ST. LOUIS – Experts recognize sleep deprivation as the most ubiquitous malady in America – 70 million Americans live with some form or degree of sleep problems.
Up to 25 percent of workers in America work night shifts, and more work rotating shifts, say government reports. Nowadays, workers indentured to the graveyard shift could just as well be bankers or computer engineers as they could be postal workers, police officers, people who make sure overnight packages are delivered on time and more.
“Shift-work sleep disorder is when people who work night shifts or rotating shifts have problems with being tired and sleepy during their night shift and/or problems sleeping during the day,” said Dr. Jonathan Schwartz, a researcher at the University of Oklahoma. “This affects their productivity; it affects their quality of life.”
And the problem is more than being overly fatigued.
They have more problems
“Shift workers have more psychiatric problems like depression, ulcers, cardiovascular disease, and if they’re working at night and trying to sleep during the day, they miss time with their families.”
The worst issue, though, is that it’s dangerous. While some shift workers operate heavy equipment that can kill, statistics show the most dangerous time for a sleepy shift worker is driving to and from work. The National Highway Traffic Safety Administration calls it “driving while drowsy.” It’s next to impossible to measure after an accident, but experts know that the rate of accidents increases during the hours of late-night shift changes.
The safety administration estimates that 100,000 to 150,000 vehicle crashes each year and 4 percent of all fatal crashes are caused by drowsy driving.
“People who work nights (upset) that circadian rhythm (the 24-hour body clock),” said Geralyn Frandsen, associate professor of nursing at Maryville University. “You suffer from depression because you don’t see the sun … you have personal conflicts within your family; it can cause loneliness, depression, substance abuse when people use (chemicals such as medication or alcohol) to get to bed …”
Dr. Joseph Espiritu, a pulmonologist who’s helping to put together a sleep disorder clinic for St. Louis University, said, “Studies have shown that shift work is associated with impaired sugar tolerance, increased risk of hypertension, increased triglyceride levels (and) an increased risk of heart disease.”
More accident prone
Federal and private safety agencies also report that hundreds of thousands of accidents, deaths and even major catastrophes can be attributed at least in part to drowsy supervisors and workers.
Your body uses sleep to clean out clutter from the brain and body.
The brightest scientific minds still don’t know how sleep works. They do know what happens when people and even animals don’t sleep. They become psychotic.
Sleep tends to operate in a process called circadian rhythm. It’s governed by a mechanism in the brain and responds mainly to the arrival and departure of the sun during a day.
When it’s light, the brain triggers the release of hormones needed for daytime functioning.
When it gets dark, the brain starts to release night hormones, including the likes of melatonin, which tells the body to sleep.
Shift work throws that process into chaos if the worker fails to take steps.
But another problem is that there are so many people suffering from sleep disorders that the medical community can’t handle them all. As a result, health care workers primarily concentrate on the physiological disorders that can be life-threatening – sleep apnea, for example.
One agency estimates that if all of the people with sleep disorders descended on the medical community, it would take eight years to begin to treat all of them.
So shift workers need options that they can use to help themselves.
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REMEDIES FOR SHIFT-WORK SLEEP DISORDERS
-Keep The Same Schedule: The No. 1 remedy voiced by all experts is to live on the same clock every day. Don’t change on weekends. “You can adjust your circadian rhythm for night work,” said Geralyn Frandsen of Maryville University. “Once you attain that sleep cycle where you’re up during the night and sleeping during the day, on your days off, don’t alter that cycle. That can be a problem, because you want to be with your family, but if you alter that cycle, that leads to sleepiness later.”
-Exercise: “Not before you go to bed, but once you get up, you should exercise; exercise before you go to work,” said Frandsen. “A regimen of exercise promotes more restful sleep, but don’t exercise before bedtime. That leads to lack of sleep.”
-Simulate nighttime: Darken the room as much as possible. Use a blackout shade and a sleep machine. A sleep machine is something that will hum a soothing noise and drown out other household noises. It’s like a fan.
-Simulate daytime at work: Encourage your employer to maintain a bright and well-lighted workplace environment at night, if possible. The circadian rhythm responds to light intensity.
-Have milk and turkey before bed: The chemical tryptophan in turkey and milk will help you sleep.
-Stay clear of medications: Try not to use medications without talking to a doctor. “If you need a sleeping pill, you need to contact your physician,” Frandsen said. Doctors remain wary of stimulants because of the bad side effects with prolonged use. Even coffee has its downside.
-Learn to nap: Sleep can be cumulative, doctors say. Getting eight hours of sleep in 24 hours is the next best thing to eight straight hours of sleep.
-Try deep meditation: Some forms of yoga and meditation and even 10-minute naps can be restorative. However, you’ll still need to lie down and sleep for several hours.
-Avoid alcohol: While it promotes sleep, when it wears off, you won’t stay asleep and may have trouble getting back to sleep.
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OTHER OPTIONS:
Physicians dealing with shift-work sleep disorder have been trying out an old drug as a new remedy. Medafanil, sold under the name Provigil, has been used since the 1990s to treat narcolepsy.
Recently, doctors have been using it “off label” to treat shift-work sleep disorder. It has been successful in helping night workers and also people who work rotating shifts.
Doctors say rotating shifts are problematic because the body never gets used to a rhythm. Strangely, some research shows that rotating shifts every two days doesn’t cause problems when compared to rotating shifts every week or every month. The drug may be able to help, doctors say.
It improves wakefulness, said Dr. Joseph Espiritu of St. Louis University, so it keeps people more alert during work. But after work, it doesn’t prevent people from going to sleep. Better yet, it doesn’t have the stimulant crash that amphetamines and other drugs do, doctors said.
Dr. Jonathan Schwartz, of the University of Oklahoma, conducted studies on the drug and came out a big fan.
But Schwartz says to be careful: “Quote me-it’s not a substitute for sleep. No drug is a substitute for sleep.”
As for natural medications, researchers continue to study the over-the-counter supplement melatonin. The body produces melatonin when it’s time for sleep. But, according to the National Center for Complementary and Alternative Medicine, no research has found it to be a safe and effective sleeping aid, and some side effects may not be worth the risks.
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(c) 2005, St. Louis Post-Dispatch.
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AP-NY-09-02-05 0615EDT
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