brownbagger-aug-08

Brown Bagger

This section is set up to provide a ready-made Brown Bag Session for you to use with employees and/or managers. Use as is, or adapt this information for a general employee group. You may reproduce as many copies as needed.

Shift Work Stress: Don’t Underestimate Your Body’s Need to Sleep f you were asked to picture the typical American workplace, you’d probably envision a bustling work environment that included numerous employees scurrying about to complete reports, send faxes, return emails, and attend meetings. But busyness does not necessarily translate into alertness.

The National Sleep Foundation states that drowsy workers cost employers an estimated $18 billion annually in lost productivity. If you factor in errors, damage, and health consequences caused by sleepiness, the costs are even higher. Consider:

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• More than two-thirds of shift workers – 68% – report having problems sleeping. Shift workers are classified as the 20% of workers who toil during periods other than normal daytime business hours. (Shift work is also referred to as an alternative or flexible work schedule.)

• An estimated 68% of shift workers note that sleepiness interferes with their concentration. In addition, 66% said lack of sleep makes handling stress on the job more difficult.

• Overall, workers estimate the quality and quantity of their work declines by about 30% when they’re sleepy.

Alertness and Rhythms How alert are you at this very moment? Are you wide awake and fully focused on reading this page?

Is your mind beginning to wander? Are you fighting sleep?

Consider your level of alertness during a typical workday. Obviously, that level varies throughout the day or night. We all strive to function at the upper end of the alertness scale, completely focused on the task at hand. Whether we are successful depends on a number of factors, some biological and some environmental. Let’s examine the latter first.

Many traditional workplaces actually run counter to alertness. For example, light, temperature, and August 2008

noise levels in offices and other work areas are kept optimal for computer operation and human comfort, but they are not optimal for operator alertness. In fact, they are often conducive to sleep!

If that sounds hard to believe, consider how many times you have found yourself staring at a computer monitor, lulled by the quiet hum of the machine, barely able to keep your head from dropping onto the keyboard. No huge deal, right?

Actually, the consequences of fatigue-induced drowsiness are quite serious – especially if you are at the controls of an airplane, truck, train, or ship.

The Exxon Valdez disaster in Alaska is but one example of a high-profile industrial accident that has been attributed, at least in part, to worker fatigue.

Biological factors also come into play. The human body was designed to sleep at night and be alert and active during the day. Yet, many people in today’s non-stop world are required to work at all hours of the day and night, disrupting their natural patterns of sleeping and waking. This is also true of people who don’t work nights, but who still fly across time zones on a regular basis. Understanding your body’s daily (circadian) rhythms can help you avoid fatigue and get the sleep you need.

Circadian – pronounced sir-KAY-dee-in – rhythms are strongly influenced by the daily change between sunlight and darkness, with morning sunlight promoting early wakefulness and darkness setting the stage for sleep. When people choose to sleep, how well they control bedroom darkness – and workplace lighting – also affect these rhythms.

In essence, we are “programmed” to sleep at night and to be awake in the daytime. While it’s true that some of us are “night owls,” most of us find it difficult to concentrate and maintain alertness between midnight and 7 a.m., and to sleep during daylight hours. It’s also hard for many of us to eat during overnight hours, because our digestive systems essentially shut down during these times.

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Brown Bagger Health Effects on Shift Workers Shift work has a serious impact on sleep.

Circadian rhythms boost alertness in the morning, making it difficult for a shift worker to obtain long blocks of daytime sleep. Moreover, external forces such as noise, sunlight (especially during summer months), and family obligations often interrupt sleep.

Less known is that, along with quantity, the quality of sleep also suffers during the daytime.

That’s because people spend less time in the deeper stages of sleep, which are critical for recovering from physical fatigue. They may also receive less Rapid Eye Movement (REM) sleep, considered important for mental health. In addition, working night shifts has a number of detrimental health and psychological effects. They include: 4 Mental health – A number of studies have found that shift workers have more complaints of mental-health symptoms such as nervousness, anxiety, and irritability. For example, one study of workers at chemical factories found that for every question related to mental health – such as “Do you feel like a nervous wreck?” or “Do you react with irritation even when you don’t want to?” – shift workers scored higher than day workers. Currently, there is no strong evidence that shift work by itself causes psychiatric problems, but some researchers believe that if a person is predisposed to a mentalhealth condition, shift work can serve as a trigger that brings on a problem. Moreover, shift workers can experience psychological problems as feelings of social isolation and loneliness can result when people are cut off from family and social activities.

4 Stomach-related problems – Higher rates of gastrointestinal (GI) problems are documented among shift workers, with digestive problems such as constipation, diarrhea, abdominal pain, ulcers, and heartburn two-to-three-times more common among shift workers than daytime workers. Another study found that peptic ulcers are two-to-five-times more prevalent in shift workers than daytime workers. The aforementioned difficulty digesting food during overnight hours contributes to these problems. For instance, consider the poor eating habits, excessive caffeine, and other lifestyle factors common among shift workers.

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4 Increase in other illnesses – Shift workers reported taking a greater number of sick days for illnesses such as colds, coughs, sore throats, and flu than workers who didn’t work night shifts. Some studies also suggest that shift workers are more vulnerable to high cholesterol and coronary heart disease – conditions that are probably also due to poor eating habits.

4 Family stress – While shift work is largely a workforce issue, it can also spill over into personal relationships. Little research has studied the effect of non-traditional work schedules on marriage, but one study suggested that shift work increased the likelihood of divorce 7% to 11% over a three-year period. This rate increased when couples had children. For men married less than five years and with children, working a night shift made divorce or separation six times as likely than if they worked the day shift. For women married more than five years and with children, working a night shift made separation or divorce three times more likely – while working rotating shifts doubled the odds of divorce or separation.

Perspective is Important It’s important to bear a few facts in mind. First, not all of these findings are conclusive. Second, for many health risks, non-shift work factors such as smoking and leading a sedentary lifestyle lead to greater health risks than working at night.

As a result, doing all the right things – understanding how circadian rhythms work, making sleep a high priority, eating a healthy diet, and exercising regularly – can significantly reduce an individual’s chance of developing health problems regardless of one’s work schedule.

Lack of Sleep also Affects Non-Shift Workers Moreover, it’s well documented that many daytime workers also do not get enough sleep. In today’s 24-7 society, many people view sleep as expendable and something you can catch up on anytime. Unfortunately, people underestimate the difficulty in catching up on lost sleep, according to the Sleep Foundation.

Certainly, sleep disorders contribute to this lack of sleep. They include: insomnia, waking up frequently during the night, and having trouble falling asleep; sleep apnea, interruptions of deep sleep; and narcolepsy, a recurrent need to sleep when you want to be awake. People who think they may be sufferAugust 2008

ing from a sleep disorder should see a specialist.

But for the majority of people who are tired at work, the reason is simply one of being too busy to get enough sleep, according to Mark Rosekind with Alertness Solutions. Rosekind notes that, between increased work hours, greater electronic distractions such as cable TV and the Internet, and longer commute times – it should come as no surprise that one-third of Americans only get an average of 6-1/2 hours of sleep a night.

“That’s 90 minutes less than most of us need,” Rosekind says. “Lose an hour-and-a-half every night, and you’ve got a cumulative sleep debt of seven-and-a-half hours by the weekend. By then, you’re wiped out, trying to catch up on lost Zs and repeating the cycle the following week. It’s as if you stayed up one full night,” he adds.

Alternative Schedules more Common Alternative work schedules are not all bad. Many workers regard flexible work schedules as valuable – giving them options to start early to have extra time in the evenings for family, while others prefer to start late to spend the mornings getting children off to school and daycare. The percentage of firms offering flexible schedules has risen 64% over the past five years, according to the Society for Human Resource Management (SHRM).

Consider also that it’s possible to call an 800 number nearly 24 hours a day – and that more and more Americans eat out, and at irregular hours.

Today’s busy lifestyles have increased the demand for workers willing to work non-traditional schedules.

Shift work can also be a financial benefit. In many cases, companies pay slightly more for working a night shift, and for families living from paycheck to paycheck, the extra income may be attractive – at least initially.

Adjusting Shift Work Schedules While working nights disturbs our natural “body clocks,” some schedules are more difficult on workers’ bodies than others. For instance, while 12hour shifts can quickly lead to fatigue, other, less exhausting possibilities include “2-3-2” (two days on, three days off, two days on), “3-4” or “4-3” shifts. In such schedules, employees get three or four straight days off, meaning they’re likely to have more time to catch up on sleep and still have a few days to enjoy leisure time.

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Brown Bagger Shift work schedules, however, are never perfect, and employees must be willing to make certain concessions. For example, in some schedules half the workers work every Saturday and Sunday – while another schedule might have employees working either Saturday or Sunday every weekend.

Additional suggestions for offsetting problems related to shift work include: What the Shift Worker can do to Cope 5 Family life – Couples working nights that don’t have children may wish to delay having kids until a more standard schedule is available. For those with kids, be sure to make time to participate in family activities.

5 Diet – Avoid caffeine toward the end of your shift, since coffee or soda can keep you awake when you’re trying to sleep at home. Don’t stop for a drink after work. At first you may feel relaxed, but alcohol disturbs sleep. Don’t go to bed too full or too hungry. Time meals carefully. A meal may decrease alertness in the second part of a night shift, so it’s better to eat before you become fatigued. Consequently, eat at or before 1 a.m.

5 Health and fitness – Increase physical activity during your leisure time. See your doctor for advice before beginning shift work if you are on a regular medication such as insulin for diabetes, or if you have a chronic recurring illness such as asthma.

5 Sleep – Try different sleep times in the daytime to determine which works best – straight after work, before the next night shift, or parts of both.

Summary Adapting to shift work is easy for some, while others never adjust. Using common-sense rules for diet and exercise should help. Family understanding and cooperation can also reduce the stress that can result from a shift worker’s lifestyle.

As mentioned, flexible work schedules have advantages as well. However, workers need to be aware of the potential mental and physical problems, and relationship issues, that working non-traditional work schedules can cause.

Additional sources: Community Health Care, Accident Compensation Corporation.

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Brown Bagger H A N D O U T More Shift Work Advice

he following are some additional suggestions for employers to minimize the health effects of shift work:

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Offer orientation and/or periodic training covering circadian rhythms and coping strategies.

Include families in the education process.

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Make sure shift workers have access to lifestyle programs aimed at improving diet, exercising regularly, etc.

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Provide 24-hour cafeteria service or make healthy snacks available around the clock.

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Permit on-the-job exercise and/or have an onsite exercise room.

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Include a mental health component in your Employee Assistance Program.

Select a shift schedule that minimizes wear and tear on workers’ bodies. (See “Adjusting Shift Work Schedules” section in the Brown Bagger.)

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Have a room with cots or easy chairs where workers can nap before and after work.

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Make job applicants aware that shift work may exacerbate pre-existing medical conditions.

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Identify and treat shift workers who have insomnia, sleep apnea, and narcolepsy. Fortymillion Americans suffer from debilitating sleep disorders, but the majority of them are undiagnosed.

10) Incorporate as many safety checks as possible to overcome the tendency for people’s reactions to slow down as the night goes on.

11) Limit sedentary, monotonous work performed in a comfortable and quiet environment.

12) Avoid scheduling someone to work alone at night. If this isn’t possible, those working alone should have some way of communicating with co-workers to provide social contact.

Sources: Circadian Technologies, Community Health Care, Accident Compensation Corporation.

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