Shift Workers

As most Americans crawl into bed for a good night's sleep, more than 2 million people are just punching the clock.

Police officers, hospital workers, truck drivers, and factory workers are among those working the "third" or "graveyard" shift that keeps the country moving along 24 hours a day, seven days a week. They make up 3.2 percent of the work force, and they toil at night because it's a dream job or they get a little extra pay. They may find a vampire schedule's more convenient, or they lack the seniority to pull a daytime shift.

Night workers may feel they've turned their lives upside down to toil on a schedule that departs from social norms and works against the body's natural circadian rhythms. Take Jennifer Salazar-Biddle, a 35-year-old aircraft mechanic at United Airlines in San Francisco and mother of a 2-year-old. She began working the graveyard shift in exchange for a promotion and a pay raise. But the switch hasn't been easy.

"I just never seem to get enough sleep," says Salazar-Biddle, who calls a "good day" getting six hours of shuteye. Sleeping during the day seems "unnatural," she says, and she often ends up cheating herself out of sleep in order to spend normal family time with her husband and son.

Routine activities like shopping, attending school conferences, and even eating present challenges to the millions of Americans who work nontraditional hours. In addition to the people who work night shifts, about 2.5 percent of the work force, or 2.4 million people work rotating shifts, meaning that they alternate between day, evening and night shifts. Getting enough sleep can be even more difficult for them, since their bodies never get a chance to adjust to a single schedule.

Despite the hardships associated with working odd hours, the fact is that these shifts are here to stay, and someone has to work them. People used to working these shifts say that those who take care of themselves and adopt a positive attitude will be most successful.

Trande Phillips, for example, a 50-year-old nurse from Oakland, California, has been working a graveyard shift for 17 years. "It gives me so much flexibility in my lifestyle," says Phillips. "I can decide to go home and go to sleep, or I can go home and run errands or do other things and sleep later."

But, Phillips adds, the night shift isn't for everyone. If you don't adjust to a night shift in two or three months, stop torturing yourself and change shifts. "I've seen a lot of people come through the hospital working graveyard, and some of them just cannot adjust -- it's physically impossible for them. They can't sleep, they're not digesting their food properly, and they get very sick," she says.

What to watch out for

The main health hazards associated with working nights and rotating shifts are:

Sleep deficiency. Getting enough quality sleep is the most serious challenge that shift workers face. Chronic sleep loss has been shown to contribute to high blood pressure, heart disease, and strokes. And even eight hours may not be enough. Research has shown that day sleep is lighter and less restful than night sleep. Sleep is what restores your brain and organs to keep the machine running smoothly. Without enough of it, your coordination will be thrown off; you may become irritable, anxious and depressed; your short-term memory may suffer; and your immune system may get run down, which makes you more likely to get sick. Many shift workers suffer more than the average number of menstrual problems, colds and flu.

Digestive problems and weight gain. Some studies have found that shift workers suffer significantly more upset stomachs, ulcers, and bouts of constipation and indigestion than do day workers. "A lot of people I know gain 20 or 30 pounds when they start working nights, and when they go back to days, they lose it again," says Phillips.

Why? Unusual sleep and eating habits disrupt digestive patterns, which also follow a circadian rhythm -- the physiological ups and downs in every 24-hour day. Second, as Phillips points out, shift workers are less likely than others to eat a regular nutritious diet because they no longer have the routine of preparing meals with their families -- and vending machines may be their only source of food at work when cafeterias and restaurants are closed.

Stress on relationships. Irritability caused by sleep deprivation -- combined with a schedule that makes it difficult for you to get together with friends and family -- can cause a strain on relationships, especially your connection to your partner or children. Night and rotating shift workers often find that trivial matters, such as responsibilities over loading the dishwasher, can easily erupt into full-blown arguments. Salazar-Biddle says she sometimes takes her crankiness out on her husband, and he understands -- most of the time. "I get really crabby," she admits. "And since I try to save all of my positive emotional energy for our 2-year-old son, I know my irritation tends to come out on my husband."

Drug or alcohol abuse. Many shift workers resort to prescription and nonprescription drugs. They use sleeping pills, alcohol or barbiturates to sleep, and caffeine or stronger stimulants to stay awake. These drugs can become habit-forming, and could end up adversely affecting your sleep, your work, and your emotional well-being.

People who are most successful at working nights, says shift work expert Janie

O'Connor, are the ones who like their jobs and adopt constructive ways to cope with their shifts. Those are the people who don't let social constraints get in the way of their sleep but also make time for what's important.

"Many (parents) succumb to the ever-present guilt that haunts shift workers who are trying to balance work and family or social roles," says O'Connor, who runs shift-work training seminars out of St. Paul, Minnesota. "But having a parent who feels guilty is not healthy for the kid."

A healthy approach for workers

O'Connor and others have some concrete suggestions for making the graveyard shift a happier experience:

  • Post your work schedule in your house so your family can plan around your schedule and avoid disappointments. Don't apologize for needing sleep or not being available for daytime activities. Make sure your family, friends and neighbors understand what time of day you're sleeping and agree not to disturb you.
  • Figure out how much sleep you need (most of us need seven or eight hours a day). When it's time for sleep, darken your bedroom and bathroom, take a warm bath, and put on a relaxing tape or CD before going to bed. Avoid doing things that can "activate" your brain like reading a thriller or balancing your checkbook. Always sleep in your bed, not on the couch, and make your bedroom as peaceful and night-like as you can. Install drapes to block light and sound, or wear a sleep mask. Try to cool the bedroom to at least 65 degrees, and avoid alcohol, caffeine, and heavy or greasy food just before sleeping.
  • Avoid being in bright daylight within two to three hours of going to sleep. Light blocks our brain's production of melatonin, a natural chemical that makes us sleepy. If you have to go out during this time, wear wrap-around sunglasses.
  • For rotating shift workers coming off a night shift, O'Connor recommends getting at least two hours of morning sleep after your last duty on the night shift -- and following that with 12 to 14 hours of night sleep. Avoid the urge to switch back to a night sleep schedule on your days off; it will be that much harder for you to get back on the day schedule when you go back to work.
  • Avoid loading up on sugary and carbohydrate-rich foods before and during your shift: Diet also plays a huge role in energy and mood levels. While you may think these foods are giving you an energy burst to help you stay awake and alert, your body may crash shortly afterwards. Try to avoid snacking and eat one balanced meal during your shift.
  • Don't be afraid to alter your diet regimen from that which is considered "normal." If you want to have pancakes and eggs for your "dinner" with your family when you get home from work, go ahead. If you want to make a salad instead, have salad while your kids munch on cereal.
  • Don't leave your most boring, tedious tasks until the end of the shift, usually between and 4 and 6 am. That's the time when you're feeling most tired.
  • Let your friends know you want to see them and aren't avoiding them; it's just that get-togethers will have to be well-planned.
  • Plan "dates" with your partner. When opposite work schedules make it hard to find the time to spend with your special someone, planning dates is a fun and romantic solution. Phone home from work at agreed-upon times to chat with your partner or children. If your partner is concerned about being home alone at night, increase your home's security and carry a beeper or cell phone so that your family knows they can always reach you.

Employers can help, too

Employers can make night shifts more pleasant and productive by providing bright lights that simulate daylight. They may also want to hire a food service to bring in hot meals -- or at least install a refrigerator and microwave. Workers can also benefit from training on how best to cope with the inevitable changes to their bodies and social lives.

Workers are more likely to be content with their shifts if they can consult with managers about planned changes and feel that their input counts. Planning social events, such as morning bowling games, help co-workers spend time together the way day workers do.

Further Resources

INTERFACE: Work/Family http://www.shiftworker.com
Janie O'Connor M.Ed.
3545 Owasso St. #106
St. Paul, Minnesota 55126-3530
651-481-3152
Janie@shiftworker.com

Circadian Technologies Inc. http://www.circadian.com
125 Cambridge Park Drive
Cambridge, Massachusetts 02140
800-284-5001

info@circadian.com

National Sleep Foundation http://www.sleepfoundation.org
1522 K Street, NW, Suite 500
Washington, DC 20005
202-347-3471
nsf@sleepfoundation.org

National Institute for Occupational Safety and Health (NIOSH) http://www.cdc.gov/niosh
800-356-4674

Occupational Safety and Health Administration (OSHA) http://www.osha.gov
800-321-6742

References

Bureau of Labor Statistics. Table 7: Beginning and ending hours, full-time wage and salary workers, May 2004. July 2005. http://www.bls.gov/news.release/flex.t07.htm

Bureau of Labor Statistics. Table 4: Shift usually worked, full-time wage and salary workers by selected characteristics, May 2004. July 2005. http://www.bls.gov/news.release/flex.t04.htm

Is there an association between shift work and having a metabolic syndrome? Results from a population based study of 27,485 people, Karlsson B; Knutsson A, Lindahl B, Occup Environ Med 2001 Nov; 58 (11): 747-52

Graveyard Shift, Light At Night Linked To Increased Risk, Cancer Weekly, November 6, 2001, Pg. 16

Health affects work, and work affects health: We know health affects productivity, but do we understand how work affects health?, Lynch, Wendy D., Business & Health, Vol. 19, No. 10, November 1, 2001 Pg. 31

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