Shift Workers and Circadian Misalignment

Speaker 1 0:00

We know the benefits of a 15 to 20 minute power nap and we know how much that improves fatigue levels , alertness levels . I believe that in almost every environment , scheduled napping should be available for those who wish to .

Speaker 2 0:23

Shift work can be brutal , but it doesn't have to be . Welcome to a healthy shift . My name is Roger Sutherland , certified nutritionist , veteran law enforcement officer and 24 seven shift worker for almost four decades . Through this podcast , I aim to educate shift workers using evidence based methods , to not only survive the rigors of shift work , but thrive . My goal is to empower shift workers to improve their health and well-being so they have more energy to do the things they love . Enjoy today's show . You are more than welcome to today's episode of the healthy shift podcast . My name is Roger Sutherland and I am your host Today . You're going to have to strap yourself in because you are going to absolutely love this episode .

Speaker 2 1:14

It is 2023 . We have massive hemorrhaging in our shift working environments , in particular , in frontline health and policing agencies . This has become a worldwide problem on the back of the pandemic . Why is this the case ? I honestly believe that in 2023 , that we need to start stripping down our business models around our shift working environments . What we need to do is we need to rebuild them to fatigue , manage and look after the employee so that they are turning up to work healthy and fit and ready to go as far as work goes . But we're not actually doing that . Shift working environments are literally just having a look at what they need . They've got a 24 seven roster and they're just packing people into it , giving it absolutely no thought whatsoever . Now I know you're resonating with this , so today my topic of discussion is circadian misalignment in shift workers and how employers can support their employees .

Speaker 2 2:21

Now , my guest today is Dr Jade Murray . Now , dr Jade Murray completed a Bachelor of Science and a postgraduate diploma in psychology at Monash University Before she completed her PhD program at the Monash University Sleep and Circadian Medicine Laboratory in 2018 . Now , dr Murray's PhD focused on misalignment between circadian rhythms and sleep and wake and its association with functional and mood outcomes , particularly depression , anxiety and productivity , in a circadian rhythm disordered population . Now , dr Murray has 10 years experience in sleep and circadian research and she's been involved in a number of clinical trials in various populations , including insomnia patients , delayed sleep , wake phase disorder patients , traumatic brain injury , tbi patients and shift workers . Dr Murray's broad research actually interests include studying the effects of circadian misalignment on overall health in both healthy and sleep disordered populations , developing simplified methods for determining the timing of the circadian phase . Now , the most important innovation in her work has been tracking light dark exposure data over time and using this information to build predictive models of circadian timing for development of personal delivery systems for sleep wake interventions to improve the health and lifestyle outcomes .

Speaker 2 3:54

Now , that last bit is the most important bit of this podcast , because Dr Murray is also in my corner as far as a firm believer that it's time in 2023 , that shift working organizations started having a good look at their business models and are they actually catering to the shift worker instead of just losing them through burnout and then just trying to find more and burning those out as well ? So , without much further ado , I'm thrilled to bring Dr Jade Murray to you today and I'd love for you to have a listen to what she's got to say around this particular topic . Strap yourselves in . I would like to welcome to the show today Dr Jade Murray out of Monash .

Speaker 2 4:36

How are you , dr Jade ? Very well . Thank you , jade . I actually heard you on the Making the Shift podcast series , which was run out of the Wellington show iron . I found your input in relation to that fascinating and I would really like to drill into some of that so that our listeners can learn more about what your research is actually starting to show and what your theories are in relation to what you think we should be doing as shift workers moving forward . So thank you very much for coming on the show .

Speaker 1 5:05

Thank you so very much for inviting me . It's an incredibly important issue , given that we now have a 24 seven society and the need for shift workers is only increasing . It's critical now that we get things right for shift workers , so I really appreciate the opportunity to come and speak to you today .

Speaker 2 5:24

What the shift workers of this world today don't realize is there are numerous people like yourself that are actually all putting a lot of time and a lot of effort into optimizing shift work . Now , we know that shift work is really bad for people . We understand that because of the circadian misalignment , and that's what we're going to go down the line off today when we have our discussion . But it's important that shift workers know that there's just an enormous amount of people that are actually working on this isn't there to try and optimize shift work , like out of Monash . We've got our Chrono-Neutrition , we've got your work . We've got people worldwide that are doing this isn't there ? I'm sure you're liaising with a lot of those people .

Speaker 1 6:01

Absolutely and importantly , we now have a really good understanding of the outcomes of shift work and those poorer outcomes and we understand that . But now we are moving towards interventions to help shift workers and , in particular , personalized interventions , because over our many years of research understand that this is a highly variable thing between individuals and personalizing those interventions is also really critical .

Speaker 2 6:31

And I think in the past , when we've done retrospective studies on shift workers and the outcomes , there hasn't been these interventions to actually help people has there . So we're in a position now where the research shows , oh , this is bad , that's bad , this is bad , everything's diabolical , it's a world of hurt , you can't do shift work . But now , with these interventions that we're putting in place or that we're learning more and more about , do you agree that we can actually optimize shift working environments ?

Speaker 1 6:59

Yeah , and I think you just hit the nail on the head we will never . Humans weren't designed to function so that we would operate that way in a shift working environment , but we can absolutely , most definitely , optimize it . Like you said , we're putting in these interventions and not only that , we're learning more about them . So earlier times we were making interventions that were based on a very broad systemic level , and we're now learning that we can implement interventions that help individuals , because everyone's slightly different in how they respond to shift work , and those changes are critical and key to optimizing the shift work environment .

Speaker 2 7:39

You've mentioned this a couple of times now already individual , and this is why it's important that people are able to be individually looked at or coached around it , because what works for Jenny at the office doesn't necessarily work for Karen , does it ? That's right .

Speaker 1 7:54

And there's many reasons for that . There's a biological underpinning to that that we're all slightly different biologically and I'll talk about that probably a little bit more later with our biological clock , but also our personal circumstances differ and that means we have to operate differently from one another . And taking all of those things into account in managing shift work and sleep is also really important .

Speaker 2 8:20

What actually is your field of research and how did you end up doing that ? Because you've got a background in psychology , don't you my ?

Speaker 1 8:26

primary field of research is sleep and circadian health and we have a particular focus on mental health and mental health outcomes and also on , obviously , shift work and what happens with body clock misalignment in shift work and how we might manage that . So we are working on various different personalized interventions at managing circadian misalignment .

Speaker 2 8:49

That is fantastic . So , working at a Monash and you're obviously liaising with people , because I think there's a whole area out of the University of South Australia that are doing this as well . So , Bill , one team . How many people would be on your team that are looking at that ? Our sleep ?

Speaker 1 9:04

group at Monash alone makes up the largest group of the School of Psychology at Monash , so there's probably at least 100 people . We all have very different focuses . Not all of them are shift work , but much of it is based on the circadian clock , and so all of that research combines , sort of builds our knowledge that helps us with things like that . And then , yes , of course , lots of collaborative work with lots of different institutions and individual researchers as well , from all over Australia and , of course , all over the world .

Speaker 2 9:38

I know it's amazing , isn't it ? Now you touched on it . You've come from a psychology background and you know that shift work interrupts our circadian rhythm . Does shift work impact on mental health ?

Speaker 1 9:50

Yes , most definitely , and of course there's I would explain it like a cascading mechanism behind that . Circadian misalignment alone is very strongly associated with poor mental health , particularly depression and anxiety , and some of the work I've done in non-shift workers but people with circadian rhythm disorders has shown that indeed there is a very strong link between depression and circadian misalignment . But of course , probably key is that circadian misalignment is also really strongly associated with poor sleep and often chronic sleep deprivation , and it's often that can create the poor mental health outcomes as well . In addition to that , shift work itself puts a lot of strain on an individual and their families , and so the timing of when they can do things and having variation in mood often puts that strain , which exacerbates the problems that shift workers experience within their family life , their social life , things like that .

Speaker 2 10:52

You've mentioned that Circadian misalignment . Can you explain to us in layman's terms what actually is circadian misalignment ?

Speaker 1 10:59

Almost every biological process in our body is coordinated by an internal body clock , and that's what we refer to as the circadian clock . The word circadian itself means about a day , and so this circadian clock is responsible for synchronizing all of these biological processes to that approximate 24-hour cycle that we observe in many of our biological processes , but probably most observably the sleep and wake cycle . Sometimes , though , that biological clock becomes misaligned with the external environment . Also , there's internal misalignment between hormone production and other biological processes , and so these processes aren't occurring at a time of day that they should be , and so , essentially , that yeah , misalignment refers to that desynchronization of the biological processes with another external factor , for example with sleep and with shift work . We're sleeping at a time we should be awake , and we're awake at a time we should be sleep , so we're kind of misaligned in that .

Shift Workers and Circadian Rhythm

Speaker 2 12:08

Now , the circadian rhythm is an anticipatory system , isn't it ? So it actually counts on us doing certain things at certain times , is that correct ?

Speaker 1 12:15

So in some ways , our activities so , for example , our light source and when we're seeking light and when we're getting light , our food timing they provide cues to the circadian clock and so , yes , it runs on . Like you imagine , it runs and everything needs to happen , sort of as it did yesterday and I guess anticipatory . Yes , but also those things and activities provide the cues to keep it running on schedule , everybody's travelled .

Speaker 2 12:47

I think the best example of circadian misalignment would without doubt be jet lag , wouldn't it Most ?

Speaker 1 12:52

definitely yes , and in fact oftentimes shift workers describe what feels like jet lag . Unfortunately , for shift workers , it tends to be a more chronic feeling and at times not resolvable , because they are continuing to do basically trans meridian travel without coming anywhere . Thankfully for those of us who travel , we do eventually re-synchronise to our new environment , but that's much more difficult for shift workers who are constantly shifting their timing .

Speaker 2 13:22

Hello shift workers . Afternoon shift , day shift . Night shift , day shift . Your body has absolutely no idea where it's supposed to be at , so it can't keep up . It keeps on adjusting . Are we changing ? No , we're not . Yes , we are . No , we're not . I don't know what to do . What does circadian misalignment look like in a shift worker ?

Speaker 1 13:41

What happens is our body does begin to adapt to shift work .

Speaker 1 13:44

So , for example , if you're doing a night shift and you've done a couple of those in a row , your biological clock , your body clock , will begin to adapt and shift to that . And then where it becomes more problematic is then when we shift back today or running on a more regular schedule , because our body has shifted to that or started to shift to that nighttime , all of those internal processes are sort of being queued to happen at a time that doesn't match with the daytime . So what we see in observing a number of shift workers is and it's somewhat paradoxical , but often times insomnia , because they're trying to sleep at times when their clock is signaling for alertness , and this isn't just when they're on night shift and trying to sleep during the day . It often is worse for the shift worker when they're on their days off , for example , and they're partially adapted to their night shift and then have to revert back to a regular day schedule . But their body is now signaling no , no , we go to sleep much later now because it started shifting around the clock .

Speaker 2 14:52

And then the paradoxical part of that is that they often then they have this insomnia , but then also really excessive daytime sleepiness , where they feel fatigued and not at all alert throughout the day , but then a struggle to sleep at the time that they need to be sleeping From my experience doing a whole week of night shift , we can actually do seven nights , and the first few nights you really struggle to go into the sleep during the day and then , as the week goes by , people will tell you and confirm that they acknowledge that they start to sleep well towards the end of the week , during the day . So it's always bad at the start and there's a logical reason for that is because the circadian rhythm is adjusting that then , after you've done your seven nights and then you come out of that , it is not uncommon for you to be exhausted , go to bed and only sleep for about two hours and once that , homey a step , once that sleep pressure is gone , bang , you're wide awake and you cannot go back to sleep .

Speaker 1 16:46

That's right and that's how it's a parallel with jet lag and that's exactly right , that partial or for some people they almost have full adaptation , depending on the length of their night shifts and how quickly , because everyone is very different in terms of their ability to adapt .

Speaker 1 17:03

Research shows exactly that that the first few nights are more difficult and then the longer it goes , the more you adapt and the easier it becomes to not only sleep during the day but also function at night .

Speaker 1 17:17

For many industries that's critical , that functioning period , because essentially what's happening is that you're working at a time when your body has no signal for alertness . Adaptation is just as critical for that nighttime period when you're working as it is for that period of sleep time as well , because our body and our alertness isn't based just on how tired we are . It's actually also very much associated with your signaling from the circadian clock . And you can be very tired and we've done lots of research on this where we measure people's like reaction times and cognitive function at a time when they've been very much sleep deprived . But it's a time when their body clock is at its highest alerting signal and they perform much better than even though they're sleep deprived , than after sleep , sometimes even having worked night shift not that I've done 38 years straight trust me , I probably would have passed on by now .

Speaker 2 18:15

If that was the case yeah , I was . You look far too healthy for that . So , having done 38 years of night shift and a regular week of night shift , I so relate to exactly . I could strongly support the evidence of it's really hard to go into night shift and then you get into a really nice rhythm and then it's really really hard , and the older you get , the harder it is to actually come out of that night shift . And I think we're starting to experiment with shorter periods of night shift as well now , like doing only the three nights .

Speaker 2 18:45

Or there are agencies and I want to get into the employees here because I want to talk about that . In fact , let's go into that right now , because that's really important . I'm a firm believer and I know you are , because I've heard you say this that shift working environments , their business plan , needs to be stripped right down and it needs to be built coping with a shift working environment and catering to a shift working environment , Because at the moment , shift working environments are actually looking at we've got to provide a 24 hour service , whether it's in health , whether it's in frontline emergency services , whether it's , no matter what it is they're looking at . We have to provide the shifts . There's no thought given to the staff and they're just literally jamming shift workers into their 24 hour clock . But I want to hear your thoughts on it From a research perspective , from a scientific perspective .

Speaker 2 19:34

Businesses need to strip down their business model and start again , don't they ? And they need to build catering for shift workers . When we talk about that , what should we be doing ? Like we can't pander to everybody because we've got a job to do , Otherwise , everyone stays in bed all night and works during the day , and that's it . How does it look ?

Speaker 1 19:52

Absolutely , and I think critical to that is that we will always require shift work at the very minimum . We need our emergency services , our healthcare professionals at the very minimum . I do agree that it needs to be the model for industry shift work . Industry needs to be reviewed and built up around the shift worker . Obviously there is a level of compromise there . We can't do that at the total expense of productivity or revenue income , all of that sort of thing . But most definitely I think and our research shows that with an emphasis on providing support for the shift worker , productivity increases , absentees and decreases all of those sorts of things . So I think where employers need to take a step back and think about it is looking at the initial cost of implementing programs and redesigning their rostering protocols and their thought processes around shift work is minimal and is far outweighed by what they will save in providing a supportive environment for shift workers .

Speaker 2 21:02

We do need to look at this because I know from coaching shift workers off coach shift workers for the last three years , so I've coached shift workers through a pandemic as well . Now you know , because if you're liaising with shift workers , you know that the impact has been enormous on shift workers because they've literally been getting jammed into rosters due to short staff . The problem that we have now is coming out of the pandemic . We are now in a position where shift workers are burnt out and they are totally burnt out . So what's happening is they're now leaving those jobs because they're sick and tired of the excuse of oh , we're short , oh we're short , oh we're short , oh , we need you to fill this shift , oh , we need you to fill this shift .

Speaker 2 21:43

Now , what we have to remember for shift workers as well , and especially in health and frontline emergency services , is they are a particular type of person , and these people are people who only want to help and support each other in their job . So they keep turning up to work , but what they don't realize is they're actually burning themselves out in a massive way and there is no help from the employer for them to cope . And that is what we need to put into place now to stop the hemorrhaging . What are some of the important steps that employers should be taking to literally help their shift working employees in today's day and age , with the hemorrhaging that we've got ?

Speaker 1 22:24

Yeah . So I think and I keep mentioning this but I think one of the most important things is for employers of shift workers to have a good understanding that each individual is very different in their response to shift work and having a really supportive environment around . That is actually really critical to maintaining the health and wellbeing of your staff as a collective , but also the individual members , because as individuals we make up the collective but also increasing your productivity , decreasing absenteeism due to illness that's come about because of , you know , burnout or overworking or just the shift work . I think also they need to focus better on education for shift workers and provide that and not just a token gesture of his leaflet on how to maintain good sleep hygiene At some point .

Speaker 1 23:21

I'd like to steer away from those sort of really important critical industries because we also need to consider

Improving Shift Work Management

Speaker 1 23:27

that there are industries in which people are working shift work , you know production lines working all night in a very mundane , monotonous environment and in some instances that's possibly even harder to maintain good productivity and and not be burnt out because the way it operates and it's mundane , I suppose .

Speaker 1 23:49

But in my initial example about education nurses , for example it's a . It's a field in which it is absolutely guaranteed you will have to do shift work . Police force and paramedics , fire people are the same and for that reason I think it should make up some part of their curriculum or training on the importance of managing that and how to manage it effectively beyond just the simple sleep hygiene practices that they can put into place . And that's not about putting all the onus back on the employee . It is about the employer providing that to some degree . The onus will always be on the individual employee because ultimately they are the ones who have to manage it , but they can most definitely have greater support in that as well , it's a two way street , isn't it ?

Speaker 2 24:40

You can't just hand a leaflet out and say this is how you do shift work , have a 30 minute session on induction and say this is how you do shift work . If you can't do this , princess , then you can just leave , because this is a shift working environment . That's just not good enough in today's day and age , and not only do we need to do it over and over again , but we need to be reinforcing this in the shift working environment , and there is so many . Well , the police and the fire and ambulance and nurses they're all busy , run off their feet , but you can't begin to imagine what the repetitiveness must be like . On an assembly line for 12 hours overnight , picking quality , controlling something off a conveyor belt must drive you absolutely bananas at night and is dangerous because of the potential for you to have an accident because you literally have fallen asleep .

Speaker 1 25:27

And I think sometimes in some ways those industries have probably more rigid structuring around their rostering . For example , we know with nurses that they in a number of different hospitals have self rostering . Seems to be pretty suitable to the vast majority of nurses . Whether they make the best choices , questionable sometimes , but if it helps them maintain their inner well being , mentally especially . But yeah , these other industries often have quite rigid and probably more limited thought to the individual employee . That is a very big generalization , is most definitely not the case across all industries or all environments . But it's probably where it's important to focus on the employer can change their approach to that , a police force in the UK .

Speaker 2 26:21

The boss is known for communicating with people and what he does is he puts the roster up in the wall and he just tells the staff you fill it out . Now they're giving people self efficacy . Now if you were to give us in our working environment self efficacy to fill the roster , every single shift would be filled . I guarantee that . Let's just say for argument sake if I could have Monday , tuesday and Wednesday afternoon and take Thursday and Friday off , I'll come in and work Saturday Sunday morning . Someone goes . I don't want to work Saturday , sunday morning , I'll work the afternoons on those days , but I want Monday and Tuesday off . With self efficacy , you probably would find that the roster would get filled out and the bonus with that is people turn up because they got what they wanted . Now , as you said , they may not make the right choices .

Speaker 1 27:06

I mean that from more of biological and circadian clock . Of course and I guess that comes from every and this is anecdotal from my experience with primarily nurses that you know they usually drive their choices around Okay , what do I want to do for the rest of my week or which days do I want to have off , those sorts of things like . I'll cram all of these shifts into this small period of time , but I think the overall , if it's maintaining a greater level of well-being because they're happier with what they're doing and the choice , and just the yeah , being able to make those autonomous choices , that's potentially balancing out to some degree any poor choices they're making from a biological perspective .

Speaker 2 27:54

Whether it be right or wrong for the employer . If a person is getting what they need , then they are actually turning up . The incidents of unplanned leave start to disappear . And then the increase in productivity , because you've got people on . Not only that , but it takes the pressure off people having phone calls coming in and then having to try and find stuff and jamming people into holes that they didn't want to actually work , but they've done it because they don't want to let the team down and things like that . I've searched for this through my Instagram stories and things like that . I've asked what problems do you actually have ? And they just find that the rostering is the biggest issue , without any doubt whatsoever , because there's no work-life balance and I know it's easy for bosses to turn around and go . If this is a shift working environment , you've got to work to it , but that's actually old school and it's wrong , isn't it ? If you want ?

Speaker 1 28:40

a broad and happy , healthy workforce . Yeah , that's not the most useful and conducive attitude to having that . There are most definitely people who would choose no , I will not do shift work and so therefore will , and that's okay . But for those that have chosen a career path that involves shift work , or for some that possibly don't have a great deal of choice , yeah , the attitude isn't helpful and ultimately doesn't help improve the employer's outcomes either , in terms of productivity and all of those things that come along with , and you know their bottom line .

Speaker 2 29:24

I hope you're enjoying the show . If you are , please don't forget to rate and review once you've finished . This helps the shows reach enormously . And have you got my free ebook the Best Way to Eat on Night Shift ? Well , this is a comprehensive guide to the overnight fast , why we should fast and how to best go about it . I've even included a few recipes to help you . I've put a link to the ebook in the show notes .

Speaker 2 29:50

And are you really struggling with shift work and feel like you're just crawling from one shift to the next ? Well , I've got you . If you would like to work with me , I can coach you to thrive , not just survive , while undertaking the rigors of 24 seven shift work . I also conduct in-house live health and wellbeing seminars where I will come to your workplace and deliver evidence based information to help your wellbeing team to reduce unplanned leave and increase productivity in your workplace . I've put the links in the show notes to everything mentioned . You can find me at ahealthyshiftcom or on Instagram at a underscore healthy , underscore shift .

Speaker 2 30:35

Now let's get back to the show . With the hemorrhaging that we've actually got today , in today's society , that are actually just leaving , my personal opinion is it's not because it's shift work . It's because the way the shift work is actually managed and I'll go on the record quite categorically is saying that there's been lots and lots of recent Research done around what the optimal shift working environment looks like , which I think is important , and it's important for people to look at what's been done . What fatigue detection systems should employers implement now , you know , and how can they do this ?

Speaker 1 31:10

This is where fatigue detection systems can be done really well , but also they are fraught with issues . For that reason and yeah , they really need to be implemented as a broader part of fatigue management , and they're only one part of that fatigue management system . They're good because they can teach the individual to sort of manage their own fitness for duty , and that self-monitoring and so truck drivers often have systems fit in the mining system is an obviously train drivers as well , but it requires careful management of the employer and thought behind . So if we get an alert that someone's tired , what does that mean ? How do we ensure that they then have the rest required

Work Shift Fatigue Detection and Management

Speaker 1 32:02

in a timely fashion in order to maintain our service whilst also ensuring safety of not only the individual but anyone they may be responsible for ? And this is where , in some senses , fatigue management systems or detection systems can be really helpful for capturing data Management , and employers in particular need to think about it in the sense of okay , this helps us determine our pain points .

Speaker 1 32:31

What is it ? Where do we see patterns and why are we seeing this particular pattern on this particular shift across all our drivers or all our miners or whoever ? How can we learn from that ? And so that is probably one of the most useful elements of a fatigue detection or management system . Is that , yeah , the ability to then monitor and adjust shift rotations or shift timing based on the data and the patterns that they see .

Speaker 2 32:58

What does a fatigue detection system look like ? Is it a nap ? Is it people wear wearables ? What is a fatigue detection system ?

Speaker 1 33:06

So I'm not entirely familiar with all of them and I know there's varying types . But , for example , in trucks often it is a system that observes the eyes and counts and I'm not overly familiar with the terminology , but basically looks at the duration of a blink , how many blinks , what's happening with the eyes , essentially , and there's an algorithm that creates a score based up for alertness and once you all fatigue , and once you hit a certain threshold , it considers you to be fatigued .

Speaker 2 33:35

And I'm doing some work with Arcuscope at the moment with Dr Olivia Walsh . It ran their shift app . You could collect data from that that would actually alert an employer . Their person is fatigued , but it's not good enough for them to send a text message and say , hey , you're tired , you need to manage this . They need to look at the pattern of behavior and they need to manage it from their end , don't they ? Hey , hang on , you've still got another two day shifts or another two afternoon shifts coming up . We need to do something about that . We need to chop and change those around , and that's what needs to happen . So , instead of putting it back on the employer and saying , hey , we've alerted you . Now it's up to you , it's your responsibility . It's actually not their responsibility . It's actually up to the employer , under the Oc Health and Safety Act , to actually make sure that they're providing a safe workplace .

Speaker 1 34:20

That's right , and this is where the mining industry handles that really well . They have an alert that someone's fatigued , they will swap people out and with the massive cohort of employees that's easy . But it's also that's where it's fraught , too , that you don't want to deny someone their work and there has to be a way of managing that so that they can maintain their hours that are required of them . And when we think of casual employees , that could become incredibly dangerous to think that , okay , that person can't work , so that's a day of , or their shift that they don't get paid for . So those considerations have to be made as well , and the honest for that is definitely on the employer not the employee .

Speaker 2 35:03

Yeah , I agree , if someone's casual and they're turning up on Wednesday and a fatigue detector goes off , that's where you got to sit down and have a conversation , don't you ? And you got to say to them hang on , like you're only working three days a week here or something like that , you shouldn't be turning up fatigued . But it all comes down again to just conversations , doesn't it ? Because if someone's full time and their roster's all over the place and the fatigue detection system is going off , that's where they've got to sit down and have a conversation and the person the employee goes . Well , hang on a second . This is the shift I've done a late , early , late , early rest , day , night shift , whereas the next person turns around and says well , I've had two days off and now I'm working day shift and I'm getting a fatigue alert . Well , hang on a second . You know it comes down to a conversation . So rostering is a really important part of managing shift work , obviously .

Speaker 1 35:48

Yes , most definitely , and I think and we talked about this before but self rostering there's evidence that that helps improve a number of outcomes for the individual , particularly sleep outcomes , that health and wellbeing outcomes as well , but also then outcomes for the employer as well . You know consideration to the way in which they roster . So backward versus forward rotation of rosters . So a backward rotation would be where they start on night , go to evening and then back to morning , whereas forward starts morning , afternoon , night , days off , for example . So you know , making sure that they're implementing that rather than backward rotation , because we know that outcomes with backward rotation are much poorer .

Speaker 1 36:35

And yeah , like you mentioned before , critical is communication and for an employee being able to come to

Communication and Napping for Shift Workers

Speaker 1 36:41

their employer and say there's something about this isn't working for me .

Speaker 1 36:46

And there is still , I must say , an onus on the shift worker to , cognizant of the fact that they're working shift work and that that doesn't , you know , they can't then work a night shift , stay up to take their kids to school , going at their hair done , sleep for two hours and then expect to go to work and be okay .

Speaker 1 37:04

And but this is where you know regular communication with the employer , so the employer can also be managing that as well and ensuring that their staff and I for want of a better term , I don't want to say are doing the right thing , because they have to do what works for them , but they're aware of what could be driving this fatigue that they might be experiencing on shift work , and helping them guide their employees through that , because oftentimes it might be the case that they're not actually consciously aware that , okay , this choice I made on this day drove me so fatigued and and it can be hard in the moment to see the connection between those sorts of things- I totally , as you know , I'll coach the shift workers , the amount of mothers that will stay up all day , do a night shift , and then they come home and they've got to get their kids ready for school , and then they get the kids ready for school and then they put the kids in the car and drive the kids to school .

Speaker 2 37:59

Now I've got to say and if anybody's listening to this and you're doing this , you are literally playing Russian roulette with your children because , as tight as you feel , your body is literally doing its utmost best to force you to go to sleep and it will sneak up on you without you even realizing and you have every chance of falling asleep at the wheel of the car , doing some serious injury or worse with your children .

Speaker 1 38:22

And it's more than likely that there is mundane drives to school that you do every day , even if it's a short drive that you know there's nothing that keeps you awake Like these are the most dangerous . And we know reaction times are reduced I mean increased significantly when we're tired and you know that child that runs out in front of the car you might be just a little bit quicker than your reaction times in that particular instance . So yeah , yeah .

Speaker 1 38:52

And this is the kind of thing I'm talking about . This is where employers can have productive , constructive conversations and communication with their employees in a non-judgmental way , and that's the critical part , because , in so many instances , probably most of those mothers doing that feel there is no other option . Sometimes , though , having a conversation even if the employer isn't providing the actual answer or the solution talking it through may help that individual discover a better solution to that , or a combined solution to their shift rostering , for example , but yeah , nonetheless communication is key .

Speaker 2 39:30

You've got to ask yourself whether the roster man knows that Karen is actually doing this . Does he even care ? He should care . Right , don't get me wrong . But those conversations are conversations that need to be going on in the workplace . You can't just tick a box and say I've had a conversation , because you'll find that whoever's riding the rosters in hospitals or police or paramedics , I'll guarantee to you the person that's riding the roster has absolutely no idea what's going on in Karen's personal life . To know what she's actually doing . It's just an expectation that you have to turn up at this time , do this shift and you must be your optimal .

Speaker 1 40:07

And , in fairness to the rostering person , it is hard to know all of that if they're not having that communicated or don't have the opportunity and they are simply just trying to fill in . You know , we need all of these discovered it would . I don't envy a rosterer's job at all . I think it would be awful . But , yes , at the same time they need to be thinking yeah , and that's where the environment needs to be created , that the roster is to some degree . Obviously , not everything can be always taken into account . That's , you know , not possible . And that's where a little bit of compromise comes back and forth .

Speaker 2 40:44

That there it's important conversation to have from the employee to the employer . But by the same token , it's important for the employee to provide the education and training to the shift worker around the way to optimize everything as well . And you know , that's where I'm pushing my own boat here . But that's where someone who's done the shift work , that is researching it , that knows and providing podcasts and having guests like you on so that people understand the dangers of what they're actually doing outside and the risks that they're taking and also how they can optimize . And I want to talk about the next way to optimize is you know what is scheduled napping and how can that be useful ? Should an employer provide time for scheduled napping ?

Speaker 1 41:26

Hi .

Speaker 1 41:26

This is probably one of the ones that I'm actually the firmest on , and I believe that in almost every environment , scheduled napping should be available for those who wish to .

Speaker 1 41:37

We know the benefits of a 15 to 20 minute power nap and we know how much that improves fatigue levels , alertness levels . So scheduled napping is where an employee is given an opportunity in a night shift to have a nap . It can go beyond that too with scheduled napping for sleeping during the day to mitigate the effects of the upcoming shift work as well . But from an employer point of view , I think it's critical that every employee is provided an opportunity and a spot , a place within the workplace where they can have the opportunity to nap . They don't have to if they don't want to , if they don't feel they need to , and I think there needs to be good education around it too , so that you know they're not sleeping for an hour where that will actually make them feel worse , all of those sorts of things . But yes , I'm quite firm on the belief that I do feel like shift workers should all be given the opportunity to take a scheduled nap during their night shift in particular .

Speaker 2 42:38

High five to that one , jade . I've got it all over my Instagram the importance of the nap and how important a nap is ,

Importance of Napping and Managing Fatigue

Speaker 2 42:45

and for people like going into night shift to still get up early on the day and then go through the day and then have a nap before they go into work . And we talk about napping for like 20 to 25 minutes maximum , because what it does is before you end up going into that next phase of sleep and you end up with that sleep inertia because a lot of people say to me oh no , I can't nap because I wake up feeling awful , you've slept too long . You've slept too long . That's the problem .

Speaker 1 43:12

Yeah , even anecdotally from myself , when I've had a brief nap , that a nice little 15 minute nap , that inertia , that you feel that sick , almost hungover feeling just doesn't exist with a short 15 to 20 minute power nap and you do feel much more refreshed .

Speaker 2 43:29

I've actually talked about the caffeine power nap as well , which is always a very , very interesting theory . But if you're on night shift obviously now I'm pushing people to say , look , don't nap with caffeine on night shift I always say , don't do that . But the caffeine power nap , you know , you slam the long black , have your sleep , let it flush the adenosine out . The caffeine goes in , bang and away you go . You wake up feeling a million dollars . I get nurses , I get shift workers telling me when they're driving home from work that they literally got all the windows down , they've got the music blaring , because they're scared that they're going to fall asleep because they're that tired . And I think , oh my God , pull over and have a 15 minute nap and then get going and the good 15 minute nap .

Speaker 1 44:10

Critical to that is that a 15 minute nap won't significantly decrease that pressure . It decreases it enough to sort of continue functioning , but it won't decrease it so much that you then can't fall asleep when you want to , and that's what's also critical about that . So if you are driving home and you have a quick 15 minute power nap , that will get you through your drive safely and the rest of us on the road but also won't be such that you then can't fall asleep when you get home as well , and for the mothers that then might stay up and see their kids off to school or whatever , it helps get them through that , probably with a lot less yelling than might have occurred if you haven't nap and then you'll still be able to go home and go to sleep .

Speaker 2 44:54

What we're basically saying here just to back over that is literally a 15 to 20 minute power nap during your shift could literally be a game changer for you . Not literally , it will literally because it just takes a little bit of sleep pressure off . It will leave you quite lucid so that you don't end up with that sleep inertia , which is that hungover feeling , and then you will still sleep properly when you get home . But that safety it's just done for safety and it's really important in internals like call centers and media centers and places like that . Can employers help manage fatigue using light ?

Speaker 1 45:28

Yes , most definitely so , and I spoke about this earlier that we have a number of cues to our circadian clocks that help regulate it to the 24 hour solar day . Light is the strongest of those , all of those cues . Light is what maintains our synchronicity with the 24 hour solar day . And so light , particularly blue light , blue enriched light , has an alerting effect and it acts on our circadian clock to sort of suppress that fatigue system , which in turn enhances our alertness . It also has the impact of suppressing .

Speaker 1 46:09

Light suppresses a hormone , melatonin . So our body , our circadian clock , is responsible for driving the timing of that hormone release and light can suppress that . So we often use light as an effective way of adjusting someone's body clock as well and shifting the timing of the body clock by shifting the timing when melatonin is secreted and released by the body . That's too much to go into here today . But they can change the lighting across the course of a shift so that it's bright and blue at the start and for the most duration of the shift , and then start winding it back towards the end of the shift so that they're not then wired to go home , but enough so that they're still okay to drive home . But yes , lighting in a big and factories and things like that , that sort of thing is one of the ways in which employers can help that overall fatigue .

Speaker 2 47:03

I think that makes perfect sense because in 2023 , that could literally be automated , can't it ? It could literally just be automated . So , for the night shift coming in at , say , 7pm or 11pm or something like that , that you could have the brightest light and as it goes through the shift , you could almost have it at 10,000 likes and then have it going down as the shift goes on , because you're actually telling the body that we're getting closer to the end as well . So we could automate that and then , on the day shift as well , have that real blast of bright light to start off with , and then that gradually stages out literally just like the Sundays every day comes up , it's bright , bright all day , and then it starts to get darker during the night .

Speaker 2 47:46

I'm also pushing at the moment the sky before screen and the light to get the light first up , to suppress everything and get you going . And , of course , because here in Australia we're going into our winter soon and it's going to start getting dark , and it's already started getting darker in the morning . So I have myself my sad light , which I'm going to start pushing out as well , for people to get that light as well . That's another way that employers can really help their staff inadvertently . It's not even a direct , it's just by the lighting and people might go oh , but the light's too bright . You know what this is beneficial ? This is research . This is how it should be , and it's really really important that we have this light at this level . Yes , that's right .

Speaker 1 48:26

Yeah , there's also ways in which the employees themselves and this would be beneficial from an education point of view for employees to give this information . You know lighting setups in their own home so you know when they return they want to return home to a reasonably dark house with no blue and rich lights . You can still maintain enough lighting for the rest of the family to be able to do what they need to do , but so that it's a reasonably dark environment for you , or at the very least not too blue and rich . And then at night you know for them to have lighting that before they leave for their shift is starting to ramp up . So they're the kinds of things that employees could also have information and education about and I would argue , in an ideal world they could even provide some some light bulbs and stuff like there's lots of options for light bulbs that change colors at various , like you can switch them to their brighter , all of those sorts of things to help them manage it themselves at home as well .

Speaker 2 49:27

Wi-Fi lights . I mean , honestly , you've only got to be able to tell Google what time you want it to start getting broader or what time you want it to start getting darker , and it will literally do that for you . Not hard , but , once again , jade , that comes down to having someone , because , let's face it , organizations don't have time to be educating , but they can certainly employ people , hello , to come in and teach them these things . That staff will actually do that themselves , because the one thing that I have definitely learned , without any doubt whatsoever , is Shift workers have no idea what is right , what they should be doing and what they should not be doing . So is there help available for shift workers to manage their slave , and how can employers provide this support to them ?

Speaker 1 50:09

So absolutely , I think well yourself , but also , I think a lot of shift workers don't understand that , and it is a shift that needs to happen . But there are sleep physicians who are trained to help guide shift workers . You know , visiting your GP and discussing it with them . If you are firm about the fact that you don't want to rely on particular medications as a pen , anything like that , to manage it , most definitely you can be referred to a sleep physician , to a sleep clinic , and they're becoming a more common , commonly seen thing . I think people are becoming a little bit more aware of them as well . It's critical that shift workers know that , that there are support systems available to them Seeing a coach like yourself , for example , because managing every part of shift work will help with managing sleep throughout shift work as well .

Speaker 2 51:07

Yeah , because it is the king , isn't it Slope ?

Speaker 1 51:09

Going back to the how can employers provide this support ?

Speaker 1 51:12

I think all shift worker employers should have a list of local sleep physicians , doctors who are on board with referring to those physicians and in their training for the job and acknowledgement that that is available and that it's .

Speaker 1 51:31

You know it can be used as something , a preventative measure . Even go and see a sleep physician before you start shift work and learn good management , effective management of your sleep and every element of that . Because , just quickly going back to what you were saying before , shift workers not knowing is that I think they find something that just works , even if it's not the best , and they cling to it because anything that changes could be worse and no shift worker wants to risk it being worse , and so they will cling to whatever they're doing , even if it's only just minimally effective , because they're too afraid to change things . And that's where seeing a sleep physician or a coach or someone like that can help guide them into more effective management . The best thing to know is that it just doesn't have to be as bad as what it is . It will never be perfect , but it doesn't have to be awful .

Speaker 2 52:29

An excellent way to wrap it up . It doesn't have to be bad , like it really doesn't . There's so many people that are out there that are begging to help you with so many ways of going about doing things , and I think that's such an important point to finish up on for us . Jade , that's been amazing . So much good information here . Now , where can people find you if they would like to read up on your research and some more information ?

Speaker 1 52:53

So I am at Monash . So if you just Google Jade Murray , monash University , you will find me on the link there .

Speaker 2 53:02

I've got your links that you've sent through to me before that I'll put into the show notes as well for people to go and have a look at what you're doing and your research , which will be really , really good . And , jade , I have a closing question that I have to ask every single person that comes onto this podcast , which is my novelty closing question . I've just won mega billions of dollars and because you've been a guest on my podcast , I'm quite happy to buy or build you a holiday house anywhere in the world as a thank you Right . The condition is you've got to live in it for six months of the year . Where do you want me to build it ?

Speaker 1 53:36

Firstly , I'm really intrigued by this question and that this is your closer question . I'm really intrigued why ? But also I really don't know that I can answer it , because there are just so many amazing places , and even right here in Australia . Even I love where I even live , but I do have some criteria . So that would have to be somewhere warm , somewhere where you could swim , quiet and picturesque , and I'd like my house to be in the treetops , with mostly walls made of glass , probably . I'm sorry I can't give you a specific location , but who's my criteria ? If you find something that fits that criteria , I'm there .

Speaker 2 54:17

I've got all this money now . I'll just use it and find somewhere in that . I'll just tell you where you're going for six months of the year and you'll just have to suck it up and go . I think that's the most important thing . I just want to say again thank you so much for giving up your valuable time and thank

Support and Research for Shift Workers

Speaker 2 54:30

you for the work that you actually do to help us pull shift workers get through .

Speaker 1 54:34

My absolute pleasure . Thank you so very much for having me . It's been really nice to have this chat with you .

Speaker 2 54:40

And there you go . What did I tell you ? I told you you'd have to strap yourself in for that one . Isn't Dr Jade Murray and her team doing fantastic work for us , the shift worker ? I think it's really , really important that you , the shift worker , get to understand that there are literally hundreds of people out there that have got your back , that are literally doing research in these areas , and they're going to be putting more and more and more pressure on the employer to start stripping down their business models and making a massive difference to you , the shift worker , in fatigue management and making it more viable for you to work the shift work .

Speaker 2 55:19

Now , if you've got any value out of that podcast , I ask that you please share it with your colleagues and friends . We really have got your back with this one , so I really do ask that you share it with your colleagues friends , tell your friends , tell your family , tell anybody that's going to listen to it , and also , if you'd be so kind to give it a rating and or a review , I'd be ever so grateful . I'll catch you on the next one . I'll catch you on the next one .