How Working the Night Shift Can Be A Death Sentence
When I have a sleepless night or two, or more, I don’t think of it as a major health issue, but studies now show that it is life threatening. How can that be? All that seems to happen when I go sleepless is that “I’m tired the next day, and of course once I finish this string of nights I’ll just catch up on the weekend”.
FALSE! We know a lot more now about the effects of lack of sleep on our health and the news is not pretty. First I have to recollect my own years of night shift nursing and the toll it took on me. Fighting to stay awake all night when my circadian rhythm was telling me to sleep, not thinking clearly enough during the night due to fatigue which could possibly lead to miscalculations, forcing me to take a sleep med daily so I could "sleep the daylight hours away", overwhelming desire to fall asleep as I drove home from work, and the disruption in my home and social life with me gone every night.
When you really spell it out, working nights is not healthy, puts nurses at great risk and we don't receive full disclosure of the risks when we take the job! Did you know that there are a lot of quality of life benefits from getting a good night's rest?
- Cell renewal and rejuvenation
- Management of stress hormones
- Gut health
- Weight management
- Chronic disease prevention
- Cognitive functioning
Seems like sleep is pretty important, don't you think? On the other hand, this is what happens when you don't get enough sleep.
Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work.Negative Impacts of Shiftwork and Long Work Hours : Rehabilitation Nursing Journal
Women who worked on rotating night shifts for more than five years were up to 11% more likely to have died early compared to those who never worked these shifts. Those working more than 15 years on rotating night shifts had a 38% higher risk of dying from heart disease than nurses who only worked during the day. Rotating night shifts were linked to 25% higher risk of dying from lung cancer and 33% greater risk of colon cancer death. The increased risk of lung cancer could be attributed to a higher rate of smoking among night shift workers.
The population of nurses with the longest rotating night shifts also shared risk factors that endangered their health: they were heavier on average than their day-working counterparts, more likely to smoke and have high blood pressure, and more likely to have diabetes and elevated cholesterol. Shift Work: Night Shifts Linked to Early Death | Time
When I worked full-time nights it was the only job available so I did not have a choice. But I never knew how at risk I was for health issues. My mother was a full-time night supervisor for over 30 years and her life was shortened by heart disease, diabetes and obesity which fits the above profile.
So how do we counter this situation? First step is to recognize we have a problem. To their credit, the ANA has a position paper with institutional recommendations. But the one that stands out for me is the recommendation that YOU have control over.
Employers should encourage nurses to be proactive about managing their health and rest, including getting 7 to 9 hours of sleep per day; manage stress effectively; develop healthy nutrition and exercise habits; and use naps according to employer policy. Addressing Nurse Fatigue to Promote Safety and Health: Joint Responsibilities of Registered Nurses and Employers to Reduce Risks
This is where WELLNESS comes in, which is my life's work. I wonder if it is because of seeing my mother suffer from the health consequences of night nursing and I didn't want to go down that same path. Here are my Top 10 Tips for Better Sleep when you work nights.
1.Assess whether you are a "night owl" or not and pursue the work hours most in line with your circadian rhythm.
2. Negotiate 8 hour shifts rather than 12 hour shifts. Negative Impacts of Shiftwork and Long Work Hours
3. Try to achieve uninterrupted sleep of 7-8 hours by:
- Darkening the room really dark
- Wear a mask over your eyes
- Turn on a white noise machine (like gentle rain) to drown out sounds that could wake you up
- Use Melatonin, your body's sleep hormone if you need a sleep aide
- Prepare for sleep by stopping caffeine 4 hours before you go to bed
- Indulge in a nice warm bath before you go to bed
4. Set a schedule for nighttime eating where you eat every 2 hours. Bring to work 2 healthy snacks and a big salad that is loaded with fresh vegetables, some fruit and protein (chicken breast, hard boiled eggs, cheese, etc). Stay away from processed foods and follow a low-glycemic eating plan to prevent weight gain. Here's a great website.
5. Enhance your nutrition with high quality supplements to give you more energy. Include multivitamin/multimineral combination, pure fish oil, vitamin D.
6. Drink 8 glasses of water during the night. The exercise you get going to the bathroom several times will keep you awake.
7. Create an exercise routine that you "love", energizes you, and you will do every day after you get up from sleeping. (Walking, Cardio, Stretching, etc.)
8. Meditate or do a moving meditation like Yoga or Tai Chi daily to get centered and reduce stress. Check out Tapping or EFT (Emotional Freedom Technique) which you can do in the night to manage stress.
9. Add fun to your day even at work to help your body release endorphins and you will feel better.
10. Write down everything you are grateful for at the end of each shift to ensure that you appreciate your accomplishments and start shifting your energy from stress and negativity to a more positive outlook – and that will help you sleep better too!
So what are you willing to do to get a better night's sleep? Or what are you already doing that is working? Please share.Last edit by Joe V on Feb 8
Feb 7"Death sentence" seems rather melodramatic to me. People engage (voluntarily) in all kinds of activities that risk shortening their life spans, and no one refers to those activities as "death sentences." Also, plenty of people (including myself) have worked night shift over the years while maintaining a healthy, active lifestyle, without becoming obese or using sleeping pills. Of course sleep is important (vital) to our overall health, and my own observation is that daytime sleep appears to be less effective than nighttime sleep (you feel significantly less rested after 6-8 hours of sleep in the daytime than you would after the same amount of sleep at night, and you have to sleep more daytime hours to feel rested). The whole "low glycemic diet" thing is controversial, and I question whether making specific recommendations about that and specific supplements here constitutes offering medical advice.Feb 7Sleeping during the day is hard. Life happens for most of the population during daylight hours.
We live across the street from an elementary school that used it's intercom freely during school hours, plus an air force base is close enough to hear Revelry at 0700, and Star Spangled Banner at 1700. Add in basketballs reverberating on the blacktop, the ice cream man's jaunty tune, yelling children in the neighborhood, and a screaming baby of my own inside the house ... well sleep in the days before sound machines were invented was nil. And I was a cranky girl.
I never had a problem staying awake at night, rather my problem was falling asleep during the day (and staying that way).
Thank God my screaming baby is now 24, and I now work evenings.Feb 7You're mixing apples and oranges. Any rotating shift schedule is bad for mental and physical health. Straight night shifts doesn't kill the average person.
I do believe co-workers who say they just couldn't adjust to working nights
I worked 11 pm to 7 am four days a week for 17 years. I am 66, in good health.Feb 8There are those that have different circadian rhythms and I am one. Left to my own devices I have always been a night person preferring to sleep during the day. I worked nights for just over 9 years and even though I do not work any longer I tend to stay up at night and sleep during the day.Feb 11I did it for 5 years and grew more miserable by the year. I never knew if I was going to be exhausted at 3 pm or wide awake at 3 AM (not leaving much to do as this was before the net and I had to be quit as my family was asleep.)
Nothing worked and when I got to the point where I was sleeping 3 hours a day I switched to days. Much busier but I just cannot do night shift.Feb 13I'm one of those people that will be awake at night and asleep during the day, even when I'm not working. I might as well be working with my natural circadian rhythm. Most of my fellow night shift workers feel the same way. Other nurses do it for different reasons - for school schedules, to have more time with their children or families, etc.
I don't know anyone who isn't exhausted after working three 12 hour shifts in a row, days or nights. We all play catch up from time to time, but I don't think it should constitute a death sentence.Feb 13LIFE is a "death sentence." The first half of your "article" is pretty dramatic.
Someone has to work the night shift -- or should we leave our patients on autopilot once it gets dark outside? It seems it would serve us as a profession better to discuss ways to thrive on the night shift rather than to proclaim that "Night shift is a death sentence." The latter part of your article did address this -- but recommending a glycemic diet? Really? That borders on the offering of medical advice which, as you know, is prohibited by terms of service.Feb 16The statistics are out there that prove that it is not good for your body to work nights but it isn't a death sentence.Mar 2Hi, ive actually looked at the research and I do agree that working night shifts has numerous negative affects, in the end there are tools (as stated) that can help mirror traditional or day shift work. The real issues tend to be the interpersonal and social relationship aspects of life, marriage, life, kids, bf, gf, friends; plays a large factor of how nurses recover from the effects of night and shift work.Mar 2I have worked nights almost exclusively for 3 decades. I look younger than my age and I get 8 hours sleep on average. I worked for 5 months getting up at 5:30 AM for day shift and I was more ill than the previous 5 years. I was a true night person, even in high school. Studies can be done to show almost anything, and should be read that way.Mar 2There IS a lot of evidence regarding increased risk of chronic conditions with prolonged night shift work. (My MSN and DNP research was around this topic)
However, calling working nights a "death sentence" is a bit much. I did it for 38 years and remain cheerfully above ground!Mar 3Even as a kid inschool, I was the typical nite owl. I stayed up late and it was such a treat and luxury for me to sleep in til noon or 1p. I hated to get up for school. If they could have moved school start to noon, I'd have been in heaven.
So no big deal when I began to work NOCs. Over my career there were times I shifted over to 7-3 or 3-11. Boy, would I be ever so happy when I would switch back to NOCs!! I've been retired to some 7 years or so, but I still haven't reverted back to normal 'people hours'. (You can tell by the times I'm posting here.)
I've come to believe that people who work NOCs consistently, do so BY CHOICE because of their individual and specific needs/reasons. Be it child care, multiple jobs, other family care obligations, education requirements, etc. We do so BY CHOICE. And if we're lucky, we work with others like ourselves. Therefore, we do our darndest to do the best we can because of our situation. The work ethic and fellowship and friendship can't be beat. And that contributes to a 'good shift'. NOT a 'death sentence'.
I like PP Ruby Vee's comment that it would behoove us as a profession to brainstorm better ways to THRIVE (I like that word!) on odd shifts. Now if we could get employers on the bandwagon would be terrific too!!! Enough staff, adequate break time, clean restful rest areas, access to nutritional supplements, etc.
OP, you asked what works for us. There are a zillion postings here re sleep tips. I've tried some (all helpful) and developed some of my own. And like MMJ, I'm 'still above ground'.
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