Millions of Americans are shift workers who struggle to stay
awake while they perform their jobs and then battle with insomnia
and other sleep-related problems once they return home. Here
are some tips for getting a good night or
day's sleep.
You stand at the bathroom sink, yawn, and splash cold water on
your face. You glance at the clockâit's 10 pm. Instead of putting
on pajamas and crawling beneath the covers, you're dressing for
work. You fill a thermos full of coffee and stumble out the door.
On the drive to work, you rub your eyes and roll down the window a
bit to keep from falling asleep at the wheel. You have trouble
concentrating on your work and you struggle to stay awake
throughout the night. Finally, it's quitting time and you can go
home to bed. Just when you're about to drift off, a neighbor cranks
up a lawn mower, the birds seem to chirp louder than usual, and you
can't ignore the sunlight seeping in around the corners of the
drawn shades.
The lifestyle of a shift worker can be pure agony. The lack
of sleep can lead to many problems, including
depression, lower job productivity, health problems, and
marital and family discord. It can also lead to accidents, both on
the job and on the highway. The National Sleep Foundation (NSF) cites a
frightening statistic: In a recent study, the foundation found that 72% of
shift workers admitted that they had driven while drowsy and 41%
said they had dozed off at the wheel.
A 24-hour Society
If shift work creates so many problems, why not just stick with
a daytime routine? While that seems like an easy answer, it's not a
possibility for many workers. Shift work is essential in our
24-hour society. Many people who make their living at odd hours
provide crucial services, such as emergency care and police and
fire protection. There's also a demand for 'round-the-clock workers
in the transportation and manufacturing industries. Our bodies,
however, are regulated by a different clock.
Humans are regulated by an internal body clock that causes them
to be active or sleepy based on different phases of each 24-hour
day. For most people, the desire to sleep is greatest when it is
dark outside, and the need to be alert and active is greatest when
it's daylight.
"Sleep [for shift workers] is ineffective because it occurs out
of synchrony with the endogenous circadian rhythm that organizes
sleep and activity," says Wolfgang Schmidt-Nowara, MD, of the Sleep
Medicine Institute at Presbyterian Hospital of Dallas. "The worker
must sleep at a time when the body expects to be active, while work
occurs at the usual sleep time. Sleep, therefore, is often short or
interrupted. During a work week, sleep deprivation accumulates and
sleepiness becomes worse. Time off from work can be used to get
extra sleep, but conflicting demands of family and other social
responsibilities prevents a full payment on sleep debt. The result
is fatigue and stress," he says.
Swing Shifts
Swing shifts present even more challenging problems to workers.
Just when they get adjusted to the hours of one shift, they spin
off to another schedule. Terri Lynn of Waldorf, Maryland used to
pull a swing shift as a police officer. "We worked three shifts:
six days of 7:00 a.m. to 3:00 p.m., two days off, seven days of
3:00 p.m. to 11:00 p.m., two days off and then seven nights of
11:00 p.m. to 7:00 a.m. followed by four days off," says Lynn. "I
was grouchy and fought with my husband. I'm sure it contributed to
our divorce. I couldn't make any permanent plans for weekly
meetings, clubs, etc, because of the shift changes."
"The biological clocks cannot adapt to frequent and large
changes in the timing of sleep from one day to the next," says Karl
Doghramji, MD, Director of the Sleep Disorders Center at Thomas
Jefferson University Hospital in Philadelphia. "Optimally, sleep
times should not be changed by more than one hour counterclockwise
or three hours clockwise from one night to the other," he says
Strategies for Getting Some Shuteye
If you're working a shift and having trouble sleeping when you
get home, here are some strategies for getting some much-needed
rest:
Keep a regular sleep schedule, even on weekends
Create a quiet, peaceful environment for sleeping
Wear eye shades if the sunlight disturbs you
Wear ear plugs if daytime noise keeps you awake
Run a fan or create other white noise to help lull you to
sleep
Turn off the ringer on your phone
Put a "Do Not Disturb" sign on your front door
Exercise regularly, but not within four hours of bedtime
Consult a physician about the use of prescription or
over-the-counter
sleep aids
A Short Snooze
When you can't get enough sleep, you may find it beneficial to
take a nap. Even a short nap can recharge a person and improve job
performance, alertness, and mood. The National Sleep Foundation says
studies show that naps at the workplace are important and effective
for employees who need to keep a high level of alertness in order
to make quick decisions. Naps at the workplace are also helpful for
people working a double or a 24-hour shift.
Time for a Change?
If you're experiencing severe symptoms related to sleep
deprivation, it may be best to consider a job change, or at least a
shift change. "There are some individuals who simply cannot handle
shift work," says Dr. Doghramji. "As we age, the ability to
withstand the effects of shift work also diminishes. Therefore, if
symptoms become severe and begin to interfere with daily life, and
especially if individuals begin to fall asleep during dangerous
situations, such as driving, they should consult a physician."
Resources
American Academy of Sleep Medicine http://www.aasmnet.org/
National Sleep Foundation http://www.sleepfoundation.org/
References
Circadian Technologies Inc.
website. Available at: http://www.circadian.com/.
Dement WC,
Vaughan C.
The Promise of Sleep: A Pioneer in Sleep
Medicine Explains the Vital Connection Between Health, Happiness,
and a Good Night's Sleep. Delacorte Press; 1999.
Sleep strategies for shift workers.
National Sleep Foundation website. Available at:
http://www.sleepfoundation.org/publications/shiftworker.html
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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
