The struggle to get adequate daytime sleep when working nights is familiar to many of us. In fact, 15 million workers – or 20% – of the American workforce work other than the typical 9 to 5 shift. Some are swing shift, some graveyard and some even rotate shifts between days and nights. Many people simply do not acclimate to this unnatural pattern of waking and sleep. The resulting sleep deprivation leads to increased short-term illness and long-term medical problems. A much higher incidence of accidents and mistakes are associated with sleep deprivation. The loss of productivity alone is estimated to be in the billions of dollars.
Night shift workers simply get less sleep. In many industries, rotating work schedules often do not allow for adequate time off. Most notable are the transportation industries such as railroads, commercial trucking and airlines. The National Highway Traffic Administration estimates more than 100,000 police-reported crashes occur annually due to driver fatigue, resulting in 1,550 deaths and 71,000 injuries in 2008. The monetary losses exceeded $12 billion. Motor vehicle accidents are more likely after 11 p.m. and greatest between 1 a.m. and 7 a.m.
In non-transportation industries, 25% of night shift workers reported that their work schedules do not permit sufficient sleep time, and 33% reported getting less sleep than needed to do their best work.
All shift workers do not suffer from sleep disorders; however, the longer a given individual is on the night shift, the more likely he or she will suffer some medical consequence or have issues with productivity. The effects of sleep deprivation on alertness, judgment and productivity have been quantitatively compared to the effects of alcohol. Just the loss of several hours of sleep can result in impairment comparable to several drinks. This worsens with increasing sleep loss. The message is that sleep deprivation from night shift work is fairly common and associated with physical and emotional distress. The net result is increased accidents, injuries and loss of productivity.
Since night shift work is necessary, how can we manage the side effects and prevent some of the problems that arise? Educating management and workers regarding the risks and being proactive can have a positive impact. Workers will benefit from healthy habits, diet and exercise. If they are having difficulty sleeping, they should consult a health care provider to asses any underlying medical conditions or medications that can influence sleep patterns.
Good sleep hygiene can be very beneficial in acclimating to night shift work. Some tips include:
• Have a quiet sleep area with black-out curtains.
• Avoid caffeine, nicotine or alcohol before sleep.
• Try using sunglasses during the morning drive home to minimize light exposure.
• Refrain from a large meal, excess fluids or vigorous exercise prior to sleep.
• Avoid radio and TV when attempting to get to sleep.
• Although melatonin has been touted by some as a sleep aid, it is not FDA-approved and has inconsistent results as a sleep aid. It does not provide any improved alertness during the subsequent work shift.
• Sometimes, short-term use of a prescription hypnotic drug can be beneficial for those struggling with disordered sleep.
• Controlled and timed exposure to light during the work shift has also been beneficial in some to reset circadian rhythms and restore a better sleep/wake pattern.
• Power naps before the work shift increase alertness, increase reaction times, productivity and do not usually interfere with the daytime sleep for the night shift worker.
Although somewhat unnatural, the night shift has become a necessary part of our working lives. Getting adequate sleep is integral in keeping alert, staying productive and reducing the risk of injuries while on the clock.
– Dr. Bruce Kaler