If you are amongst the 30 percent of nurses who work the night shift, you will suffer from frequent fatigue. You might even find it difficult to fall asleep, and then to stay asleep? These sleep problems could play havoc with your family and social life. If you have been aware of these sleep problems for at least a month, you are probably suffering from shift work disorder.

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According to  Terry Cralle, Vice President of the Keswick Sleep Institute in Charlottesville, Virginia (Scrubs), shift work disorder is a type of circadian-rhythm sleep disorder that can adversely impact not only your job performance but also the quality and even duration of your life. The good news is that by observing a few procedures, you can improve your health and well-being and get your life back to normal once again.

What exactly is shift work disorder?

Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia and excessive sleepiness affecting people whose work hours overlap with their typical sleep period.
The human body naturally follows a “circadian” or 24-hour period of wakefulness and sleepiness, with the desire to sleep strongest between midnight and 6 a.m., and between 2 p.m. and 4 p.m. Your circadian sleep-wake rhythm, which is linked to nature’s cycle of light and darkness, is regulated by an internal biologic clock located in the hypothalamus. Shift work disorder and its consequences occur when you try to stay awake when your internal biologic clock is telling you to sleep, or when you try to sleep when your internal clock wants you to be awake.

What are the consequences of shift work disorder?

Shift work disorder typically results in a decrease in total sleep time of between one and four hours and waking up feeling as if you have not slept at all. This ‘non-restorative” type of sleep can result in difficulty staying alert, concentrating, remembering things and making decisions, as well as problems with hand-eye coordination, headaches, decreased attention span and increased reaction times.

In a sleep study of nurses conducted in 2005, Kenshu Suzuki, MD, and colleagues reported that those who were excessively sleepy during the night shift, were more likely to make drug administration errors, have needle-stick injuries and operate medical equipment incorrectly—mistakes that can impact both patient and nurse alike. These findings are consistent with studies that demonstrate that experiencing only two hours of sleep loss has the same effect on performance as drinking three alcoholic beverages.

Individuals with shift work disorder are more likely to be absent; suffer from gastrointestinal and digestive problems such as heartburn and indigestion; be diagnosed with heart problems, including an increased risk of heart attacks and hypertension; carcinoma of the breast, uterus, and colon; menstrual irregularities; colds and flu; and weight gain. Granted, these are extreme consequences but health-wise, it makes sense long-term.

Shift workers have more automobile accidents, especially driving to and from work, probably because they’re more likely to drive while fatigued and almost twice as likely to fall asleep at the wheel. In fact, two-thirds of shift workers report driving drowsy after a shift. In addition, associated irritability, impatience and mood disorders such as anxiety and depression have also been noted as a consequence of consistent sleep disruption and deprivation.

Of course, not everybody who works night shifts in a hospital suffers from SWSD. It is rather about being aware of your own body clock. There are ways of preventing this shift disorder. A nap before reporting for a night shift is said to help re-energize for the long haul. Also, eating well can lessen the effects of being unable to fall asleep and stay asleep. A good idea is also to adjust your sleep schedule to prepare for a change from an evening shift to a night shift.

EG Evening Shift (5 pm – 1 am) Night Shift (11 pm – 7 am)
Normal sleep time for shift: 3 am – 11 am 9 am – 5 pm
Sleep time – Night 1 of Transition: 5 am – 1 pm
Sleep time – Night 2 of Transition: 7 am – 3 pm
Sleep time – Night 3 of Transition: 8 am – 4 pm
Sleep time – Night 1 of New Shift: 9 am – 5 pm

Terry Cralle is Co-founder and Corporate Vice President of the Keswick Sleep Institute in Charlottesville, Virginia. She holds a B.A. in Sociology from Randolph-Macon College and received her Bachelors of Science in Nursing at the Virginia Commonwealth University and completed a Masters of Science in Healthcare Management with an Emphasis in Healthcare Risk Management from the Finch University of Health Sciences at the Chicago Medical School. Terry is a Certified Professional in Healthcare Quality as well as a Certified Quality Auditor. Terry has had over 20 years experience as a healthcare consultant. She has published on clinical research topics as well as serving as Lecturer at Piedmont Virginia Community College in Charlottesville, Virginia.

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