THE SHIFT WORKER...
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 America's workplace. You may work when most people are asleep and attempt to sleep when the rest of the world is awake. Shift workers perform critical functions in hospitals, on police forces, as emergency personnel, and in the transportation and manufacturing industries. In addition, they are meeting the demand for "round-the-clock" service in an age of global interaction. More than 15 million Americans are shift workers.
AND SLEEP...
Unfortunately, when it comes to sleep, most shift workers don't get enough. When shifts fall during the night (11 p.m. to 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 typically 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, safety, productivity, memory, and mood.
SLEEP AND THE CIRCADIAN CLOCK
Sleep is needed by all animals — even plants appear to have rest periods. The human body naturally follows a 24-hour cycle of wakefulness and sleepiness that is regulated by an internal circadian clock. In fact, the circadian clock is linked to nature's pattern 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 six 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 10-20% 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 National Sleep Foundation polls, the overwhelming majority of people report that they do not get enough sleep (most adults need 7-9 hours of 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 U.S. 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 (especially heartburn and indigestion), 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 accidents and automobile crashes 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 (see Tips List). The key is to make sleep a priority!
Set the stage for sleep even though it might be broad day light outside. Prepare your body and mind for sleep. If you are on the night shift, wear wraparound dark glasses on your way home from work to keep morning sunlight from activating your internal "daytime" clock. Follow bedtime rituals and try to keep the same 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
* Take a warm bath.
* Lower the room temperature (a cool environment improves sleep).
* Don't "activate" your brain by balancing a checkbook, reading a thriller, or doing other stressful activities.
LIGHT
* Darken the bedroom and bathroom.
* Install light blocking and sound absorbing curtains or shades.
* Wear eye shades.
SOUND
* Wear ear plugs.
* Use a white noise machine or a fan to block out noises.
* Install carpeting and drapes to absorb sound.
* Unplug the telephone.
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 that the shift worker often misses 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 times to share with a 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!"
TIPS FOR SUCCESSFUL SHUTEYE
FOOD
* Avoid caffeine at least five hours before bedtime.
* Don't stop for a drink after work; while you may feel relaxed at first, alcohol actually disturbs sleep.
* 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.
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 drowsy 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 before work to be refreshed.
Studies show that napping at the workplace is especially effective for workers who need to maintain a high degree of alertness, attention to detail, or make quick decisions. In situations where the worker is working double shifts or longer, naps at the workplace are even more important.
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. For the evening worker coming home around midnight, the risk of meeting drunk drivers is higher. People think that opening the car windows or listening to the radio will keep them awake. However, studies show that these methods do not work. In fact, these actions should signal you that you are fatigued and need to pull over immediately. 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:
1. Carpool, if possible. Have the most alert person do the driving.
2. If you are sleepy, stop to nap, but do so in your locked car in a well-lit area.
3. Take public transportation, if possible.
4. Drive defensively.
5. Don't stop off for a "night cap."
PROMOTING ALERTNESS AT WORK
Just as you can take steps to ensure a good night's — or day's — sleep, you can try these steps to stay alert on the job.
* Take short breaks throughout the shift.
* Try to work with a "buddy."
* Talking with co-workers can help keep you alert. And co-workers can be on the lookout for signs of drowsiness in each other.
* Try to exercise during breaks.
* Use the employee lounge, take a walk, shoot hoops in the parking lot, or climb stairs.
* Try to eat three normal meals per day. Eat healthy snacks, avoiding foods that may upset your stomach.
* If you consume caffeine (coffee, tea, soda, energy drinks, gum, mints), do so early in the shift, e.g., before 3 a.m. for the night worker.
* Don't leave the most tedious or boring tasks to the end of your shift when you are apt to feel the drowsiest.
* Night shift workers hit their lowest period around 4 a.m.
* Exchange ideas with your colleagues on ways to cope with the problems of shift work.
Set up a support group at work so that you can support and learn from each other.
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.
* 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 both get enough sleep and 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 trouble falling or staying asleep, or you wake up feeling unrefreshed, you may be suffering from insomnia or sleep apnea, serious conditions that should be treated. Be cautious about self-treating the symptoms of these conditions. Your doctor can suggest safe and effective options.
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 centers.
A LAST WORD… OPERATING EQUIPMENT SAFELY
If you operate heavy equipment, drive a vehicle during your shift, or provide health care, you must pay careful attention to signs of sleepiness or fatigue. To ignore signals such as yawning, frequent blinking, a sense of tiredness and 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.
