hospital, working in critical care with the province's sickest children. Her interests include research in circadian rhythm disruption, sports medicine and pediatrics. A competitive sports enthusiast, she has completed ultramarathons and marathons in all 7 continents. As a shift worker she has been using the ingredients of AWAKE and ASLEEP to boost her performance, endurance and overall health.
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