Working Nights

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.
Read this article…

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…..

Read this article…

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’

2010 Sleep in America Poll Released!

The National Sleep Foundation (NSF) has just released the 1st poll to examine sleep among four ethnic groups in the United States: Asians, Blacks/African Americans, Hispanics and Whites-the 2010 Sleep in America Poll. Although significant differences in the sleep habits and attitudes of each group are revealed, there are also a number of interesting similarities. The poll found that more than three fourths of respondents from each ethnic group agree that poor sleep is associated with health problems. It also showed that each group reports similar experiences missing work or family functions because of fatigue. This is of extreme significance to shift workers who routinely average less sleep than day workers.

The NSF is committed to understanding people’s sleep needs and giving them the tools necessary to get the optimum amount of rest. Read more about the poll and its findings at the NSF’s website…

Working Nights President, Betsy Connolly, to Chat with Nurses on NurseTogether.com – Join us Tomorrow at 6 pm est.

Nurses are used to working shifts - nursing was one of the first professions to require that work schedules be matched to the needs of patients.  Medical complexities, expanded services, and consumer demand for all types of health care around the clock has meant that more nurses are working shift work now than ever.

Betsy Connolly, President of Working Nights is going to be chatting on-line with nurse members of NurseTogether.com.  Topics will include a review of circadian rhythms as well as practical tips for managing work/life balance when working shifts, particularly roating ones. 

When:  Thursday, February 25, 2010 at 6 pm est.

Where:  NurseTogether.com – click here for the link and to become a member.

WSJ Covers Heart Risk at Work and Seasonal Affective Disorder

There were two articles in the Wall Street Journal today that are significant to shift workers. One story is about Seasonal Affective Disorder (SAD), and the other’s about a new study reporting that men who didn’t confront colleagues or bosses who treated them unfairly doubled their risk of heart attack.

Seasonal Affective Disorder – the article states that SAD “affects an estimated 6% of Americans, causing depression, lethargy, irritability and a desire to avoid social situations. It can also create an urge to overeat, particularly carbohydrates. As many as 15% of people in the U.S. may have a milder version that includes only some of these symptoms.” What the article leaves out, that all shift workers know, is that SAD symptoms are routinely felt by workers at jobs outside the normal day-time hours of 7 a.m. to 7 p.m. See more about this in our articles on Vitamin D and Serotonin.

Reducing Heart Risk with Confrontation – the lead researcher from Stockholm University and her research partners asked 2,755 men how they typically responded to unfair treatment at work. Those who said they just let it pass and said/did nothing had significantly more heart attacks during the next ten years. After adjusting for age, socio-economic factors, risk behaviors, job strain, and biological risk factors, the risk of heart and death from a cardiovascular event was 2.3 times greater than it was for those who said they confronted those treating them unfairly. Read more about how shift workers can manage stress on the job and about controlling bullying at work.

To read the two Wall Street Journal articles:

Seasonal Affective Disorder
Reducing Heart Risk with Confrontation

©2009Circadian Age, Inc. ‘Working Nights”

Working Nights Spanish Calendar Provides Critical Health and Safety Know-How for Hispanic Population

Press Release Issued Today to Announce the Working Nights Calendar for Hispanic Shift Workers:

BOSTON–(BUSINESS WIRE)–Circadian Age, Inc. – ‘Working Nights’ – a company dedicated to helping shift workers and their families adjust to their unique lifestyles, is announcing a new Spanish calendar. The 2010 Working Nights Spanish Calendar offers organizations with Hispanic workers the opportunity to show added concern about the health and safety of this group of employees, by providing them with educational material in their own language, to use at home.

“Hispanic shift workers face the same circadian rhythm and biological clock challenges that all 24/7 employees do” says Betsy Connolly, President of Circadian Age. “But often, language barriers make an already difficult situation worse. Spanish speaking workers are often less knowledgeable about chronic health conditions and safety prevention at work, which may result in more accidents and errors and increased health care costs.”

For the full release read here.

A Pitch to President Obama – How About a Shift Workers Day?

In moments of great stress and loss, our immediate tendency is to point the finger and blame those we see as having had the responsibility for predicting, and thereby preventing, the crisis. Most recently, experts responsible for issuing emergency warning alerts have been criticized for their slow response to an 8.0 magnitude earthquake and tsunami followed by even more quakes earlier this week in the Samoa Islands region (150 deaths). This was followed by Wednesday’s 7.6 magnitude earthquake in the southern Sumatra region of Indonesia which has reportedly killed at least 700 (and many are still missing – 30,000 homes destroyed). Now emergency workers and aid groups are scrambling 24/7 to respond to the havoc and devastation resulting from these disasters.

It takes you back to 911, Katrina, or the 2004 Indian Ocean earthquake and tsunami that killed 150,000 people. People working 24/7, working nights, evenings, and weekends for multiple days in a row! How do we get through these emotionally draining and often physically taxing periods?
Read this article…

Be Careful When and What You Eat, When Working Shift Work – No Greasy Fries and Burgers Anymore! Sorry!

Our bodies circadian rhythms regulate when we should eat, sleep, and be active. However, when we work shift work we don’t allow our bodies to adhere to these regulations, especially when we are working nights. We run around working, when we should be sleeping and inactive, and we eat at night when our bodies are normally shut down and not focused on digestion. We all know it doesn’t help us to maintain our weight when we eat junk food at night while sitting in front of the television. But what causes the problem? Is it the calories in the junk food? Would it make a difference if we chose to nibble on carrots and celery instead? Or is it because we’re eating late at night? A recent study in the journal Obesity, has found that when we eat may be more of a driver of weight gain than what we eat. This obviously has significant impact for shift workers.
Read this article…

Calendar Contest Provides Healthy Benefits for Kids and Adults

BOSTON, MA (July 27, 2009) — ‘Working Nights’ announces an exciting new calendar contest. The 2010 Working Nights Creative Arts Calendar Contest offers organizations the opportunity to create a custom health and safety calendar incorporating winning illustrations or photographs submitted by company employees and their family members. For the full press release click on the link below:

Full Press Release

pycve82sbg

Merry, Merry Shift Work: Reducing Holiday Stress

Holidays, and the stress they bring, can be difficult to integrate into a shift work schedule. Even if you manage to pencil in Fun between two eight- or ten-hour shifts, stress and holiday errands can quickly override your best laid plans. There’s a lot to look forward to in holidays, but also a lot to worry about, and people can sometimes feel the need to make sure everything is absolutely perfect before taking any time for themselves. It’s important to balance family obligations with relaxation and to prioritize things you really want to do on your time off work. Read this article…

Vitamin D Deficiency Updated

When a diet lacking in proper nutrients collides with a job that rarely lets you see the sun, vitamin D deficiency can rear its ugly head. Too much time in the sun of course can cause sunburns and raise the risk of skin cancer, but too little and the risk of heart disease skyrockets. Spending some relaxing time out in the sun and eating vitamin-D rich foods such as eggs can work wonders. Read this article…

Women and Sleep…Sleep Stress and Sleep Disturbances…Welcome to the Bedroom!

Kids and caffeine, stress and sleep apnea, menstruating giving way to menopause: women have a lot of unwanted guests in the bedroom when it comes to getting enough sleep. Studies have shown sleep makes a huge difference in concentration, memory, alertness, and even weight loss and happiness. Staying safe at work depends greatly on workers getting enough sleep. Over a quarter of shift workers report making mistakes from inattention several times a month, and almost half report having nodded off while driving to or from work. These tired mistakes can have sometimes fatal consequences. A healthy sleep schedule can save lives. Read this article…

Men and Sleep; Yes – Men have Challenges Too

Going for 22 hours without sleep is equivalent to having a blood alcohol level of 0.05. One is perfectly legal, but the other could cause you to be arrested for being behind the wheel and kicked out of work. Shift workers, especially night shift workers, might see nothing out of the ordinary in going 22 hours without sleep, but they pay for it with their health, and sometimes even with their lives. Exhaustion decreases alertness, attention and the ability to process new information, creating danger on the job. When working with machinery, as many shift workers do, or in health care of emergency services, one slip of attention can cause accidents, injury, and death. Bad sleep habits also set off a whole variety of health problems, including weight gain leading to obesity. Many existing issues, such as depression, asthma, and addiction to drugs or smoking can make sleep habits worse, and then continue to worsen themselves because of the troubled sleep. Sleeping pill prescriptions reached 56 million in 2008, showing the extent to which sleep problems haunt Americans. But this is a problem that can be conquered. Read this article…