Dr.N.Ramakrishnan AB (Int Med), AB (Crit Care), AB (Sleep Med), MMM, FACP, FCCP, FCCM, FAASM, FICCM, FISDA
Senior Consultant, Critical Care & Sleep Medicine,
Director, Critical Care Services, Apollo Hospitals, Chennai
Director, Nithra Institute of Sleep Sciences, Chennai
Door # 29, Plot # 1997
J Block, 13th Main Road
Annanagar, Chennai 600 040
Ph: +91 44 4350 2252
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The theme for this year‟s World Sleep Day is “Preserve the rhythms to enjoy life”. While shift work has been the norm in several industries including healthcare, there is a growing concern about sleep cycle and related health problems ever since the Information Technology (IT) boom started. Business Process Outsourcing (BPO) centers started employing professionals to work at night to suit the needs of countries who seek such expertise. It is important to realize that even before this era, about 20% of the full-time workforce were shift workers, meaning they work more than half their hours outside the traditional work window of 7 a.m. to 7 p.m. Working a schedule different from most of the world can be challenging and most importantly puts people at risk for chronic sleep disruption. This Shift Work Sleep Disorder (SWSD) impacts overall lifestyle of an individual and may result in significant health, social and family related problems.
Health effects of shift work
While most of us tell time with watches and clocks, our body uses a different method. A small area in our brain continually monitors outside influences such as sunlight, sleep and eating. These factors determine the daily schedule of our body, referred to as circadian rhythm. The body’s natural sleep-wake cycle tells the body to sleep at night and be awake during the day. Shift workers, therefore have two particular sleep-related problems: difficulty sleeping during the day and difficulty staying alert at night. More importantly the daily fluctuations in body functions such as body temperature, hormone production and blood pressure stay oriented to daytime living. Working consecutive night shifts prompts circadian rhythms to slowly begin to shift, but factors such as the cycle of sunlight and darkness, the tendency to revert to daytime living on days off, and the need to rotate shifts prevent complete adaptation. Some researchers believe that complete adjustment to permanent irregular shifts may take as long as three years, and others believe the body never fully adjusts to a modified sleep-wake schedule.
Living and working “out of synch” with circadian rhythms, as well as constantly shifting them, places stress on one‟s body, potentially leading to health problems such as sleep disorders, stomach ailments, heart disease and mental health problems. There is a strong correlation between a shift worker`s ability to remain alert and the physical fitness of the individual. It would be beneficial to maintain some sort or regular sports or physical activity.
Tips to shift workers to sleep better
- Convince yourself first that you have to sleep during the day and make every attempt to enjoy a good sleep. Take all the necessary steps to optimize the environment to make it conducive to sleep.
- Wear earplugs to block noise during day sleep.
- Hang heavy curtains or blackout shades over bedroom windows.
- Use relaxation techniques before sleep.
- Unplug phones. Most importantly, do not keep your cellphone near the bed! Remember this is your time to rest and not extended hours of work
- Teach family and friends that your daytime sleep is your night, not a nap. In particular, they should not wake you up for „their‟ routines such as lunch when you may be deep asleep.
- Create and maintain a consistent sleep routine, even on days off.
- Limit caffeine intake, particularly 4-5 hours before „your sleep time‟.
- Eat earlier in your shift; avoid heavy meals 2-3 hours before „your sleep time‟.
- Walk, stretch or exercise during your break at work to improve oxygen flow and help boost energy and alertness.
- Remember that your difficulty to sleep may sometimes be complicated by other sleep disorders. If continuing to have trouble adjusting, it would be best to get advice from medical specialists.
Tips for minimizing family and social challenges
The fact is that shift workers sometimes experience frustration with home and social life due to the nontraditional work hours. Shift workers commonly cite difficulty maintaining friendships, keeping the kids quiet during the day, accomplishing household duties, and finding time for a satisfying marriage. Partners of shift workers, meanwhile, may not like the feeling of being left alone at night.
- Bring up problems early and resolve them – before they threaten relationships.
- Designate specific time to relax and talk with your partner.
- Make sure your partner can reach you by phone or pager at work.
- Develop a circle of friends who understand your work schedule and are willing to be flexible in order to spend time with you.
Benefits of Shiftwork
While shiftwork has its drawbacks, it’s important to recognize that it has advantages too. Perhaps the biggest advantage of working at night is that public places are less crowded during the daytime. You can breeze through shopping areas and banks without having to wait in long lines. Similarly, by working at night, you may avoid traffic! It’s easy to schedule personal business such as doctor’s appointments and car tune-ups without interfering with work.