HOW TO COPE WITH NIGHT SHIFTS - FELLOW NURSES AFRICA
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November 02, 2017

HOW TO COPE WITH NIGHT SHIFTS

By Hannah Nichols
What do doctors, nurses, firefighters, truck drivers, and air traffic controllers all have in common? Many of them work night shifts.
Whether you are an early riser or a night owl, working shifts at night can be challenging. We have compiled some tips to help you cope with working into the late and early hours of the day.
Due to our modern 24-hour society, nearly 15 million people in the United States work full-time night shifts, evening shifts, rotational shifts, or other such irregular schedules. What is more, almost 19 percent of adult workers work for 48 hours or more every week, and more than 7 percent work for 60 hours or more each week.
Shift work and long working hours have been linked to a number of health issues, according to the National Sleep Foundation. These include an increased risk of metabolic problems, heart disease, gastrointestinal difficulties, obesity, and certain cancers.
Night shift work may also interfere with the body's ability to repair DNA damage that occurs from normal cellular processes. The suppression of melatonin — which is the hormone responsible for regulating the internal body clock — may play a role.
Individuals need to work through the night for numerous reasons. Finding ways to cope can be the difference between living a healthy existence and being subjected to the many health and safety risks that are elevated during night shifts. Here are Medical News Today's coping strategies for working after dark.
1. Manage sleep patterns
Some people can work at night with no problem at all, while others experience sleep deprivation and fatigue. This is because the human body is designed to sleep at night-time.
The human body is controlled by an internal body clock, or circadian pacemaker, which is located in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN generates circadian rhythms, which regulate behavioral and physiological processes in the body, including alertness, sleep, temperature control, and hormone production.
Circadian rhythms run in 24-hour cycles and are significantly influenced by the natural light and dark cycles. Many of the processes in your body that are active in the daytime slow down at night to prepare you for sleep. At night, the circadian pacemaker releases the sleep hormone melatonin from the pineal gland, which causes you to feel less alert and raises your desire to sleep.
Night shifts cause you to battle against your natural rhythms by trying to be alert when you are programmed to be sleeping. Similarly, when you go home after a night shift, the cues from your internal body clock and daytime light exposure tell you to be awake and active.
Adults need between 7 and 9 hours of sleep to function at their best. If you sleep for under that amount, you will incur "sleep debt." The only way to pay back sleep debt is to catch up on sleep you have missed, and this has to occur as soon as possible after it is incurred.
Working at night involves successfully managing your sleep during the day — that is, to keep sleep debt to a minimum — and your fatigue during the night. Daytime sleep can be lighter, shorter, and of poorer quality than sleep at night due to light, noise, and temperature.
Try these steps to keep your sleep in check and make your environment more favorable for sleep.
Do not delay going to bed. The longer you delay going to bed, the more awake you are likely to become.
Try to set aside a block of 7 to 9 hours to dedicate to sleep after a night shift.
Have something to eat and drink before you go to bed. Pangs of hunger or thirst may wake you up.
Avoid alcohol before you try to sleep. Alcohol may help you to fall asleep, but it diminishes sleep quality and disturbs the deep stages of sleep, which will leave you feeling unrefreshed the next day.
Avoid smoking before bed. Nicotine is a stimulant and can therefore cause you to experience difficulties in getting to sleep.
Stay away from activities that make you feel more alert until the hours before your next shift.
Make sure your bedroom is quiet, dark, and at a comfortable temperature. Use earplugs to block out daytime noise and blackout curtains to prevent daylight entering the room. Electric fans can be useful to keep air circulating and provide neutral background noise.
Notify friends and family of your working hours so that they do not disturb you.
If this is your last shift in a block of night shifts, remember that the more days in a row that you have been working through the night, the more sleep debt you will likely have accrued. Repaying some of the sleep debt that you accumulate as quickly as possible will help you to recover sooner.
2. Control light exposure
Exposure to light cues chemical events to be triggered by the circadian pacemaker that affects your sleep and wake cycles. For example, melatonin is released as it gets dark in the evening to make you feel drowsy, while melatonin is suppressed and cortisol elevated by the morning light to make you feel more awake.
Artificial light can affect your circadian pacemaker in the same way as sunlight, and timed exposure to bright light can help to alter your body's sleep cycle.
During night shifts, you can try to "trick" your body into an alert state with exposure to bright light, and promote sleep by suppressing light exposure after your shift.
Research has shown that night workers who were exposed to bright light during their shift and wore sunglasses on the way home to suppress light drifted off to sleep quicker and slept for longer after their shift than people who received no bright light exposure. Furthermore, another study found that intermittent exposure to bright light is almost as effective as continual exposure.
Beware of exposure to blue light emitted from digital devices, such as your smartphone, tablet, or television, before you go to bed after a night shift. Research has suggested that blue light knocks our circadian rhythms off-kilter, which signals to your brain that it is daytime and results in poorer sleep quality.
Ways that you can control your exposure to light include:
increasing bright light exposure during your shift with regular overhead lights or a bright desk lamp or lightbox
wearing sunglasses on your journey home
using blackout blinds, curtains, or drapes or a sleep mask to block out daylight in your bedroom
not watching TV before you go to bed
switching off digital devices situated in your bedroom, including powering down tablets and computers, putting your phone away, and blocking light from bright alarm clocks
Keeping your bedroom dark will help to keep your body in sleep mode until it is time for you to wake up and begin your day.
3. Watch your diet
When typical daily rhythm is thrown off balance, so too is metabolism. Night shift workers are more likely to experience metabolic syndrome and have a 29 percent increased risk of becoming overweight or obese due to poor diet and the disruption of the body clock.
Planning your meals can help you to stay alert during your working hours and be more relaxed when you need to sleep.
Try to stick to a similar eating pattern to the one that you would follow during the daytime.
Eat frequent light meals or healthful snacks to avoid the drowsiness that is associated with heavy meals.
Choose foods that are easy for your body to digest, including bread, rice, pasta, salad, milk products, fruits, and vegetables.
Avoid foods that are difficult to digest, such as fried, spicy, and processed meals.
Steer clear of sugary foods. Although they provide a short-term energy boost, this is quickly followed by an energy dip.
Snack on fruits and vegetables. Sugars from these are converted slowly into energy, and they are an important source of vitamins, minerals, and fiber.
Keep hydrated while you are working to promote physical and mental performance, but do not overload the bladder with fluid before bed.
Access to the grocery store and adequate facilities to prepare food can be hard for night workers. Be prepared and take food to work to ensure that you eat properly and stay alert.
4. Take a nap
Taking a nap can become an essential element of working safely overnight. While a short nap before you start your shift can help to combat fatigue, a nap during your break may be vital for maintaining alertness and remaining vigilant.
A nap taken midway through the day has been shown to boost and restore brainpower. Even naps of 20 to 45 minutes in length have proven beneficial for shift workers to counteract fatigue.
Ideally, your night shift naps should not exceed 45 minutes. Sleep is comprised of different stages, which complete in cycles of between 90 and 100 minutes. One sleep cycle runs from light sleep to deep sleep.
Be careful about how long you nap for in order to ensure that you do not wake up during deep sleep. Deep sleep waking is associated with greater sleep inertia, meaning that you will take longer to feel alert and will not feel refreshed.
5. Use caffeine wisely
Caffeine is a stimulant. When used carefully, your daily dose of coffee can help you to remain alert throughout a shift. However, improper use can cause gastrointestinal upsets and muscle shakes.
Most people take a huge dose of coffee at the start of their shift in order to jump-start their day. However, research suggests taking a different approach to maximize the effects of caffeine for shift workers.
Workers that consumed smaller — equivalent to quarters of cups of coffee — and more frequent doses of caffeine throughout their day experienced enhance wakefulness, performed better on cognitive tests, and had fewer accidental naps than those who had had no caffeine.
Some evidence suggests that the effects of caffeine kick in after around 20 minutes, and that a small dose of caffeine before a nap can counter the sleep inertia you may experience after you awake.
Caffeine use should be stopped around 6 hours before bedtime to ensure that the stimulant does not affect your sleep.
Every person is different, so finding the right combination of techniques that suit you best may take time. Applying some of the above strategies may help you on your way to coping better with working at night and ensuring that you get the right amount of sleep to function properly.
Source : Medical News Today

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