From How Work Schedules Effect Sleep
Studies show that 85 percent of police officers, 80 percent of regional pilots, and 48 percent of air-traffic controllers nod off on the job. And a frightening 41 percent of medical workers admit they’ve made fatigue-related errors. In one survey alone, 19 percent report “worsening” a patient’s condition. What’s more, the Exxon Valdez grounding, the space shuttle Challenger accident, and the Three Mile Island nuclear accident have all been blamed, at least in part, on fatigue related to sleep loss.
Besides the negative consequences resulting on the job, shift workers are feeling the effects of their schedules. A study of 437 day workers and 246 rotating shift workers at the Universidad de Buenos Aires in Argentina found that shift workers have seriously lower levels of serotonin, a hormone that plays a role in regulating sleep and mood, than their day-working counterparts. Unfortunately, lower levels of serotonin are associated with anger, depression, and anxiety, as well as poor sleep. Another study, conducted by Harvard Medical School—this one of more than 78,000 women who worked rotating night shifts over a 10-year period—found that shift work significantly increased a woman’s risk of breast cancer.
A second team of Harvard researchers studied the same group, and they found that women who worked a rotating night shift at least three nights per month for 15 or more years had an increased risk of colorectal cancer.
And a third team of Harvard researchers studied more than 53,000 women who worked rotating shifts and found that night work increased the women’s risk of endometrial cancer by 47 percent—and actually doubled the risk of endometrial cancer in obese shift workers.
It’s this type of research that led the World Health Organization late in 2007 to classify shift work as a “probable” cause of cancer—a position that the American Cancer Society indicates it is likely to follow.
Most of the 25 million hardworking American women who work rotating night shifts get between five to seven hours less sleep each week than their non-shift friends and neighbors, says sleep researcher Kar-Ming Lo, M.D., FCCP, a critical-care specialist in the Akron, Ohio, Summa Health System.
It’s a seemingly insignificant deficit, but two hours of sleep loss, studies report, have the same effect on your brain as knocking back two or three 12-ounce beers. It’s also an amount that week after week, year after year, may build up to a huge effect.
Most workers try to catch up on weekends, but how much that helps is a matter of intense debate and millions of research dollars. Given the complexity of individual biology and the variables of each individual work situation, soon-to-be-released studies from the University of Pennsylvania suggest that recovery from sleep deprivation may not be as simple as sleeping an extra four hours on Saturday and Sunday to make up for the four you lost during the week.
So why aren’t our shift workers getting the sleep they need?
“There are three main reasons,” says Dr. Lo.For one thing, our bodies are hardwired to be alert and active during the day and sleepy at night. But when you sleep during the day, many of the brain chemicals that keep the brain asleep in response to darkness are simply not released—or not released in the amounts you need for good sleep and optimal health.
As a result, says Dr. Lo, shift workers miss out on a portion of the restorative sleep you need to build and repair the body. Shift workers also get less of the other types of sleep, which affect mood, memory, and the ability to make quick decisions.
A second reason shift workers aren’t getting proper sleep is that sleeping during the day runs against the grain of society. You can come home and lie down to sleep at 9 or 10 o’clock every morning, but the rest of the world goes on. Dogs bark, trash haulers pick up the recycling, hedge trimmers keep the world neat.
What’s more, since most people don’t understand the biological importance of sleep, your need to sleep may not be respected—even within your own family. Your children may wake you and demand attention as they run in the door after school at 3 o’clock, or your husband may try to initiate sex on the one day all week you have to sleep in. Studies reveal that shift work actually increases the risk of divorce by 57 percent.
It’s a tough way to make a living.
What’s really diabolical, however, is the fact that over the course of a week, the shift workers’ biological clocks will begin to adjust. That sounds like a good thing, but come the weekend, many shift workers try to be more a part of the family and live life on the family’s schedule. One mother may get only a few hours of sleep, then get up and go to her daughter’s T-ball game. She’ll come home and nap, get up again, make dinner, and eat with her family. Another mom may cut short her sleep to take a child to the doctor’s, then spend a little time shopping at the mall. She’ll nap during the afternoon, then make dinner and eat with the family.
Unfortunately, says Dr. Lo, those innocent attempts to participate in family life on the family’s schedule is enough to throw all the adjustments her biological clock made the week before into disarray. The result is that she’ll feel cranky, exhausted, and sleep deprived for the first two days of the next week—the time it will take her body to readjust.
You think jet lag is bad?
“The lag from shift work is worse,” says Dr. Lo.
Soon-to-be-released studies from the University of Pennsylvania suggest that recovery from sleep deprivation may not be as simple as sleeping an extra four hours on Saturday and Sunday to make up for the four you lost during the week.
Tips to Cope With Your Work Schedule and Get a Good Night's Sleep
Shift work twirls the dials on your body’s biological clock until it can’t tell when it should wake you up and when it should let you sleep. And although there’s no single magic plan that’s right for everyone, there is agreement among sleep researchers that the following strategies will help you get a good night’s sleep. Here’s how to get started.
1. GET YOUR PARTNER ON BOARD. Shift work is tough on the entire family. Make sure your partner knows how it will affect him—increased parental responsibilities and household tasks, less time with you—before you sign on for night or rotating work.
2. GIVE YOUR BODY A THREE-DAY WARNING. If you’re headed toward a major change in work schedule, begin to alter your sleep time three days in advance.
Let’s say your usual shift is 5:00 P.M. to 1:00 A.M. and you’re moving to an 11:00 P.M. to 7:00 A.M. schedule. If you usually sleep from 3:00 to 11:00 A.M., postpone your bedtime to 5:00 A.M. and sleep until 1:00 P.M. on the first day of the transition.
On day 2 postpone your bedtime to 7:00 A.M. and sleep until 3:00 P.M.
On day 3 postpone bedtime to 8:00 A.M. and sleep until 4:00 P.M.
On day 4 you’ll begin the new 11:00 P.M. to 7:00 A.M. shift. That day sleep from 9:00 A.M. until 5:00 P.M.—and on every day thereafter.
3. MAINTAIN A SCHEDULE. Keep the same sleep/wake schedule on your at-home days as on your workdays, says sleep specialist Kar-Ming Lo, M.D. It will help your body understand when you need to be alert and when you need to sleep.
4. WORK CLOCKWISE. If you work rotating shifts, ask your manager to schedule succeeding shifts so that a new shift starts later than the last one, recommends the American Academy of Sleep Medicine. If you’ve just finished a 3:00 to 11:00 P.M. shift, for example, you’ll be more alert and sleep better if the next shift you work is 11:00 P.M. to 7:00 A.M.
5. GET OUTDOORS. Once you wake up, get outside. Take a walk and sit in the sun. The sun will cue your biological clock that it’s time to be alert.
6. PASS UP OPPORTUNITIES. Shift work stresses the body big-time. It puts your health at risk and denies you time with your family. Even if you need extra money, think twice about accepting an opportunity to work overtime or extra hours or skip vacations. The price may be higher than the added income.
7. GET A PICKUP. Two-thirds of shift workers report driving drowsy after a shift—and drowsy driving is the direct cause of an estimated 1,550 deaths every year. Take the bus, hire a cab, have someone better rested than you are pick you up after your shift and take you home.
8. MAKE SLEEP A FAMILY EFFORT. Discuss your sleep needs with kids, says Dr. Lo. Tell the kids that “Mom’s working hard and she works nights.” Then ask that they not go into your room unless it’s an emergency. And be sure to specify precisely what is—and what is not—an emergency.
9. STICK TO PERRIER. If you feel like a nightcap—morningcap?—make it water. Although alcohol may seem to relax you so you can get to sleep more quickly, what it actually does is disrupt your sleep later in the night. As a result, you get less sleep and sleep that’s less than refreshing.
10. FORGET THE QUICK. There isn’t any, although there are plenty of people around who will sell you one. One example: Sales of the herb valerian, which has historically been used to aid sleep, have reached more than a million dollars a year. Yet a review of 37 sleep studies reveals that it doesn’t do a thing.
11. USE ROOM-DARKENING DRAPES. They are lined with a heavy light-blocking fabric that will give you your best shot at convincing your brain it’s dark and therefore time to sleep. Use them in the bedroom and wherever else you might wander during a rest period.
12. FORGET THE EARLY-BIRD SPECIAL. Don’t stop at the store for early-bird specials or watch late-late-late-night shows or early morning news shows once you get home, says Dr. Lo. Hit the hay.
13. NAP. A 20- to 30-minute nap just before reporting for the night shift can increase your alertness on the job.
14. CREATE A COCOON OF QUIET. Close the windows, turn off the phone, wear earplugs, and use white noise, says Dr. Lo. Running a bedroom air-conditioning unit during the summer or a fan in winter will mute outside distractions like trash haulers and slamming doors.
15. LIVE CLOSE TO YOUR JOB. A long commute steals sleep, says Dr. Lo. A short one facilitates it.
16. GET FIXED. If you have the option of working a fixed shift—that is, the same shift each and every evening or night—go for it. You’ll feel and sleep better.
17. GET HELP. If you feel as though you’re walking under water all the time, ask your doctor if a prescription medication, melatonin, or bright-light therapy might help.
18. INFLUENCE WORK POLICIES. If your employer knew that a 26-minute nap could double your productivity, don’t you think he’d make naps an approved corporate policy and figure out how to make nap time available? He probably would—especially if you’ve been complaining that you’re tired. So do some research—you can start at www.sleepeducation.com—and develop some suggestions that will help you feel less fatigued and solve a problem or two for your employer. Who knows? You may end up getting a promotion along with a nap!