Shift work - how it affects your health and how to bounce back

​As I write this inaugural blog post for the brand-spanking new Dr Kate website, I am sitting in a jet-lagged haze where I can’t decide whether the next few hours should be spent sleeping, or spent making the most of daytime, knowing that when I get to work tonight I’ll still feel tired regardless of how long or how little I slept for today. Ahh yes, the wonderful world of night shift. If you are a nurse, doctor, hospitality or transport worker or someone else lucky enough to be in a 24/7 career, you will know this feeling precisely. But did you know just how hazardous shift work can be to your health?

Shift workers are more likely to be obese, have heart disease, metabolic syndrome (a cluster of pre-diabetes, high blood pressure, high cholesterol and abdominal obesity), suffer mood disturbances, have accidents both at work and on the journey to/from work, and may even have higher risks of some cancers though the evidence isn’t quite as clear.

How can simply being awake and working at night do all this damage? Mostly it is thought to be due to the body’s internal clock which controls hormones, digestion, body temperature, heart rate and of course the sleep-wake cycle. Also known as circadian rhythms, they rely on exposure to light during the day (and lack thereof at night) to keep everything running as planned. It seems that confusing our natural sleep-wake cycle changes the release of hormones that influence digestion and metabolism, and may cause higher blood pressure (especially when shift work is prolonged), and has pretty marked impacts on mood, alertness and cognitive function in the short term. 

As well as stuffing up the hormones that control how we feel, our digestion, weight and most basic bodily functions; shift work quite simply means that many workers just don’t get enough sleep. Even someone who has never worked a night shift in their life knows how much easier it is to order take away, be tempted to eat that last row of chocolate and skip the gym when you are tired, and if this goes on for months or years the consequent damage to your health is pretty obvious.

So now all that grim part is out of the way, what can you do as a shift worker to counteract these risks as much as possible and to just feel better when you are working the graveyard shift? Here are my personal insiders’ tips…


1. Get as much good quality sleep as possible
Throw away the 8 hour rule, stop tracking it on your FitBit and stop watching the clock. Just make your bedroom as dark, cool and comfy as possible and don’t overthink it. Simple things like an eye mask, ear plugs, blackout blinds or window shades or even a fan can make your sleep haven just that little bit more inviting and help you stay asleep longer. If you aren’t tired or sleep isn't happening, get up and do something else until you do feel tired enough. One of the hardest things when sleeping in the day is to actually stay asleep for more than a couple of hours at a time - your body likes sleeping at night when your body temp is lower (yes that’s why around at 2am at work you are reaching for a jumper as well as a coffee) so sleeping at midday in summer is like fighting your own physiology. Power naps can be effective in reducing fatigue and I like to have an hour nap ending about half an hour before I need to leave for work to help me feel refreshed and ready to start my work day.


2. Avoid caffeine hangovers
If you are going to have anything containing caffeine, keep it to the first few hours of your shift and not within 6 hours of the time you’ll be trying to sleep. Steer clear of energy drinks and stimulant medications which have a whole host of other problems associated with them (and where energy drinks are concerned, are not worth the filthy amount of sugar in each can). 


3. Mentally switch off the second you sign out of work
Meditate, listen to music on the drive home, watch 20 mins of trashy TV or take the dog for a walk - whatever you need to do to clear your mind before you hit the hay. Keep a to do list next to your bed and offload anything to it that is floating around your mind as you are trying to sleep. 


4. Get into a routine
Figure out which part of the day is the best sleeping time for you - it might be the second you walk in the door after work, or might not be until the afternoon, but try and stick to somewhat of a day to day routine. It not only helps your body get into the zone of sleeping when your head hits the pillow but also helps you feel more human and get more done with the time you aren’t at work.


5. Eat sensibly 
If you are on a rotating roster and know you have nights coming up, prepare snacks and meals for before and at work in advance. I like to have a stack of meals in the freezer that I’ve made in bulk so I can sleep until just before work starts and have a healthy dinner (/breakfast) ready in no time. If you have a healthy snack to eat overnight it also makes resisting those staff room chocolates and vending machine chips much easier. Have your kitchen fully stocked before your run of nights begins so you have decent food at your fingertips and don’t have to do grocery shopping on 2 hours sleep - this always ends in buying multiple blocks of chocolate and cakes that weren't on the list.


6. Stay active
You don’t need to run 10k every day to keep your health and fitness on track while you throw your body through the night shift ringer, but you do need to do something active every day to help counter-act those aforementioned risks. As with any exercise, find something you like doing that gets your heart rate up and makes you sweat and do it regularly. My active pursuit for today was hitting up my old friend the trampoline park for an hour and I can tell you that not only are my legs sore now but I know I’lI have a solid pre-work power nap because of it!


7. Stay safe
DON’T DRIVE HOME FROM WORK IF YOU ARE OVER-TIRED. In capitals because it is so so so important for those finishing work as everyone else is starting their day. All too often there are fatal car accidents involving nurses and others who have been at work all night and don’t want to trouble someone else for a lift home when they are really too fatigued to safely drive themselves. It’s not worth it - check yourself before you get behind the wheel and keep an eye out for your colleagues. Pump the air conditioning, blast some music and drive with a full bladder if you must but don’t risk your life and everyone else’s on the road - check the RMS tool “Test Your Tired Self” for more info (http://www.testyourtiredself.com.au).


8. Soak up some sunshine
It’s much easier in summer with longer days to find time to catch some rays, but no matter what time of the year, it’s especially important for those who might spend most daylight hours under the covers to get out and make some vitamin D! It does wonders for your mood and alertness to feel some sunlight on your skin after working under fluorescent lights all night.


9. Look out for your colleagues
There is a sense of camaraderie in my workplace after hours - everyone works really well as a team and it makes stressful moments much more tolerable. Be there for your colleagues and they will be there for you - keep an eye out for anyone who isn’t coping and remember that lack of sleep can wreak havoc on a person’s mood so lend an ear where one is needed. Just be a nice human - this goes for all working hours!


10. Look on the bright side
This all sounds like a long list of cons about working nights but remember there are some positives!! Think of the extra money, the ability to be flexible around your other commitments and the fact your workplace may be quieter at night - whatever the highlights may be. Focus on these and you’ll be out the other side of your night shifts in no time!


What are your night shift hacks that make being awake all night easier, or improve your sleep in the day? Do you have any other insiders tips on how to survive and thrive as a shift worker? Let me know below!


References: 
http://www.testyourtiredself.com.au

https://www.mja.com.au/journal/2013/199/8/sleep-loss-and-circadian-disruption-shift-work-health-burden-and-management

https://www.betterhealth.vic.gov.au/health/healthyliving/shiftwork

http://occmed.oxfordjournals.org/content/61/2/78.full

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