Adjusting to Shift Work

Or how to survive your first

taste of nights!
Way is it so hard to work
nights?
• The human body was not
designed to work night
• An intrinsic complex mechanism
known as the circadian rhythm
keeps the human body on a
roughly 24 hour cycle which has
us sleeping at night and wake
during the day
 What is a circadian
rhythm?
• Roughly the 24 hour cycle of the human body
• Controlled by “clock genes” that turn on and
off certain proteins through out the 24 hour
period
• Also there is the “master clock” which is the
suprachiasmatic nuclei (SCN) in the
hypothalamus of the brain which regulates
sleep metabolism and hormone production
• Influenced by Zeitgebers (environmental
clues)
• Has both peaks and nadirs for alertness,
ability to stay awake and to fall asleep
http://learn.genetics.utah.edu/content/begin/DNA/clockgenes/
http://learn.genetics.utah.edu/content/begin/DNA/clockgenes /
What is Shift work?

• Shift work is defined as regular

employment outside of the
normal “day work”
• It also can be defined as work
during suboptimal points in
ones circadian rhythm
What are the problems with
shift work?
• Sleep disturbances and excessive
daytime sleepiness
• Poor concentration
• Increased risk of accidents and errors
• Family issues
• Is a “lark” (morning person) more likely
to have problems than a “owl” (a night
person)
• Weight gain
What are the factors that
influence the ability to cope
with shift work?

• Intrinsic circadian rhythm

factors
• Sleep factors (both intrinsic and
extrinsic)
• Domestic issues
 Ways to stay awake
during night shift clinicals

• Avoid long commutes and extended hours.

• If drive home in the AM is sunny wear sunglasses
• Do eat a nutritious meal during the shift
• Work with others to help keep you alert.
• Try to be active during breaks (e.g., take a walk)
• Drink a caffeinated beverage (coffee, tea, colas) to help
maintain alertness during the shift.
• Don't leave the most tedious or boring tasks to the end of
your shift when you are apt to feel the drowsiest. Night
shift workers are most sleepy around 4-5 a.m.
• Ask your preceptor what works for him/her.

http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.4813151/k.6EA9/Sleep_and_Shift_Work.htm
Ways to help sleep during the
day
• Wear dark glasses to block out the sunlight on your way
home.
• Keep to the same bedtime and wake time schedule,
even on weekends.
• Eliminate noise and light from your sleep environment
(use eye masks and ear plugs).
• White noise for some works
• Avoid caffeinated beverages and foods close to
bedtime.
• Avoid alcohol; although it may seem to improve sleep
initially, tolerance develops quickly and it will soon
disturb sleep.
• Experiment - you will find what works for you both for
staying awake at night and sleeping during the day
 Overall good sleep habits
(whether you work nights or
not!)
• Bedroom should be cool and dark
• Same bed time and wake time 7
days a week
• Limit caffeine intake esp. in later
afternoon
• Limit ETOH consumption
• Regular exercise
• Regular meals and do not go to
bed hungry
 Overall good sleep habits
(whether you work nights or
not!)

• Avoid smoking
• Do not take problems to bed
• Sleep only as much as you need to feel
rested.
• Avoid naps (unless you need a nap before
going to work at night!)
• Don’t try to fall asleep in bed, only go to bed
when you are tired
• Use your bed only for sleep and sex