Get Some Sleep: When shift work disrupts your rest



An estimated 20 percent of the American workforce does some type of shift work. This doesn’t have to mean working the graveyard shift. It can mean any work done between 7 p.m. and 7 a.m.

Most sleep doctors agree that working at night, from a biologic point of view, is not natural for human beings. We have evolved to be active in the daytime and to sleep at night. In fact nearly every cell in our body has a circadian rhythm, meaning that biological processes have a 24-hour cycle. And this is how we lived for thousands of years, until the invention of the lightbulb, which has allowed us to separate our activities from the rhythm of the sun, but at our own peril.

More and more research is showing the consequences of shift work. It has been linked to work-related and traffic accidents, to psychiatric and GI illness and even to heart disease and cancer. In fact, The International Agency for Research on Cancer (a subcommittee of the World Health Organization) published a statement in 2007 that classified shift work as a “probable carcinogen.”

Cancer is thought to be linked to shift work because of the suppression of melatonin, which is normally at its highest during the biological night. If you’re working under bright lights at night, you produce less melatonin. Melatonin, a naturally occurring “darkness hormone” secreted by the pineal gland in the brain, is a potent antioxidant, and secreting less could explain the connection between night work and cancer.

For the millions of you who do shift work, here are some tips to help minimize insomnia and fatigue.

It is important to make your daytime sleep environment mimic a nighttime one as much as possible. Blackout shades are a good idea. Shut off the telephone. Disconnect the doorbell. Family members must be encouraged to protect the sleep time of their loved one who is a shift worker. An additional approach is to use melatonin.

Studies have shown that melatonin can be a useful sleep aid to people trying to sleep in the daytime. In fact, it is much more successful at inducing sleep when taken in the daytime when your levels are naturally low. It should be taken when you are already home because it will likely start having an effect in about 30 minutes.

The other big piece of advice if you’re working the graveyard shift is to try to not completely shift your sleep/wake time when you have days off. Try to have a bedtime that is in between your nightshift bed time and the time that a day worker would go to bed. That way, you have sleep/wake times on days off that allow you to socialize or take care of your affairs, but you will still have a late bedtime so that when you go back to work, you can make the transition more easily.

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois

 



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