Coping With Shift Work: Strategies For Workers Who Sleep At Unusual Times

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More than 22 million Americans are like you—working evening, rotating or on-call shifts and facing sleep-related problems like trouble sleeping during the day and staying alert on the job. Shift work may cause you social and family problems, or even physical illness. Working a schedule different from most people’s can be challenging, but following the following guidelines may make it easier for you to live with — and safer too.

A main reason that shift work can be challenging to you health and lifestyle is the fact that your body is so sensitive to changes in circadian rhythms. “What are circadian rhythms?” you ask. Circadian rhythms are like “messages” that tell various body functions when to kick in. Things like temperature, alertness, sleepiness, hunger and most hormones operate at different times during the day. In healthy adults, sleepiness tends to occur during ta specific phase of the circadian rhythm with the strongest sleep urges between 2:00 A.M. and 5:00 A.M. If you work at night, you must fight your body’s natural rhythms by staying awake when you would normally be sleepy and by trying to sleep when you would normally be awake.

Some researchers believe that complete adjustment to permanent irregular shift work may take as long as three years to achieve. Others believe that a person never fully adjusts to an unusual sleep/wake schedule.

Whichever is true, shift workers tend to be continually sleep-deprived. If you are a night shift worker who sleeps during the day, your average sleep cycle may be two to four hours shorter than that of a day worker who sleeps at night. Your day sleep is probably light, interrupted and less likely to make you feel well rested. You may even be experiencing sleep deprivation and insomnia. The sleep problems you face as a shift worker can be made worse if you already have some kind of sleep disorder (such as narcolepsy or sleep apnea) and/or a schedule that does not allow for you to get enough sleep each day. If you suspect that you have a sleep problem, even if it existed before you started shift work, see your healthcare professional for advice and treatment.

Are There Treatments for Sleep Loss Related to Shift Work?

Since your work setting and tasks can vary greatly from other worker’s, whether they work shifts or not, it is necessary to explore a variety of solutions and treatments to help you overcome your sleep problems. The ideal approach for someone who works in a hospital, for example, may not be best for someone who works on an assembly line. Also, some people are more naturally suited to working one kind of shift than another. “Night people” may adjust to the night shift better than “morning people.” Older workers in general find it harder to work nights or rotate shifts. Sever al treatments appear to help with shift workers’ problems but they approach like to help you best depends on your individual needs and circumstances.

Work Schedules

The best work schedule is one that allows you to sleep when you are off duty and be alert when you are on duty. Of course, the best schedule for you may depend on the above mentioned factors as well as the job and position you hold. work schedules that go along with your body’s circadian rhythm by rotating clockwise (from evening to night) are helpful. Studies have shown that changes in the work schedule that consider circadian factors are likely to lead workers to be more productive and feel more satisfied, and to reduce accidents. Your ideal schedule should be determined by your body’s natural sleep needs, by what feels “right” and helps your overall work-time alertness.
Breaks during work hours may also increase your alertness. There is evidence that brief rest periods in certain types of jobs may reduce fatigue without reducing output; in fact, breaks may actually increase your productivity and job satisfaction. Ask your employer to work with you to determine a scheduling change that could improve your job performance and make you feel less tired.

Sleep Schedules

If you are a permanent night shift worker, you should keep a regular (day) sleep schedule seven days a week, even on your days off work. Going back to a typical day schedule during time off will only make it harder for you to sleep during the day when you return to your night shift work.

If you are someone who works rotating shifts, try to adjust your sleep schedule so that you will be able to adjust are easily to a new shift time when it happens. On the last few days of the evening shift, for example, bedtimes and arise times should be delayed by one or two hours. Then you an begin your night shift work already well on the way to being adjusted to the new schedule. Family and social responsibilities may, of course, make this difficult or impossible to do. Still, following this treatment approach may really help improve your life, and indirectly help your family and social relationships.

If you are an on-call shift worker, you are probably aware that your sleep problems are somewhat different from those of night shift or rotating shift workers. Because on-call workers usually can’t predict work schedules far enough in advanced to plan the right sleep/wake schedule they should try to be well rested at all times. Napping may be worth trying. Although there is some evidence that sleeping in one longer stretch is better than sleeping in several shorter periods, those of you who can’t get all of your sleep in once stretch may increase your total number of sleep hours by napping. Napping is especially helpful when naps are taken off-shirt, at an appropriate point in your circadian rhythm. The napping can help offset the sleep loss associated with poor daytime sleep.
On the other hand, brief naps taken during a work shift may only increase your alertness for the moment, since your job performance can be slowed at first as a result of sleep inertia. You should seriously consider the effects of sleep inertia before you decide to use napping during the work shift, especially if your job requires you to wake up quickly or react immediately to different situations.
While naps are not a substitute for a regular schedule of normal sleep, they can help you reduce your sleep “debt” and improve your alertness, at least for the time being.

Sleep Aides

Shift workers often use sleeping pills (also known as hypnotics or sedatives) to override the time of day and make themselves able to sleep. There are disadvantages to using these medications, including side effects in some people. You should avoid long-term use of medication because its effectiveness may wear off over time, and you may develop a dependance on the drug. Most important, however, is the evidence that even if daytime sleep is improved with the use of sleeping pills, there will likely be only partial improvement in alertness and performance in the night shift following a workers dose of such medication. Although sleeping pill may offer relief and may be appropriate along with other treatment, they do not address the actual cause of you sleep problems. Sleeping pills cannot reset your internal clock.
If you think sleeping pills could help you one in a while, talk with your healthcare professional. Over-the-counter sleep aids are not the best choice to help you sleep since many of them cause drowsiness for several hours after you awaken, which can be unsafe.

Stimulants

Studies have shown that the occasional use of stimulants such as caffeine, can reduce sleepiness and improve your ability to be alert on a night shift. However, you should avoid caffeine within four hours of your desired bedtime since it can actually cause difficulty falling asleep.

Melatonin

Our brain’s natural production of melatonin appear to affect our sleep/wake cycle. Melatonin is a chemical produced by the pineal gland in the brain at night, during sleep. Research has recently begun to explore the possibility of giving a synthetic (man-made) form of melatonin to night workers in the morning to help adjust their circadian rhythms so they can sleep during the day and be awake at night. Further research is needed to determine the effectiveness of the treatment.

Bright Light Therapy

Some recent studies have produced early evidence that timed exposure to bright light can help adjust the sleep cycle quickly. Just as the sun helps set your body’s clock, exposure to bright light may actually shift the circadian phase, reversing your sleep/wake schedule so you are able to sleep during the dyad be alert on the job at night. Bright-light boxes are available from several manufacturers.

Sleep Hygiene

The best treatment may be to follow the guidelines of good sleep hygiene especially the need to sleep in a dark, quiet room. Proper sleep hygiene requires using the bedroom only for sleep and sexual activity (not for watching TV or balancing the checkbook), keeping the room temperature cool and comfortable, relaxing before falling asleep, and having a regular routine for preparing to sleep. You may find it useful to use “white noise” to block out other noises. Turning the phone off and and disconnecting the doorbell or putting up a “Do Not Disturb” sign can also help.

Other Measures

Diet may also pay a role in good sleep: shift workers should eat meals that are high in protein and carbohydrates, and should avoid fried or hard-to-digest foods, going to bed when hungry, or going to bed immediately after eating a large meal.

If you suspect that you have a sleep disorder, it’s important that you discuss your symptoms with your primary care doctor. You could be missing out on better sleep and overall better health. Contact us for more information or to schedule an appointment.

 

 

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