- NIGHT SHIFT WORK
This is one of the general life conditions of Step B
People who work at night have several problems in addition to the problems of daytime workers. In part, this is a consequence of the way that night-shift work is organized. Typically, the person works in a larger context of daytime work by others, and the compromise is to work nights for five days and then have two days off. During their time off, workers commonly revert to a daytime schedule; and then they go back to night work for the following five days.
Normally, it takes people about two weeks to adjust to a permanent change of schedule. So people who change their day-night schedule twice a week (day-to-night for work and back for weekends) are constantly out of adjustment (Hauri and Linde, 155). They may never become fully adjusted to either part of the day.
26a. Consequences
They tend to sleep less than others, because their normal sleep time is when the rest of the world is awake and active. Meals, involvement with family, shopping, and many other normal activities may be scheduled when they need to sleep. And even if they spend an adequate amount of time in bed, it can be interrupted by those other obligations and opportunities. Weekends and holidays are typically spent with daytime activities and sleep at night, making a return to the work schedule difficult.
Sleep can also be disrupted by daytime events, which commonly are louder and more insistent than the things that happen at night. Telephones, automobile noises, and other daily events can interrupt sleep (Sack, 190).
Compared to other people, night workers get less exposure to sunlight when they are awake (at night), and may have to sleep in spite of it (during the day).
This can lead to symptoms of fatigue, irritability and other mood disturbances, poor performance, headaches, gastrointestinal issues, weight gain, and substance abuse. It can also lead to a greater chance of accidents that affect the person and others nearby (Hirshkowitz and Smith, 172-176).
It is commonly known that younger people often tend to delayed sleep cycles, actually preferring to be up late at night. For them, night work may have some appeal. However, as we age, our sleep cycles normally drift to earlier, and night work may be more difficult to sustain (Hauri and Linde, 156). Older workers may be better advised to move to daytime work.
26b. Some Solutions
There are several aspects to the sleep problem one can address.
It is important to allow adequate time between the end of work and bedtime (Section 18) and use it to prepare for sleep. If that is insufficient, some of the other issues of falling asleep may need to be addressed (Section 17 ).
A second issue is light management (See Section 27), attempting to create an environment that simulates the usual sequence of light and dark. Bright light exposure at work may be the best and possibly the only way to change body rhythms to new times as rapidly as needed (Hauri and Linde, 156; Sack, 191). One way is to make sure that the workplace is brightly lit, as a simulation of daytime light ( Glovinsky and Spielman, 207-210).
For people who leave work as the day is arriving or the sun is already up, Glovinsky and Spielman, 207-208, recommend simulating night on the return from work to home. They suggest wearing dark blue sunglasses the entire time that the person is exposed to sunlight, even when home and preparing the bed for sleep. This can also apply to trips outside or even to the bathroom during sleep time – wearing dark glasses simulates the continuation of night.
Making sure that the bedroom is as dark as night is another part of this strategy.
A third issue is sleepiness. A person who carries out daytime activities and then goes to work for the night can become very tired by the end of his/her shift. To deal with this, many people recommend taking a nap (Section 32) before going to work. Hirshkowitz and Smith (p.175) recommend sticking to the usual (up-at-night) schedule, as much a possible, on days off, to minimize the frequency of schedule shifts.
Drinking caffeinated beverages at work may make it easier to stay awake, but they can also affect the ability to fall asleep after work (Section 8). Any caffeine should be taken early in the work shift. Taking melatonin or hypnotic medications may help a person sleep during the day (Sack, 192).
Spicy or heavy foods should also be avoided (Section 9), especially because shift work can affect digestion and lead to gastro-intestinal difficulties.
A fourth issue is the intrusion of the day into sleep time. A person needs to plan, to avoid interruptions of sleep by outside noises, telephones, clocks, doorbells and family members. If necessary, earplugs and sleeping masks may help. The details will depend on the person’s circumstances, and could be explored in session as they come up.
There is a danger that we might on the effect of night work on the individual and look only at solutions for him or her. However, most people live in families and other relationships, and the impact on others of one person having a radically different can be serious. They may have to adjust their activities and expectations to accommodate to the special schedule and needs of the night shift worker. This requires extra awareness and schedule changes for them as well. It is important for the night worker to have regular conversations with everyone impacted, both before taking on such a schedule, and regularly thereafter, to plan together and support each other.
A night work schedule can separate family members. One extreme would be a newly married couple with a young child and two jobs. A logical adaptation would be for one to work in the day and be responsible for the child at night, and the other to work at night and babysit during the day. There are many problems with this, including the fact that the adults have very little time together, and that one of them – the one with the night shift – may need to sleep when the child needs to be up and about.
People can be separated by attitudes to sleep. A person who works all night and then sleeps during the day may be seen as lazy by others who are up and about in daylight. This can lead to resentments on both sides.
Hirshkowitz and Smith, 172-176