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NIGHT SHIFT WORKERS AND SLEEP APNEA

HOW SLEEP APNEA AND NIGHT SHIFT WORKING ARE RELATED:

In this competitive world, businesses are operating 24/7 to meet the demand for round-the-clock services. In order to keep the business operating, people work in rotating day shifts, full night shifts, and evening shifts. The workday for many employees across the world no longer fits the conventional 9 to 5 model. According to the US Bureau of Labor Statistics, about 16% of salary workers in the US follow shift work schedules, and 19% of adult workers work for more than 48 hours per week. Below we will discuss how sleep Apnea and night shift work should be something you should monitor for a successful routine while working during nighttime.

Since the natural sleep-wake cycle of our body, known as the circadian rhythm, is set for the routine of nighttime sleep and daytime activities, working in night hours or irregular shifts can result in insufficient, disrupted, and/or poor sleep.

Interrupted or too little sleep can cause:

  • Drowsiness
  • Fatigue
  • And disruption of your circadian rhythm
  • Cardiovascular diseases
  • Obesity
  • Diabetes
  • Gastrointestinal difficulties
  • Dysfunction of the immune system
  • And may lead to certain types of cancers.

As this irregular sleep schedule is becoming common with the changing lifestyle, it is important to understand the risks associated with the lack of sleep or irregular sleep-wake sleep cycle. Below we will discuss why sleep apnea and night shift working are related.

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Effects of Nightshift on your Health

One of the main questions people keep asking is—How night shifts affect health. Working in irregular sleep schedules and night shifts can force your body to work on a different schedule than the natural circadian rhythm. However, it is possible for you to retrain your body to adjust to the sleeping schedule.

Irregular sleeping schedules or longer working hours can result in:

  • excessive sleepiness
  • fatigue
  • and shift work sleep disorder.

It is also linked to various health diseases like:

  • heart disease
  • obesity
  • stroke
  • metabolic problems
  • and cancer.

how night shift work can affect the health of a person not diagnosed with sleep apnea:

Interferes with the repair process

When you sleep, your body reduces stress levels, repairs from injuries, and eliminates harmful toxins. Working throughout the night can interfere with these processes, resulting in the development of various kinds of disorders.

Risk of shift work sleep disorder

Rotational shift or night shift work can also cause shift work sleep disorder (SWSD). The disorder impacts the body’s internal clock and may result in insomnia when a person tries to sleep and/or may feel excessive sleepiness during work. Shift work sleep disorder causes significant sleep loss. On average, a person with SWSD can experience a loss of 1-4 hours of sleep every night. Loss of sleep or poor sleep quality can also result in decreased work performance, and the chances of work-related accidents increases.

Increases risk of heart attack

Working night shifts can increase a person’s risk of developing heart disease. The change in sleeping habits of a night shift or rotating shift worker can affect the blood circulation and pressure in the body.

Increases the chances of depression

Working at night or in an irregular shift can also have a negative impact on your mental health. When you don’t get enough sleep or when your sleep-wake cycle is disturbed, the risk of mood disorders and depression increases.

High chances of Workplace injury

Night shift working or working in rotating shifts means that you are working against your body’s natural rhythm, which can impact certain body functions such as mobility and consciousness. When you cannot retrain your body to work in a changing cycle, you are just forcing the body to stay awake and active. This may lead to loss of attention, focus, and productivity, increasing the chances of workplace accidents and injuries.

Higher risk of diabetes and obesity

When you work at night, you will sleep in the morning, which over time may increase the risk of diabetes and obesity. The increased risk of these medical conditions are due to hormonal imbalance in the body. A study reported that people working with irregular night shifts have a greater risk of type-2 diabetes mellitus. The night-shift workers with type-2 diabetes show differences in response to pancreatic β cells, lipid metabolism, and glucose levels in the body, increasing the risk of metabolic syndrome and obesity.

Deprivation of Vitamin D

Your body requires Vitamin D as it assists in the absorption of calcium in your body and promotes the growth of bones. Deficiency of Vitamin D can result in mis-shaped bones or osteomalacia along with the development of several health conditions like colon cancer, breast cancer, and prostate cancer.

Effects of Nightshift on Health of a Person Diagnosed with Sleep Apnea

A person working in rotating or night shifts has a lower oxygen saturation level, and more frequent pauses in breathing during the night than a daytime working person. People with sleep apnea who work in shifts or at night may experience more severe sleep apnea symptoms than a sleep apnea patient with a regular working schedule. A study on shift workers and sleep apnea showed that shift workers might experience severe symptoms of obstructive sleep apnea.

The study was conducted on 31 rotational or night shift workers and ten daytime workers. All the people in both groups were already diagnosed with OSA and were similar in age, sleep duration, and weight. Polysomnography (PSG) of these workers during the daytime and nighttime showed that those who sleep during the day had lower levels of oxygen saturation levels and more frequent breathing pauses. This showed that shift workers experience more severe sleep apnea symptoms. 

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The study also warned that people diagnosed with sleep apnea should avoid working in rotational shifts or night shifts. Sleep apnea is associated with the risk of the development of some severe health conditions, including dementia, diabetes, asthma, cancers, and cardiovascular diseases.

How to Cope with Night Shifts and Get More Sleep?

If you are working on the night shift and find it difficult to get enough sleep, the following can help you to improve your quality of sleep to avoid associated health risks, so you can enjoy healthy living.

Manage your sleep patterns

While some people manage to work night shifts without any problem, others may experience fatigue and sleep deprivation. This is because the body is trained to sleep at night. Our body is controlled by the internal clock or circadian clock, located in the suprachiasmatic nucleus (SCN), a pair of cells located in the hypothalamus.

The suprachiasmatic nucleus generates circadian rhythms that regulate the physiological and behavioral processes of the body, including temperature control, hormone production, sleep-wake cycle, and alertness. The rhythms run in a 24-hour cycle and are influenced by natural light. Several processes in our body that are active during the day slow down during the night, preparing the body to sleep. The circadian clock releases sleep hormones or melatonin (See Melatonin Article)during the night, causing the body to become less alert and increasing sleepiness.

As a night shift worker, your body fights against the natural rhythms and tries to keep you alert when it is actually designed to sleep. When you try to sleep during the daytime, the circadian clock influenced by exposure to daylight signals you to be awake and alert. For more information on staying alert during night shift work, check out our article on “how to stay awake at work.”

If you are a night shift worker and feel sleep deprived or suffer from sleep apnea, you need to train your body and manage your sleep during the day. The sleep quality and length during the day can be poor compared to night sleep because of temperature, noise, and light.

 

To manage your sleep during the daytime, you can make the sleep environments favorable for sleep by following these steps:

  • Avoid delays in going to bed. The longer you delay, the more likely you will stay awake.
  • Dedicate 7-9 hours for sleep after your night shift is over.
  • Drink water before going to bed. You may wake up in the middle if you feel hungry or thirsty.
  • Avoid alcohol consumption before going to bed. It may help you get to sleep quickly, but it will decrease the sleep quality, and you may have trouble achieving the deep sleep phase, leaving you tired and sleepy when you wake up.
  • Avoid using a cell phone or watching TV when you get into your bed. Using cell phones or performing activities on electronics that make you alert can make it difficult to fall asleep.
  • Keep your bedroom quiet and dark. Maintain a comfortable temperature in the bedroom when you are going to sleep. You can use blackout curtains to prevent daylight and earplugs to avoid daytime noises.
  • Avoid smoking before going to bed. Nicotine is a stimulant, and you may find it difficult to fall asleep after you smoke.

On average, an adult requires seven to nine hours of sleep for the body to function properly. If you sleep less than this, it may be insufficient to rejuvenate yourself, and you may be sleep-deprived and can experience sleepiness during work among other health factors that can arise over time.

Control the exposure to light

As mentioned, your circadian clock is highly influenced by light. Exposure to natural light triggers chemical reactions in the clock that affect the sleep-wake cycle. When it is dark, the body releases melatonin that promotes drowsiness, whereas when you are exposed to light, cortisol (learn more about cortisol) is released that promotes alertness and keeps you awake. Timed exposure to light can help you adjust the body’s sleep cycle according to your shift work schedule.

During night shift working, you can expose your body to bright light during nighttime to promote alertness, and blocking your exposure to light during the day can help you promote drowsiness. Moreover, exposure to blue light emitted from the digital screens of your cell phones, tablets, computers, and televisions can also trigger the emission of cortisol, affecting your sleep.

Tips on Controlling exposure to light after your shift ends

  • Wearing sunglasses to block exposure to sunlight while going home after your shift can benefit you in suppressing the effect of sunlight and fall asleep quickly when you get home.
  • Use blackout curtains, drapes, blinds, and sleep masks to keep the light out of your bedroom when you are trying to sleep.
  • Avoid using digital devices, including television, cell phones, tablets, and computers, before going to bed.
  • Increase your exposure to light during your night shift. You can use overhead lights or desk lamps while working at night.

Keeping a dark and comfortable environment in your bedroom will help you in get to sleep quickly.

combatting various deficiencies due to lack of sleep

When the normal sleep-wake cycle of the body is off-balance, the metabolism is also affected. People who work during night shifts are more likely to experience metabolic syndrome. They also have a 29% more risk of obesity due to disruption of the circadian clock and poor diet. Planning your meals properly throughout the day can help you stay fit and alert during the shift and relaxed during your sleep.

When you work during the night, you minimize your exposure to sunlight, which may cause Vitamin D deficiency that is linked to several health risks. To combat various deficiencies and to improve your sleep quality while working in night or rotational shifts, you should maintain a healthy diet, and if needed supplement accordingly.

tips to stay healthy and get a sound sleep during the daytime

  • Stick to a fixed eating schedule
  • Add exercise to your daily routine for a healthy lifestyle
  • Eat light meals. Avoid heavy meals as it can cause fatigue and sleepiness
  • Add foods that are easy to digest to your diet. Try to avoid food that is difficult to digest easily for your body.
  • Do not depend on unhealthy sugary foods as they may help provide a short energy boost but soon after, you may experience a sudden energy dip.
  • Stay hydrated throughout to improve mental and physical performance. However, taking too much fluid before going to bed should be avoided.
  • Add foods rich in Vitamin D into your daily diets.
  • You can also spend your day off outside to get direct sunlight exposure.

Conclusion

When working night shift and facing difficulty coping with the abnormal schedule, you need to train your body’s circadian clock and adjust your sleep-wake cycle accordingly to avoid feeling tired and sleepy while working. If you are awake during the day and experience sleepiness during the night, you should follow the tips mentioned above to help adjust to your new schedule and get the required sleep of 7-9 hours during the daytime. Getting enough quality sleep during the daytime can help you enjoy a healthy life and reduce the risk of developing sleep disorders and chronic health diseases, such as heart disease, metabolic syndrome, diabetes, obesity, and cancer or causing your existing sleep apnea to become more severe.

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