Night Shift Workers

(Aamir Ali Rajput, karachi)

Do you work at times other than the usual "night shift”? If so, unfortunately you are at risk of unhealthy life. When shifts fall during the night, 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 .Here I will discuss about the physiological and psychological problems associated with night shift and how can we manage these problems.

Most adults need eight hours of sleep. As one’s body moves through 24-hour period of wakefulness and sleepiness cycle that is regulated by an internal circadian clock It experiences fluctuations in temperature, wakefulness, gastric activity, heart rate, blood pressure and hormone levels. This flow of body activity is known as the circadian rhythm. These rhythms are important for optimal functioning of the many processes vital to health. When the normal circadian rhythms are disrupted by lack of sleep or by crossing time zones, it causes physiological problems. There is strong evidence linking night work to sleep disorders, fatigue, heart disease, high blood pressure and gastrointestinal complains including constipation, diarrhea, excessive flatulence, abdominal pain and heartburn The causes of gastrointestinal complains are poor eating or diets high in saturated fats. Too much fast food is consumed because of constant tiredness and lack of time to prepare healthy foods. People also have difficulty digesting food during the overnight hours. In addition, Night shift workers may drink more coffee to stay alert at night. Heavy tea/coffee consumption increases the risk of developing ulcers. Potassium, uric acid, glucose, cholesterol, and total lipids are all increased during night work but return to normal during day work. Although the evidence for a link to night shifts is diabetes, heart disease, cancer risk is inconclusive. Furthermore, The Obstetrics and Gynecology study found standing for long periods and lifting heavy weights do not increase the risk of premature labor. But working nightshifts in the first three months is linked to a doubling in a woman's risk of early labor. The researchers say this is possibly because they disrupt the normal activity in the womb at night.

A recent article by two sleep and respiratory physicians, Leslie Olson and Antonio Ambrogetti, published in the Medical Journal of Australia, cited research showing that: "Night-shift workers seldom sleep more than five or six hours in each 24-hour period, so that after seven nights the accumulated sleep deficit is 15 to 20 hours. At least 48 hours off duty are usually needed to recover this deficit, and rosters that require workers to go from night shifts to day or afternoon shifts with no break are dangerous."

Stress and psychosocial factors play an important role in chronic disorders. Writing in the Occupational and Environmental Medicine journal Dr Ludovic van Amelsvoort, says: "working at night is a chronic stressor." A spokesman for the British Heart Foundation said: "There is some evidence to suggest that people who work on night shifts may be more vulnerable to stress. Most night workers complain of sleepiness. Sometimes they fall asleep on the job. Accumulated sleep deficit from prolonged shift work can decrease a worker's level of performance and alertness, regardless of the time of day. This poor perforfomance indirectly lead to stress and exhaustion. Perception and decision-making ability may also be affected on extended shifts. Moreover, Night shifts leads to symptoms of psycho physiological disturbances of well-being, resembling symptoms of affective disorders, such as irritability, fatigue and poor sleep, apathy, poor appetite, and psychosomatic complaints. In addition, changes in mood have been shown to be associated with irregularity of sleep patterns, and with sleep deprivation. The potential for shift work to increase risk for depression is suggested by studies of patients diagnosed with a depressive disorder which demonstrate that these patients typically have a dysfunction of the circadian system. 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.

Within the constraints of the shift schedule, individual workers can apply chronobiological principles to determine the best time for sleeping. After working the night shift, going to bed as soon as possible after arriving home will usually maximize sleep length. Caffeine should not be ingested closer than around 5 hours before bedtime. Fruit juice is good alternative drink for the second half of the shift. A three-hour nap before work is ideal if you didn’t sleep a full eight hours after work. Even a 10-minute nap can clear your brain and refresh you before work The best rotating shift system is fast forward rotation, for example, two mornings, two afternoons, and two nights. When working nights you should take your main meal break between midnight and 1 am, when a protein or health food meal should be taken, followed by a shorter break between 3 am and 4 am. Exercise, a cool workplace, music, and opportunities to interact with colleagues all enhance alertness on night shifts.

In conclusion, working nights goes against the body's design. One individual’s body is designed to be awake in the day and sleep at night. It all relates to the circadian rhythm. Circardian rhythm disturbance create physiological and psychological effects on body. Peoples now realize that sleep loss is dangerous and that night shift work has different effects on sleep, health and work performance. But there are some ways to overcome these effects and we can live healthy life.

Aamir Ali Rajput
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