Night working seems to be on the increase in the UK. The TUC report that since 2013, the number of people working night shifts has increased by 5%. In the US, it is estimated that over 9 million workers are regularly working night shifts. The drudgery of a night shift is a familiar concept the world over, as it is, unfortunately, an unavoidable need within society. From nurses to 24-hour hotel workers, night shift workers play a major role in supporting communities.
Unfortunately, though, working through the night often takes a toll on mental and physical health. Because of this, key questions are raised about how best we can support ourselves and others when in these arduous roles.
Naturally, our circadian rhythms will keep us somewhat in time with the sunrise and hours of darkness. Depending on our unique chronotype, each of us is naturally programmed to release wakeful and sleep-inducing hormones at scheduled times each day. For most of us, that means getting around 8 hours of sleep over the hours of darkness.
Because of the unnatural nature of night shift work, we can end up with a broad array of symptoms whilst undergoing such a tricky schedule. Below are the most common ones:
Firstly, our digestive system is programmed to be largely inactive during night time hours. This means that when a night worker inevitably eats their "lunch", they become bloated and may experience discomfort or indigestion.
In terms of daylight, we receive a large portion of our daily vitamin D from sunlight on our skin. When we shift to a nighttime schedule, we tend to miss out on this essential nutrient. An organisation called GMB Union in the UK reports that night shift workers are at the greatest risk of developing a vitamin D deficiency. They are currently running a campaign in favour of free vitamin D supplements for night shift workers based in the UK.
Furthermore, the negative effects of shift work and particularly night shifts have been attributed to causing an increased risk of metabolic diseases such as obesity or diabetes. It is also linked with inflammatory diseases such as autoimmune disorders, as well as malignant diseases such as cancer.
As if the long list of physical effects wasn't foreboding enough, there is also a plethora of psychological consequences we experience from working the night shift.
Similar to the issue of vitamin D deficiency, missing out on daylight can cause mood disorders such as depression. According to healthline.com, when we don't get enough sunlight, our serotonin levels can dip. This puts us at greater risk for depression.
Also, not surprisingly, working the night shift increases the risk of developing sleep disorders.
During their shift, people are also less capable of cognitive tasks and have impaired decision making.
Not all night shifts are created equal. A study into police officers who work overnight revealed that officers who often worked the 8 pm to 4 am shift were most likely to develop metabolic syndrome. Of those people, the ones who regularly achieved 6 hours or less sleep regularly were 4 times more likely to develop a metabolic syndrome. Because of the toll, this type of schedule takes on a person's wellbeing, the more favourable option would be to work through half the night and then do a handover. However, this is unfortunately not always the case in many professions, so it is necessary to make certain alterations to a sleep schedule in these cases.
When preparing for your first night shift, it's best not to stay awake for a full day before. This is due to the cognitive impairments that can result from not getting enough sleep. Try getting some daytime sleep with the help of blackout curtains, a sleep mask, or some sleep aids. It would be best to avoid caffeine on days such as this.
If there is more time available to prepare for a night shift, it can be most helpful to gradually shift your sleeping pattern over several days. To achieve this, go to sleep two hours later each day as a way to gently adjust your body clock.
If preparing for regular night shifts, it may be better to try and maintain a later sleep time even on days off, to reduce the need for body clock adjustment on a regular basis. To cope better with a lack of daylight, it can be good to use light boxes in order to maintain better mental and physical health.
However, if you are on rotating shifts and cannot maintain a regular work schedule, it may be best to stay up late the night before your shift, then nap during the afternoon if possible. By loading up on sleep hours closer to the shift, you are more likely to stay awake and alert throughout the shift.
It is always better to try to adjust to a new schedule gradually. If your first shift is in the coming week, try altering your sleep schedule by a couple of hours each day in the four days leading up to it. However, be sure to get adequate sleep within that time- if you need to be up early on those days, you will accumulate a fair amount of sleep debt. This is best avoided at all costs when preparing to work nights.
The best sleeping pattern for each person varies depending upon their circumstances and internal body clock. The best measure is to maintain awareness of how each adjustment affects you and note down any side effects. For some people, their sleep pattern can take much longer to adjust than for others. Be sure to note whether the changes are having too many negative effects- working at night is not something everyone can handle, regardless of how much preparation you put into it.
It is essential to try and sleep during the day in preparation. To make this more possible, try to minimise or completely avoid caffeine intake during the day leading up to your night shift. A lot of caffeine will make it hard for you to sleep before your shift, causing more fatigue during working hours.
A few hours before your shift begins, it is recommended to eat a full meal. This meal should have plenty of healthy fats and be otherwise nicely balanced with protein, carbs, and vegetables. It is best to avoid processed foods as these can cause digestive issues and do not provide such a steady release of energy. Maintaining steady energy levels is essential for staying awake when working nights.
Likewise, it is recommended to pack healthy snacks to nibble on throughout your shift. Though it is recommended to eat the largest meal first (due to slower digestive function overnight), it is still fine to periodically graze on healthy snacks containing healthy fats, lean protein, and plenty of water.
Find ways to soothe yourself to sleep during the day, even if you are not used to napping. Getting a good sleep or at least a long nap before your shift can help reduce sleepiness during the night shift. Try listening to soothing music or taking a melatonin supplement to help you drift off.
To help adjust your wake cycles, it can be really helpful to focus on the kind of light you're exposing yourself to. During the day, when you are planning a nap, be sure to switch any devices to night mode to ensure you don't get any blue light from them. Keep the curtains closed to achieve as much darkness as possible. It still may take a while for your body to relax into sleep, but it should help.
Equally, when trying to feel more awake before the shift, try utilising bright light to help your body to wake up. This can be achieved by using lightboxes to mimic natural light. During the day, bright light signals to the brain that it is time to release hormones to increase alertness. Influencing the brain in this way before your shift can make a massive difference to performance.
Try some moderate exercise 30 minutes before your shift to improve your circulation and, in turn, your focus and general mood. For people with a unique schedule, a short burst of cardio can signal to the brain and body that it is time to step into action. It can also help to motivate you for the work ahead.
Finally, although it is best to avoid caffeine in the daytime before a night shift, it can be hugely helpful to keep us alert during those sleepy hours. Green tea contains high quantities of the amino acid L-theanine, which helps to maintain steady energy levels (unlike the quick spike and dip of coffee.)
Shift Work Sleep Disorder (SWSD) occurs due to the disruption of our body's sleep cycle if we rotate shifts on a regular basis. This can affect those on a day shift but it is particularly prevalent in people who work night shifts. It is estimated that between 10% and 40% of shift workers suffer from SWSD.
The symptoms of shift work sleep disorder include low energy, difficulty concentrating, depression, and consistent sleepiness. It can also further affect a person's ability to get refreshing sleep when they go to bed; they may find themselves waking periodically after they fall asleep, too.
If we do not keep up with consistent sleep patterns, we can have trouble sleeping when we want to. Particularly for those working in a night shift position, the difference in sleep schedule is huge when working compared with a day off, when a person may try to readjust to daytime activities.
Night shifts are known to cause fatigue, which can be dangerous in daily situations such as driving. It is essential to try and minimise sleep debt as much as possible to keep yourself safe and maintain good general health.
It can be difficult to get into a deep sleep when we settle down to rest during daylight hours. In order to maximise the chances of getting enough essential deep sleep, try to avoid drinking caffeine in the last few hours of your shift. Also, resist the urge to drink alcohol before you go to bed. Even though it may help you fall asleep, it can disrupt your sleep quality.
Exhaustion and stress are huge causes of bad habits. Night shift workers are more likely to smoke and to give in to cravings for high-fat, processed foods. This can build up over time and lead to poor health.
If you are stressed on a night shift, avoid smoking and try to find other ways to decompress or get a mental break.
Be sure to have plenty of snacks on hand if you start to feel hunger pangs, but ensure they are healthy and easy to digest. For example, soft fruits such as bananas or strawberries can provide a tasty burst of energy but are much less likely to cause bloating than high carb or meat-based snacks.
It is understandable to need a pick-me-up if you feel tired during an overnight shift, particularly if you're not naturally a night owl. However, be sure to taper off the caffeine content in the early hours before your shift ends. Caffeine is reported to have a half-life of 5 hours. This means that if you consume 40mg of caffeine now, you will still have 20mg in your system in 5 hours. Because of this, it is best to be mindful of the amount you consume and at what stage in your shift. Drinking a coffee in the second half of your shift may keep you awake when you get home!
During the early hours (around 3 am-6 am), the body lowers its temperature and most adults experience a physical dip in energy. This means that a space with a normally-comfortable temperature can cause people to shiver at this time. This time of the circadian clock is known as the "circadian nadir". It can cause people to feel nauseous, shaky, sleepy, and unalert.
It is best to prepare for this probability by bringing an extra layer to wear. You can also make preparations to eat or drink something warm. If possible, you may wish to take a break at this time to help your body recuperate.
For some people working nights, it is permitted by the organisation to take a short nap during shift. It is always advisable to gain written permission from an authority in the organisation in these cases and to ensure naps are supervised.
Usually, the first night shift is bearable but the following ones will begin to cause more fatigue. Try to ensure the time for a nap outside of work, e.g. before a shift, if you are unable to do so during work hours.
Exercise during your shift can help you in the same way it does before a shift. It helps to stay alert, supports good circulation, and improves mood. It is essential to try and remain active during night work as you may be feeling too drained to get enough exercise throughout the consecutive days. Because of this, inactive night shifts can take a toll on the body. It is advisable to do short bursts of exercise such as jogging on the spot or taking deep stretches whenever possible.
Finally, remember that the best way to support yourself through a potential lack of sleep is to consult a healthcare professional. This way, you can work out the best way to support yourself when taking into account all information.