Q: Could you shed any information on the possible harmful effects of alternating day and night shift work for the older worker? Thank you.
A: Sleep patterns vary from person to person. Some of us can put our heads down in the evening and get a good night’s rest. Others sleep for an hour or two, awaken for as long. They may get out of bed, eat, read a book or begin a project and ultimately return to the bedroom to go back to sleep. I prefer evenings when my house is quiet, dark, and conducive to getting quality rest. I have family members that feel they must sleep with a television on and providing light and noise. When the TV is turned off, they awaken and cannot get back to sleep. I’ve yet to determine how they can awaken in the middle of a show and not want to finish watching it, despite the fact that the clock indicates it’s 2 AM!
Then there’s the shift worker. Swing shift work isn’t for everyone but many individuals are so accustomed to it, they adjust relatively easily. In fact, they prefer to work nights. How they do this five nights a week and perhaps change their pattern on weekends is totally beyond my comprehension. Those that don’t adjust so well, may develop shift work sleep disorder (SWSD). It is more commonly seen in older individuals, women, and is affected by the duration of the shift work exposure. Shift work can also cause a higher incidence of cardiovascular disease, breast cancer, metabolic disease, obesity, and ulcers.
Factories are now working around the clock. Security workers always have. Our growing culture simply means that more individuals are shift workers than ever known before. A great deal depends on fitness, job responsibilities, age, and the capability of the worker to adjust to the timing. The first thing to do is to consider which of the non-working hours would be best for sleep. This may occur just following work, several hours after returning home, or perhaps even prior to beginning the shift. The worker should eat several hours before retiring, even if that means heating up a full meal in the microwave at what appears to be odd hours for most of us. The dinner hour should not be immediately prior to sleep. He or she should not consume caffeine prior to sleep but should coordinate at-home chores for those hours which would normally be used for sleeping – providing, of course, it doesn’t keep others in the home awake because of the schedule. The bedroom may or may not be the same one a spouse or partner sleeps in because of the possibility of disruption. Keep in mind that one person may work at home or elsewhere during the day and require sleeping at night, much as the worker with the unusual hours is working at a job during the night which requires sleep during the day. Each daily pattern will require adjustment but they can actually be coordinated with minimal adjustment. This may take time and a little effort to stabilize. For example, if you are an at home housewife, you may prefer to grocery shop, fill the car with gas and visit your local library for a book during the other person’s sleeping hours. And, that person should reciprocate with courtesy, as well.
Beyond that, the person involved should speak with his or her physician for other issues that may arise. For example, if the job is relatively permanent, the use of over-the-counter melatonin that might help re-set his internal sleep clock might be discussed. As I see it, the biggest obstacle is household disruption for others. The individual involved will learn new sleep patterns but should be considerate and cause as few ripples as possible.
Readers who are interested in learning more can order Dr. Gott’s Health Report “Sleep Wake Disorders” by sending a self-addressed, stamped #10 envelope to Peter H. Gott, MD Health Reports, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
