Shift Work

---

According to the Bureau of Labor Statistics, an estimated 15 million Americans work shift work, or blocks of time designed for working that fall outside of standard working or business hours. Shift work may include shifts that regularly rotate or change, shifts that are split apart by several hours, permanent shifts in the day or evening or shifts that regularly change in length, varying from eight to twelve hour shifts.

While shift work may be essential for industries such as healthcare, transportation, communication and utilities where 24-hour services are necessary, other industries utilize shift work as cost-saving means, reducing the need to shut down and restart machinery and processes. While industries may benefit from shift work, the individuals actually working the shift work often suffer serious health and safety risks.

Facts about Sleep

• The National Institutes of Health reports that 40 million Americans suffer from chronic, long-standing sleep disorders. Another 20 million have occasional problems getting – or staying – asleep.
• Sleep disorders often remain unidentified and undiagnosed. Nearly one in two who have the deadliest sleep disorder – sleep apnea – remain undiagnosed.
• There are more than 70 sleep disorders.
• Insomnia and sleep apnea account for more than 50 percent of all sleep disorder diagnoses.
• An estimated one in five adults has some form of sleep apnea. One in 15 adults suffers from moderate and severe forms of the disorder.
• Untreated sleep apnea has been linked with three of the four leading causes of death. Of the four – heart disease, cancer, stroke and chronic obstructive pulmonary disease – only cancer has not been associated with sleep apnea.

The Body's Need for Sleep
For most, the natural 24-hour cycle of the body, known as circadian rhythms, finds them active during the day, while asleep at night. Factors such as light and darkness are natural influences that help instruct our bodies when to sleep, keeping the body's natural cycle in tune with the earth's 24-hour rotations. Changing daily activity from daytime to nighttime due to shift work disrupts the body's natural tendencies.

Employees that are required to work the unconventional hours of shift work often find they are forced to drastically change their sleeping patterns as often as every week, and in some cases, every day. A person's body can usually adjust to shift work if the hours are permanent, consistent shifts, allowing the shift worker to regularly sleep during the day and wake up at night, well rested and ready to work. Inconsistent shifts, however, disrupt the sleep wake schedule. Unfortunately, the body is not equipped to handle changes in circadian rhythms well, causing failures to rest and rebuild itself.

Sleep helps the body to replenish and regulate specific functions vital to good health, including:

• Body temperature
• Blood pressure
• Digestion
• Regulation of hormones
• Pulse rate
• Repair and maintenance

The Science of Sleep
There are two categories of sleep:

• Non-rapid eye movement (NREM) - Sleep a restorative period during sleep which consists of little activity
• Rapid eye movement (REM) - Sleep the period of sleep in which the brain is active and dreams occur

Sleep Stages
There are four stages of sleep, though the duration of each stage varies from person to person.

• Stage N1 (NREM sleep) - The transitional stage between waking and light sleep, typically lasting between 10 and 15 minutes.
• Stage N2 (NREM sleep) - Known as clinical sleep, blood pressure drops and heart rate decreases during this stage. This stage typically compiles 50 percent of every sleep day/night.
• Stage N3 (NREM sleep) - This stage provides restorative sleep while the body and mind repair itself in its deep sleep mode.
• Stage R (REM sleep) - When an individual, such as a shift worker, significantly changes the timing of their sleep schedule, the NREM/REM cycles become desynchronized, causing a reduction in the amount of REM and Stage N2 sleep.

Negative Effects of Shift Work on Sleep and Health
While the effects of shift work on sleep, and ultimately health, vary from person to person, many shift workers experience one or more of the following:

• Heart disease. Shift work may be linked to heart disease, as shift workers generally have shown higher cholesterol levels and blood pressure, which contribute to heart disease.
 
• Digestive issues. Ulcers, stomach and bowel problems and a decrease in appetite are all digestion issues that can be affected by shift work.
 
• Sleep problems. Shift work affects how much sleep a person gets, as well as the quality of sleep. Daytime sleep is not nearly as deep and restful as sleep gotten throughout the night, leading to sleepiness and fatigue in shift workers.
 
• Magnification of existing health problems. Shift work can further worsen health conditions such as diabetes, epilepsy, asthma and depression.
 
• Social problems. Shift work also disrupts life outside of work, including inhibiting participation in social activities and family events due to either working or sleeping during normal active hours of the day, often leading to feelings of loneliness and isolation.
 
• Safety concerns. Sleepiness during nighttime work shifts can lead to slow reaction times and impaired judgment, increasing the risk of accidents.

Reducing the Negative Effects of Shift Work on Sleep
While many circumstances associated with shift work can not be altered for some individuals, overcoming the obstacles that are inherent with shift work and a healthy sleep routine are possible. Suggestions include:

• Get at least eight hours of sleep per day/night to help reduce sleepiness while awake.
• Eliminate external disturbances, where possible, such as telephone ringers, noise and non-essential obligations or appointments that may cut into daytime hours designated for sleep.
• Take time to relax or decompress after working a shift.
• Maintain a healthy diet.
• Avoid caffeine, alcohol and smoking near bedtime.
• Keep the bedroom dark and lower the room's temperature to help mimic the body's natural circadian rhythm temperature during sleep.
• Get sufficient sleep on days off to repay any "sleep debt" you may have accumulated throughout the work week.
• Avoid stimulants, or medications intended to keep you alert during waking hours, as these substances "trick" the body into not feeling tired, which may further complicate sleeping disorders.

Consult with a medical professional or sleep specialist to determine which treatment option is best for you.