I've always wondered how people who work night shifts function. For most, getting out of bed in the morning feels like a Herculean task while operating on a normal circadian rhythm! What effects do night shifts have on health? Across the world, healthcare workers comprise the most significant proportion of shift workers. Do they do this at the risk of compromising their health?
Night shifts disrupt our body's internal clock, aka the circadian rhythm. A healthy circadian rhythm promotes the release of certain hormones which influence metabolism. The body's metabolizing ability is significantly altered when that rhythm is interrupted or frequently inverted. Without proper management, these issues can lead to metabolic disorders, elevated levels of triglycerides, reduced HDL cholesterol, increased fasting glucose, and high blood pressure. Melatonin is a natural hormone produced by the pineal gland in your brain. It plays a role in managing your sleep-wake cycle and circadian rhythm. However, it's not only a sleep hormone but also an antioxidant. Antioxidants protect your cells against free radicals, which may play a role in heart disease, cancer, and other diseases. A disrupted circadian rhythm interferes with melatonin production, giving your body less of the critical compound for cellular protection.
Night shift work has also been shown to raise the risks of mental health issues such as nervousness, irritability, and anxiety as consequences of stressful working conditions.
Night workers also experience a decreased quality of sleep. REM sleep studies show that it is the stage of deep sleep we need to restore our emotional balance. Night shift workers don't get as much REM sleep as they need, resulting in more significant risks of irritability and mood disorders. The brain and body rest and recharge while we sleep. If we are not getting quality rejuvenation time, our brains don't get the chance to repair and process our experiences properly. Research has shown that disrupted sleep cycles can lead to impaired brain function, decreased reaction time, poor memory and emotional control, early cognitive decline, and Alzheimer's.
Short-term Health Consequences of Sleep Disruption include increased stress responsivity, psychosocial issues, and cognitive and performance deficits. Fragmented and interrupted sleep leads to heightened sympathetic activation, impacting stress hormones, cognitive functionality, attention, executive function, emotional reactivity, decision-making, and motor control. Long-term Health Consequences of Sleep Disruption include cardiovascular, metabolic, and gastrointestinal effects, as well as increased mortality and cancer risk. Sleep disruption increases sympathetic nervous system activity, contributing to hypertension, dyslipidemia, and cardiovascular disease. Sleep disruption is associated with metabolic disorders, including obesity and type 2 diabetes, through impaired insulin sensitivity, increased food intake, and disturbances in glucose metabolism. Sleep disruption worsens symptoms of inflammatory bowel disease, irritable bowel syndrome, and gastroesophageal reflux disease, while these disorders can also contribute to sleep disruption, indicating a bidirectional relationship. Disruption of circadian rhythms and sleep deprivation may accelerate tumor formation, increase cancer risk, and affect hormone production. Sleep disruption is linked to higher all-cause mortality risk in men and adolescents with sleep disturbances. sleep disturbance is associated with higher risks of suicide. The relationship between sleep disorders, depression, and suicidal ideation contributes to increased mortality risk.
To stay healthy while working night shifts, consider the following tips:
1. Wear sunglasses when walking home: Protect your sleep by blocking blue light exposure, especially after night shifts. Use lamps with red or orange bulbs before bedtime to mimic sunset colors.
2. Work in bright light whenever possible: Increased exposure to light during night shifts can enhance alertness and performance. Short bursts of bright light may be beneficial.
3. Get seven to nine hours of sleep every 24 hours: Maintain a consistent sleep schedule, even if it's broken. Exposure to light can affect circadian rhythms, so manage your sleep time to avoid "social jetlag."
4. Optimize daytime sleep: Use blackout blinds or an eye mask for better daytime sleeping. Experiment with spending eight hours in bed, rising one to two hours before your night shift.
5. Consider napping before your shift: A one-hour nap before starting your night shift, preferably between 2 pm and 4 pm, can enhance performance and alertness.
6. Manage caffeine intake: If consuming caffeine, have it early in the shift and avoid it towards the end to prevent impacting daytime sleep.
7. Plan and bring healthy food to work: Be mindful of your diet to balance blood sugar levels, avoiding sugary snacks and simple carbohydrates.
8. Eat a main meal before your shift: Provide your body with fuel for the night shift by enjoying a nutritious main meal before starting work.
9. Stick to an eating routine: Regular mealtimes help synchronize your body's secondary cellular clocks and regulate blood sugar.
10. Stay hydrated: Carry a reusable water bottle and refill it regularly to avoid mild dehydration, which can affect mood and cognitive functioning.
11. Adjust your circadian rhythm with temperature: Exposure to cold temperatures, such as a cold shower or bath, may help regulate your circadian rhythm and boost energy.
12. Exercise in the early evening: If needed, delay circadian rhythms by exercising between 7-10 pm. Avoid exercising 90 minutes before sleep.
13. Consider alternative transportation: Due to reduced cognitive performance after night shifts, consider leaving the car at home to prevent accidents or near-misses while traveling.
14. Understand stress: Be aware of prolonged stress and its sources. Make minor adjustments in nutrition and sleep to minimize stress impact, and seek support from colleagues.
Night shift workers play a vital role in maintaining the continuous operation of essential services, ensuring that our communities are supported around the clock. Their dedication during the often overlooked hours of the night is a testament to their indispensable contribution to the well-being and safety of society.
References:
https://www.evergreen-life.co.uk/health-wellbeing-library/how-to-work-night-shifts-and-stay-healthy/
Assessed and Endorsed by the MedReport Medical Review Board
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