QIPS TIPS Danger : Night Shift at Work

Shari Welch, MD FACEP

Shari WelchAt the State University of New York in Albany, recent research demonstrated that rats that were forced to be sleep deprived at night (analogous to night shift workers), aged more quickly, had a shorter lifespan and demonstrated more tumorigenesis than rats that were not sleep deprived.  It has been suggested that humans working the night shift may have an increased risk of developing breast cancer and other cancers, though the research is contradictory and inconclusive.  On the other hand, we do know that night shift does take a toll on its workers.  A recent article in Chronobiology International showed that night shift workers had an increased odds ratio of being obese, having central obesity (suggesting endocrine dysfunction) and hypertension. 

A third article published in 2010 in Euro J Epidem showed an increased risk for cardiovascular disease in night shift workers. Numerous studies over the years have shown a shortened life expectancy, an increased risk of diabetes, increased risk of anxiety and depression, eating disorders and sleep.  Night shift workers eat fewer calories but consume more fat and sugar and often resort to fast food, caffeinated drinks and energy drinks. The long term consequences of this diet are only beginning to be studied.  Suffice it to say that night shift work is hazardous to your health.

It is also increasingly recognized that the sleep deprivation inherent in night shift work has effects on human performance.  A study performed at Henry Ford Hospital and reported in the journal Sleep in 2010 studied attention and memory in sleep deprived subjects and non-sleep deprived subjects.  The findings were significant and support other work that has demonstrated that the limits of human performance are tested when subjects are forced to challenge their natural circadian rhythms.  Sleep restriction experiments have also shown that the ability to multi-task and psychomotor testing falter when subjects are sleep deprived (J Sleep Res. 2010). Another study done at Stanford noted that people that worked nights get less sleep overall, are prone to sleep attacks (falling suddenly asleep, often at work) and are at increased risk for motor vehicle collisions . Should night shift workers be chauffeured to and from work?

Sleep deprivation has also been associated with a lessened sense of well-being, increased negative mood and decreased psychomotor performance (Neuropsychiatric Dis Treat 2014). Even more disturbingly, MRI studies have shown that signals involved in attention, memory, and executive function are affected after sleep deprivation and thalamic gray matter is actually reduced in otherwise healthy men after total sleep deprivation (Neuroreport 2013)!

“DANGER Will Robinson!!”* Working night shifts is hazardous to your health and by virtue of its impact on your performance, it is a danger to patients too.  In the next issue we look at ways to optimize work on the night shift.

*Regularly chanted by the robot body guard from the 1960’s hit TV show Lost in Space.

 

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