Working Nights

Seratonin Levels Feed Anger

Many studies have shown that low levels of serotonin are also associated with anger, depression and anxiety. Fluctuations of serotonin levels in the brain, which often occur when someone hasn’t eaten or is feeling stressed, affect brain regions that enable people to regulate anger. So when stressed or hungry, people are often unable to manage their anger. This is especially relevant to shift workers as the stress of working outside regular daytime hours is significant and good eating habits of shift workers are often lacking (self-reported). A new study published September 15, 2011 in the journal Biological Psychiatry has shown that individuals who might be predisposed to aggression were the most sensitive to changes in serotonin depletion.

Do you Learn from your Mistakes?

People who think they will learn from their mistakes have a different brain reaction to mistakes than people who think intelligence is fixed. Jason S. Moser, of Michigan State University, who collaborated on a new study, found that people who think intelligence is malleable say things like, “When the going gets tough, I put in more effort” or “If I make a mistake, I try to learn and figure it out.” On the other hand, people who think that they can’t get smarter will not take opportunities to learn from their mistakes. People who think they can learn from their mistakes did better after making a mistake; they successfully bounced back after an error. Their brains also reacted differently, producing a bigger second signal, the one that says “I see that I’ve made a mistake, so I should pay more attention” Moser says.

Dealing with People on a Power Trip?

Individuals in roles that possess power but lack status have a tendency to engage in activities that demean others. The experiment demonstrated that “individuals in high-power/low-status roles chose more demeaning activities for their partners than did those in any other combination of power and status roles.” It feels bad to be in a low status position and the power that goes with that role gives these workers a way to take action on those negative feelings.
©2011 Circadian Age, Inc. ‘Working Nights’

New Research Shift Workers Should Be Aware of…….

Read on if you are interested in identifying whether you might have heart disease, learn about a possible new way to treat sleep apnea, or hear more about sleep disorders…….
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Preventing Cardiovascular Events

Cardiovascular disease is the most common cause of death in the United States and other developed countries. Cardiac events are more common in winter, at the beginning of each month, on Mondays (in working people), and during the early morning hours of each day. Between 6 a.m. and noon, there is a 40% higher risk of heart attack, a 29% increased risk of cardiac death, and a 49% increased risk of stroke (if these events were evenly distributed throughout the day).

Several studies have reported a higher prevalence of coronary risk factors among rotating shift workers, including increased cigarette consumption, higher blood pressure, and increased cholesterol and blood sugar levels. Each of these risk factors can be controlled with lifestyle adjustments.
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Have Heartburn during the Nightshift?

A team of researchers recruited 350 people to look at whether their nighttime eating habits predicted their risk of gastroesophageal reflux disease (GERD). Stomach contents (food or liquid) of people suffering from GERD leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This can irritate the esophagus, causing heartburn and other symptoms. Obesity, cigarettes, and possibly alcohol also increase the chance of GERD.

After controlling for smoking, body mass index and other things that influence heartburn, the researchers found that eating dinner within three hours of going to bed was associated with a sevenfold increase in the risk of reflux symptoms. As for why three to four hours is the threshold, researchers say that is roughly the amount of time it takes for food to clear the stomach.

Researchers from Mid Sweden University performed a systematic review of the medical literature noting studies that have reported gastrointestinal symptoms and diseases among shift workers by researchers from Mid Sweden University. Studies have indicated that shift workers appear to have increased risk of gastrointestinal symptoms and peptic ulcer disease. Workplace noise, increased work schedule variability, and working the evening shift may have the most adverse affect on gastrointestinal functioning.

Here are some suggestions of ways to minimize gastrointestinal discomfort by the National Center for Biotechnology Information, U.S. National Library of Medicine:
• Avoid bending over or exercising just after eating.
• Avoid garments or belts that fit tightly around your waist.
• Do not lie down with a full stomach. For example, avoid eating within 2 – 3 hours of bedtime.
• Do not smoke.
• Eat smaller meals.
• Lose weight, if you are overweight.
• Reduce stress.
• Sleep with your head raised about 6 inches. Do this by tilting your entire bed, or by using a wedge under your body, not just with normal pillows.
© 2011 Circadian Age, Inc. ‘Working Nights’

Beware of the Brownies!

Baked World, a company based in Memphis, TN markets a brownie called Lazy Larry, but BEWARE-these are not your mother’s brownies! They are filled with melatonin, a naturally occurring compound often used to treat sleep disorders. As a result, the Food and Drug Administration has sent Baked World a warning letter ordering them to stop marketing Laxy Larry as simply a “brownie”. Dr. Lloyd Sederer reports in the Huffington Post that the misuse of melatonin can result in numerous side effects and serious consequences. To learn more about these brownies, click here.

IS SNORING…….

………. keeping you or your partner awake night after night? We often joke and laugh about snoring but it can be a serious matter, especially for shift workers as they already get less sleep than daytime workers. Almost one half of the adult population snores at least occasionally, resulting in many sleepless nights for many people.

Snoring occurs when air flows over relaxed tissues in your throat causing the tissues to vibrate as you breathe; this creates those annoying sounds. The tissues may obstruct your airway making it narrower, so the airflow becomes more forceful and the snoring becomes louder. While snoring itself is not a health problem, it may indicate a more serious health condition, such as sleep apnea where your airways are so obstructed that you stop or nearly stop breathing as you sleep.

There are risk factors that may contribute to snoring. Some of them are:

• Being a man
• Being overweight
• Alcohol consumption close to bedtime
• Nasal problems
• Having a narrow airway

 

If you do suffer from plain old snoring, most doctors recommend making some lifestyle changes such as losing weight, reducing your consumption of alcohol near bedtime and sleeping on your side. These are all low cost or free. There are plenty of products (throat exercises, special pillows, mouth and nose devices) out there that do promise to eliminate snoring but their results have not yet been proven. If lifestyle changes do not help, doctors often recommend the mask or CPAP, oral appliances or surgery. Most insurance plans will not cover treatments for regular snoring, but will cover them if you are diagnosed with sleep apnea.

Do see a doctor if your snoring is disrupting your or anyone’s sleep or if you wake up gasping for air. A good night’s or day’s rest is essential to a happy and healthy you!

What is Enough Sleep?

Sleep is an often discussed subject, as most of us say and think we do not get enough. But what is enough and what does happens when we are sleep deprived? A recent New York Times article reports these were some of the questions being looked at by the Hospital of Pennsylvania’s Sleep & Chronobiology Laboratory when conducting the longest sleep restriction study of its kind.

For two weeks, dozens of subjects were assigned to one of 3 groups with each group sleeping for a designated number of hours. Not surprisingly, those subjects who slept 8 hours a day hardly had any attention lapses and no cognitive decline over the course of 14 days. However, those who slept less had significantly different experiences and outcomes . Read this article….

Come On…..Get up and Stretch or Walk Around a Little Bit

The results of two studies released in January will attack the couch potato tendencies present in many of us! Too much time in front of a TV or computer appears to dramatically increase the risk of heart disease and premature death from any cause, even regardless of how much exercise a person gets. Taking plenty of breaks, even if they are as little as one minute, appear to be good, both for people’s hearts and their waistlines. Continue Reading…

It’s Time to Think about Seasonal Affective Disorder Again

Now that it’s December 1st, and we’ve adjusted our clocks, some of us will find their circadian clock more out of order than others. Seasonal affective disorder strikes this time of year. We’ve written on this in the past. See our earlier post which highlights a Wall Street Journal article written by health editor, Melinda Beck.

For a newer article, read Seasonal Affective Disorder: How to Beat ‘Winter’ Depression.

Imagine a Hamster with Jet Lag?

Researchers come up with all kinds of crazy studies….all in the spirit of solving complex medical and scientific challenges that expand our knowledge and can potentially lead to curing disease. Sometimes however, all the research in the world seems to only take us back to what we already know. A recent study by psychologists at University of California – Berkley found that performance on learning and memory tasks are compromised by jet lag. The impact of jet lag has been closely correlated with the consequences of working shifts in research on the body’s circadian rhythms. But, learning and and memory problems can be avoided…..

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Strategic Implications of Keeping Workers Safe from Harm – The Impact of Bullying at Work

Recently, the topic of bullying has hit the headlines in a big way. Painful stories of persecuted, harassed, and tormented high school and college students who have committed suicide, have shocked educators, parents, students, and the public-at-large. The emotional, verbal, and physical abuse that constitutes bullying is not anything new. But recent attention to adolescents’ cyber-bullying (e.g. harassing others using Facebook, Twitter, or Utube or by cell phone or e-mail) has taken concerns about protecting victims to a new level.

Last month the federal government told educators that civil rights laws obligated schools to prevent bullying. The “Dear Colleague” letter sent by the Department of Education to school administrators puts into clear words the fact that educators have a legal obligation to “protect students from student-on-student racial and national origin harassment, sexual and gender-based harassment, and disability harassment.” As a result, school districts and colleges around the country are cracking down on those students who terrorize and intimidate others who are supposed to be their peers. Society and workplaces change over time (Pynes 2009). Will the recent attention to student bullying have strategic management implications for the workplace? Clearly it will for schools. But, what will be the impact be to other employers?

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A Primer of Sleep Disorders for Shift Workers

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) won’t be published by the American Psychiatric Association APA) for a few years (May 2013).  However, developing the roadmap of psychiatric diagnoses is a huge initiative as feedback is being sought from over 600 global experts.  The DSM provides the standard classification of mental disorders used by mental health and other health professionals for diagnostic and research purposes.  In addition, insurance companies use the DSM diagnoses to determine which psychiatric conditions will be covered by health insurance.

Over the years since the last DSM was published (1994), new research has been published on many psychiatric conditions.  New research leads to new opinions on the identification and treatment of disorders. Sleep disorders, many of which often plague shift workers, have received a significant amount of attention in recent years and as a result, the current draft of the DSM-5 includes information that shift workers and their employers should be aware of.  The recommendations for revisions to the DSM are posted on the APA’s web site for the manual – www.DSM5.org.  Public review and written comments are welcome. Comments will be reviewed and considered by the DSM-5 Work Groups.

 The sleep disorder work group is recommending greater inclusion of sleep disorders. This is being proposed primarily as a way to educate non-expert sleep clinicians (such as psychiatrists and general medical physicians) about sleep disorders that have mental as well as medical/neurological aspects.

Among the changes being recommended the significant ones impacting shift workers include:

1.  Adding obstructive sleep apnea hypopnea syndrome to the DSM-5 – this disorder was previously contained under the sleep disordered breathing category.  Obstructive sleep apnea is associated with snoring, obesity, increased waist girth, and male gender. Central sleep apnea is most strongly associated with advanced age, heart failure, and diabetes.  Cardiac problems associated with obstructive and central apnea are different.  

• Obstructive sleep apnea is associated with ventricular ectopy which is often experienced as a strong or skipped heart beat resulting from abnormal electrical activation originating in the ventricles (heart’s lower chambers) before a normal heartbeat would occur.  Studies have indicated that sleep apnea promotes ventricular ectopy. 
•  Central sleep apnea is more strongly associated with atrial fibrillation. During atrial fibrillation, the heart’s two upper chambers (the atria) quiver instead of beating effectively. Blood isn’t pumped completely out of the chambers, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results. About 15 percent of strokes occur in people with atrial fibrillation.

People with coronary artery disease whose blood oxygen is lowered by sleep disordered breathing may be at risk of ventricular arrhythmias and nocturnal sudden death. CPAP treatment may reduce this risk. Sleep disordered breathing, including apnea, may cause coronary artery disease and hypertension.

2.  Adding primary central sleep apnea to the DSM-5.  See 1. above. Point is to separate obstructive and central sleep apnea as the risk factors and outcomes for each are different. 

3.  Adding restless leg syndrome to the DSM-5.  According to the DSM web site the rationale is that “RLS is a sufficiently common syndrome to merit elevation to an independent category. In national and international studies the prevalence of RLS appears to be between 7-10% of the population, depending upon age and gender.”

4.  Including circadian rhythm, delayed sleep phase, advanced sleep phase, irregular sleep wake rhythm and free-running sleep disorders in the DSM-5 as separate subtypes.  The rationale for this proposed change is based on new data indicating not only the differences in clinical characteristics, but also the underlying pathophysiology and in some cases, genetic basis for the different types of circadian rhythm sleep disorders.

To read more about other primary sleep disorders, follow the links below: 

Primary Sleep Disorders 307.42 Primary Insomnia 307.44 Primary Hypersomnia   347.00 Narcolepsy   327.3x Circadiam Rhythm Sleep Disorder   307.47 Nightmare Disorder  

©2010 Circadian Age, Inc. ‘Working Nights’

It’s Important to Talk with your Doctor about Working Shift Work

If you’ve read much of the material on this blog, you know that working shift work contributes to many challenging, but manageable, health and lifestyle issues.  One way to make sure you manage your own unique circumstances is by talking with your health practitioner about the fact you work shifts and raising any concerns you have about shift work.  A recent study by the University of Illinois at Chicago and the VA Center for Management of Complex Chronic Care found that physicians tend to follow a fairly standard approach to care for most health conditions.  Physicians do not generally take into account  a particular patient’s situation or life context, so the fact that a patient works shift work is not likely to enter the doctor’s radar screen.  But, it’s critical for shift workers to have doctors who understand the unique challenges of working shift work.

Some of the special issues shift workers can face include:

1.  Sleep disturbances from work schedules distrupting sleep schedules.

2. Lower levels of Vitamin D resulting from lack of exposure to sunlight.

3. Overweight due to lack of nutritional food when working nights.

4. Higher rates of divorce due to lifestyle challenges of working shifts.

5. Increased risk for depression arising from lower levels of seratonin.

Read other posts throughout this blog for more areas of risk when working shifts. 

Next time you go to your health practitioner, bring a list of your concerns and be vocal about them with your provider.  Make sure your doctor or nurse practitioner knows you work shift work.  The University of Illinois at Chicago and the VA Center for Management of Complex Chronic Care study found that doctors were more likely to respond to biomedical facts – e.g. test results - than to contextual red flags - such as I work  shift work and I’m concerned about my increased risk for cardiac problems even though I don’t have any family members with heart health issues.  Both biomedical facts and contextual red flags are equally important to planning appropriate care, according to the study researchers.  By planning care with your provider you can prevent shift work challenges from impacting your health and lifestyle.

©2010 Circadian Age, Inc. ‘Working Nights’

Extra Sleep Improves Performance, Alertness and Mood

According to a new study being presented tomorrow at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC, getting extra sleep over an extended period of time improves athletic performance, alertness and mood.  In this small study, football player participants extended their sleep for seven to eight weeks during the season, obtaining as much sleep as possible and aiming for a minimum of ten hours of sleep each night.  By substantially increasing their length of sleep, the players decreased daytime sleepiness and fatigue and felt increased vigor towards the end of their season.  For more details click here.  This study supports other research indicating that sleep improves the performance, alertness and mood of shift workers.

Employee Health and Shift Work Lifestyle Training Leads to a Happier and Healthier Workforce….and to Increased Company Profits!

Is employee morale low at your company? Employee morale is higher when companies provide shift work lifestyle training.  Nearly 60% of employees at companies providing shift work lifestyle training rank their morale as good or excellent compared 35% without shift work training.[i] 

Some shift workers are at a greater risk for cardiovascular disease.  Want to save upwards of $6,500 for each of these at-risk employees per year?  And, protect your employees from this number one killer!

Workers in shift work operations generate, on average, more health care costs than other workers.  How about reducing overall company health care costs by 17% to 37% by targeting this population and helping them improve their health?[ii] Other cost savings may also be possible, including safety incident and workers’ compensation costs. Worker productivity may increase, possibly even up by 39%.[iii]

In extended 24-hour operations, a well-designed shift schedule or roster is unlikely to provide adequate protection from worker fatigue.  An integrated risk management system incorporates data analysis and training towards an effort of reducing fatigue and reducing a company’s costs, risks, and liabilities.[iv]

Among the shift worker population, 71% of men and 53% of women are overweight, 54% of workers have smoked or currently smoke, only 27.5% workers report having good nutritional practices, and 77% report not exercising regularly.  Add to this the sleep deprivation statistics, 27% of shift workers report making mistakes of inattention several times per month, and it’s clear that both shift workers and their employers would benefit from worker health and lifestyle training.[v]  In addition, a fatigue management program would help target the reasons shift workers aren’t always as attentive and productive as day-time workers and help companies and employees develop some initiatives to reduce employee fatigue levels. 

Each of the examples above show the overwhelming benefits to a company and its employees when an employee health and shift work lifestyle training program tailored to the company’s needs is implemented……..It’s all in the details, so read on for more information about targeting a program for your operation….. Continue Reading…