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FIGHTING THE CYCLE
Sleep strategies for shift workers
by The National Sleep Foundation
Do you work at times other than the usual “nine to five” business day? If so, you are among the millions of shift workers in the workplace. You may work when most people are asleep and attempt to sleep when the rest of the world is awake.
Unfortunately, when it comes to sleep, most shift workers don’t get enough. When shifts fall during the night (11 p.m. – 7 a.m.), the worker is fighting the natural wake-sleep pattern. It may be hard to stay alert at night and just as hard to fall asleep and stay asleep, during the day. Night workers get less sleep than daytime workers do and the sleep is less restful.
Sleep is more than just “beauty rest” for the body; it helps restore and rejuvenate the brain and organ systems so that they function properly. Chronic lack of sleep harms a person’s health, on-the-job safety, task performance, memory and mood
{Sleep and the circadian clock}
The human body naturally follows a 24-hour period of wakefulness and sleepiness that is regulated by an internal circadian clock. In fact, the circadian clock is linked to nature’s cycle of light and darkness. The clock regulates cycles in body temperature, hormones, heart rate and other body functions.
For humans, the desire to sleep is strongest between midnight and 6 a.m. Many people are alert in the morning, with a natural dip in alertness in the mid-afternoon.
It is difficult to reset the internal circadian clock. It is not surprising that 10 to 20 per cent of night shift workers report falling asleep on the job, usually during the second half of the shift. That’s why shift workers who work all night may find it difficult to sleep during the day, even though they are tired.
{When you don’t get enough sleep}
According to a National Sleep Foundation poll, 65 per cent of people report that they do not get enough sleep. When sleep deprived, people think and move more slowly, make more mistakes and have difficulty remembering things. These negative effects lead to lower job productivity and can cause accidents.
The financial loss to US businesses is estimated to be at least $18 billion each year. Lack of sleep is associated with irritability, impatience, anxiety and depression. These problems can upset job and family relationships, spoil social activities and cause unnecessary suffering.
Shift workers experience more stomach problems, menstrual irregularities, colds, flu and weight gain than day workers. Heart problems are more likely too, along with higher blood pressure. The risk of workplace and automobile accidents rises for tired shift workers, especially on the drive to and from work.
{Getting ready for successful shuteye}
There are several steps a shift worker can take to successfully fall asleep and stay asleep. The key is to make sleep a priority.
Set the stage for sleep even though it might be broad daylight outside. Prepare your body and mind for sleep. Wear wraparound dark glasses on your way home from work if you are on the night shift to keep morning sunlight from activating your internal “daytime” clock. Follow bedtime rituals and try to keep a regular sleep schedule – even on weekends. Go to sleep as soon as possible after work.
At home, ask family and friends to help create a quiet and peaceful setting during your sleep time. Have family members wear headphones to listen to music or watch TV. Ban vacuuming, dish washing and noisy games during your sleep time. Put a “Do Not Disturb” sign on the front door so that delivery people and friends will not knock or ring the doorbell. Schedule household repairs for after your sleep time.
{Tips for successful shuteye bedtime rituals}
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Take a warm bath.
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Lower the room temperature (a cool environment improves sleep).
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Don’t “activate” your brain by balancing a checkbook, reading a thriller or doing other stressful activities.
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Darken the bedroom and bathroom.
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Install light blocking and sound absorbing curtains or shades.
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Wear eye shades.
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Wear ear plugs.
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Use a white noise machine, like a fan, to block other noises.
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Install carpeting and drapes to absorb sound.
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Unplug the telephone.
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Avoid caffeine less than five hours before bedtime.
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Don’t stop for a drink after work; although at first you may feel relaxed, alcohol disturbs sleep.
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Eat a light snack before bedtime. Don’t go to bed too full or too hungry.
{Exercise}
If you exercise at the workplace, do so at least three hours before you plan on going to bed. Otherwise, exercise after you sleep. Because exercise is alerting and raises the body temperature, it should not be done too close to bedtime.
{Balancing life and work}
The shift worker faces special problems in trying to maintain family relationships and social and community ties. It becomes difficult to balance work, sleep and personal time.
The need to sleep during the day (or, for the evening worker, to be on the job during the dinner hour and the family-oriented part of the day) means often missing out on family activities, entertainment and other social interaction. That is why it is important to talk with family members and friends about your concerns. With their help, you can schedule special as well as regular times with spouse, children and friends.
Remember that sleep loss and feeling at odds with the rest of the world can make you irritable, stressed and depressed. As one expert puts it, “Blame the shift work – not your kids”.
{Sleeping pills and aids}
Prescription sleep medications do not cure sleep problems, but may be recommended for short-term use. Be sure to tell your doctor that you are a shift worker. These medications may be helpful for one or two sleep cycles after a shift schedule change. Talk to your doctor about whether this type of medication would be helpful to you.
Melatonin is a chemical the body produces to help induce sleep. Melatonin supplements have been advertised as a sleep aid. However, studies have not shown that melatonin helps shift workers. Also, questions about safety and dosing have not been answered. The US Food and Drug Administration considers melatonin experimental.
{Napping}
It is important to keep a regular sleep schedule, even on days off and weekends. However, if you can’t get enough sleep or feel drowsy, naps as short as 20 minutes can be helpful. Naps can maintain or improve alertness, performance and mood.
Some people feel groggy or sleepier after a nap. These feelings usually go away within 1-15 minutes, while the benefits of the nap may last for many hours. The evening or night worker can take a nap to be refreshed before work.
Studies show that napping at the workplace is especially effective for workers who need to maintain a high degree of alertness, attention to detail and who must make quick decisions. In situations where the worker is working double shifts or 24-hour shifts, naps at the workplace are even more important and useful.
{The ride home}
Driving home after work can be risky for the shift worker, particularly since you have been awake all night and the body needs to sleep. People think that opening the car windows or listening to the radio will keep them awake. However, studies show that these methods work for only a short period of time. If you are sleepy when your shift is over, try to take a nap before driving home. Remember, sleep can quickly overcome you when you don’t want it to.
Follow these steps to arrive home safely:
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Carpool, if possible. Have the most alert person do the driving.
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Drive defensively.
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Don’t stop off for a “night cap.”
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If you are sleepy, stop to nap.
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Take public transportation, if possible.
{For the employer}
There are a number of ways you can make your workplace safer and more productive for your shift workers. Educate managers and shift workers about the need for sleep and the dangers of fatigue.
Install bright lights in the work areas. A well-lit workplace signals the body that it is time to be awake and alert. Provide vending machines with healthy food choices and a microwave oven.
Schedule shifts to allow sufficient breaks and days off, especially when workers are re-assigned to different shifts. Plan enough time between shifts to allow employees to not only get enough sleep, but also attend to their personal life. Don’t promote overtime among shift workers.
Develop a napping policy. Encourage napping by providing a sleep friendly space and time for scheduled employee naps. A short break for sleep can improve alertness, judgment, safety and productivity.
Be concerned about employee safety going to and from work. Encourage the use of carpools, public transportation, rested drivers and even taxis.
{Seeking medical help}
If you have tried some of these tips and your efforts to get enough sleep are not successful, it may be time to seek professional help. If problems persist, talk to your doctor.
Remember, when you are not getting the sleep you need, you are at risk and so are those around you. Inadequate sleep increases your risk for falling asleep at the wheel, accidents on the job and problems at home. Your doctor can help identify the cause, which can be successfully treated or managed. Your doctor can evaluate your sleep problem and determine whether you may have a sleep disorder.
Sleep specialists have additional training in sleep medicine and can both diagnose and treat a variety of sleep disorders. Many sleep specialists work at sleep centres.
{Operating equipment safely}
If you operate heavy equipment or drive a vehicle during your shift work, you must pay careful attention to signs of sleepiness or fatigue. To ignore signals such as yawning, frequent blinking, a sense of tiredness, or a failure to make routine safety checks may put you and others at risk.
If you feel sleepy or drowsy, stop your work as soon as safely possible. Contact your supervisor and request a break or nap, or have a caffeinated product in order to help increase alertness. Remember, caffeine is not a long-term substitute for sleep.
BIO BOX
This article was first published in the May 2001 issue of
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