Improving Sleep for Shift Workers

Speaker 1 0:00

You've come out of a run of shifts and you finally get to bed . You sleep for a few hours and the next minute you're staring at the ceiling and you're wide awake . In today's episode , which is part one of a three part espresso series , we will discuss why this happens . 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 . Welcome to a healthy shift podcast , where we discuss evidence based strategies for improving sleep and overall well being , especially for you , shift workers . I'm your host , roger Sutherland , and it gives me absolute great pleasure to welcome you to the episode of the podcast , and thank you so much to each and every one of you who are out there listening , either on your walk or on your commute to work or back . I appreciate you .

Speaker 1 1:30

Now , in today's episode , I'm going to focus on a common sleep problem , which is waking up in the middle of the night . And did you know that about a third of the people experience nighttime waking at least three times a week ? It is a prevalent issue that can significantly impact our quality of sleep . Now I want you to be aware it is perfectly natural for us to stir or to even wake between cycles of sleep . It's just that we generally don't remember it because we go straight back to sleep . Now we have a circadian rhythm , but we also have what is called an ultradian rhythm . Now our ultradian rhythm runs approximately 90 minutes , a 90 minute cycles repeatedly every 24 hour cycle . So it's going 90 , 90 , 90 , 90 . And different things occur within our circadian rhythm , within that ultradian rhythm as well . I hope I didn't confuse you with that , but anyway , that's what it actually does . So while we're sleeping , we are actually sleeping in 90 minute cycles when we go from one phase of sleep to the next . Now we've all heard of REM sleep and we've heard of deep sleep and things like that . So it's important to remember that they are generally 90 minute cycles , and it is for this reason that I recommend that you nap for 90 minutes up to 30 minutes or 90 minutes , and the reason for this is because you are waking yourself as you go from one cycle into the next , where we are at the lightest sleep between Now when we totally wake up .

Speaker 1 3:12

There could be any number of reasons , so let's go into some of them . Firstly , it's important to note that repeated late night awakenings can indicate a health issue , or they may be due to lifestyle factors . So let's go into some of the health issues as reasons to start with . So I'm going to start at the very top with the most significant sleep issue which affects us as shift workers . Now shift work sleep disorder . Now , this is important for you to understand .

Speaker 1 3:43

Shift work sleep disorder , which is SWSD , is a circadian rhythm sleep disorder that occurs when your work schedule is outside of the typical 9 to 5 day . Hello , shift workers . Now , this leads to a misalignment between your natural circadian rhythm and your work hours , and this misalignment can result in great difficulty in falling asleep , in staying asleep or getting that restorative sleep that is so important to us in the time that we do get to sleep . Now , the incidence of shift work sleep disorder among shift workers can vary depending on the specific population and also it's very dependent on the nature of your work schedule . Now , research suggests that shift work sleep disorder is a prevalent issue among individuals engaged in shift work , with estimates indicating that anywhere from 10 to 40 percent of shift workers may experience symptoms consistent with shift work sleep disorder at some stage in their shift working life .

Speaker 1 4:50

Now , what sort of factors influence shift work sleep disorder ? First of all , the type of shift work . Now , different types of shift work , such as night shifts , rotating shifts or irregular schedules , can impact the prevalence of shift work sleep disorder . Night shift workers in particular will be more susceptible to shift work sleep disorder , which is literally due to the complete desynchronization of your circadian rhythm . Number two , the duration and frequency of shifts . Now , longer or more frequent shifts , as well as regular shift patterns , may increase the likelihood of you experiencing shift work sleep disorder . And number three , individual susceptibility . Some individuals are more vulnerable to the effects of shift work on their sleep and circadian rhythm , which lead to a high incidence of shift work sleep disorder in certain populations . And , as we know , everyone's got someone at work that seems to just absolutely dominate night shift and they sleep well and they come to work and they're up and about and buzzing , whereas others literally do not cope with shift work or night shift in any way whatsoever . We are all very , very different . Now , occupational factors is my number four , and that is the specific demand and the stresses which are associated with their different types of shift work , as well as the availability of accommodations and support for shift workers , can also influence the prevalence of shift work sleep disorder within a particular workforce . Do you have restrooms ? That can be a significant help , and also being afforded the opportunity to have sufficient breaks between shifts will help . So , overall , shift work sleep disorder is recognized as a significant concern for our shift working community , which impacts on sleep quality , overall health as well as our job performance , and addressing shift work sleep disorder through tailored interventions and also through sleep programs is essential for promoting the well-being and productivity of individuals which are engaged in shift work .

Understanding Sleep Disorders and Solutions

Speaker 1 7:02

Now , the key characteristics of shift work sleep disorder include insomnia . So individuals with shift work sleep disorder often struggle with insomnia . They find it very challenging to get to sleep , to maintain sleep or to wake up feeling that they've had restorative , good restorative sleep , and they can't go to sleep in the designated or allocated sleep time . Number two is excessive sleepiness , despite the attempt to sleep during our non-traditional hours . Individuals with shift work sleep disorder may also experience excessive sleepiness or difficulty staying awake during their work shift , so we can't sleep when we get the chance to sleep , but then we can't stay awake when we're meant to be at work , and that is a classic sign of shift work sleep disorder . We have impaired functioning . The sleep disruption associated with shift work sleep disorder can lead to impaired cognitive function , mood disturbances , and can also reduce the ability for us to perform daily tasks effectively , not only at work , but also in our personal life as well . It is chronic . Shift work sleep disorder is considered a chronic condition when the symptoms persist for at least three months and are not solely explained by other sleep disorders , medical conditions or our own self-sabotaging lifestyle factors . It is important to note that shift work sleep disorder is particularly relevant for individuals engaged in shift work , such as night shifts or rotating shifts , where the timing of work hours varies and conflicts with our own body's natural circadian rhythm . And addressing shift work sleep disorder often involves a combination of lifestyle adjustments , a solid sleep hygiene practice , and in some cases we may need a medical intervention to help us to adapt to our non-traditional work schedule and improve overall sleep quality , so that in itself is just shift work sleep disorder .

Speaker 1 9:04

Insomnia is another one . Now let's just define insomnia . You don't have an insomnia if you just can't go to sleep one night . That can be any number of reasons , but the definition and the symptom of insomnia insomnia is a sleep disorder which is characterized by persistent difficulty falling asleep , staying asleep or experiencing non-restorative sleep , despite adequate opportunity for sleep . Individuals with insomnia often report that they have a dissatisfaction with the quality or the quantity of their sleep , which can lead to daytime-impaired incognitive function , our moods or our overall well-being . And insomnia can occur on its own or coexist with other medical conditions , psychiatric disorders or , in particular , lifestyle factors . And we talk about alcohol , caffeine , nicotine , blue light exposure and things like that when we talk about lifestyle factors . And it can be classified as acute , short-term or chronic for long-term based on the duration of the symptoms . Now I'm not gonna go deeply into insomnia , because it's an extremely complicated condition , but I just wanted to make it clear that just because you're up for one night doesn't mean that you're suffering from insomnia . It could just literally be a lifestyle factor that's occurred during that day . But what is important is that we incorporate tips for improving our sleep hygiene and developing a regular bedtime routine , and more on that in the next podcast episode on how to wake up less frequency , and then the next one , which will be how to go back to sleep Now .

Speaker 1 10:39

Mental health conditions . There's a connection between mental health conditions like anxiety or depression and PTSD , and bipolar disorder and fragmented sleep . These are all related . The impact of stress on our sleep quality and strategies for stress management are really really important . It's vital that we don't try and go to sleep while we are in a sympathetic state . If we do , we will wake up , and that is a problem . It can be as simple as something that is very stressful that is causing us to wake up . More on that in the next episode as well . But we need to manage our light exposure and we need to reduce electronic device use so that it can benefit with us with our sleep hygiene . And I'm not even talking blue light here . I'm actually talking about the content that you're exposing yourself to from your mobile phone . That can impact severely on our mental health as we're looking at our fitsposes , our bodies , our friends off enjoying holidays while we're on night shift , things like that .

Speaker 1 11:44

Now , sleep apnea is also another reason what is sleep apnea and how does it affect our sleep ? Now , sleep apnea is a severe condition that will be diagnosed by doctor as well , and we need that to be diagnosed by a doctor and to help us . There are treatment options for sleep apnea , which include lifestyle changes and a continuous positive airway pressure , which is like CPAP therapy . We need to incorporate the tips for our weight management , alcohol management and caffeine intake to minimize our sleep disruptions , which will cause sleep apnea in itself . The next one will be restless leak syndrome and periodic limb movement disorder annoying . A lot of females will suffer from restless leak syndrome and it's not even known why . And periodic limb movement disorder . Now , this can be where your legs just twitch or you can't keep your legs still , and it's really , really annoying . I have heard people that have used magnesium to help them in relation to this and get great success with using magnesium . And make sure that you're getting the right magnesium for your condition , and this is something that you would discuss with your physician .

Speaker 1 13:53

It's also extremely important that we reduce fluid intake before bedtime to minimize that nighttime waking for restless leaks as well . And here's another one nocturia and you're probably not aware of what nocturia is , but nocturia is actually the condition where you have frequent nighttime or sleep time urination . It's known as nocturia , and what we can do is we can make lifestyle changes and you can also speak to your physician around this and for a medical intervention which will address nocturia for you . It is incredibly annoying having to continually get up and urinate , so we need to be really careful , incorporating tips for adjusting our nap schedule and avoiding large meals and fluid before we go to bed . That can help to reduce nocturia .

Speaker 1 14:39

Poor sleep hygiene is something that is . It's something that I'm a massive advocate for a good , solid sleep hygiene . Now , sleep hygiene is a routine for us as we're going to sleep . It's a routine that we go through every single time that we're going to sleep and by doing that , we are actually programming our body in a routine that this is what we do to go to sleep . We stop looking at the phone , we stop looking at electric devices . We don't have the TV on in the bedroom . We put the white noise on . We take our face creams off . We put our or take our makeup off , put our face creams on , spray our pillow with lavender , climb into bed , do some deep breathing . All of this is part of a routine that teaches our body that this is what we're doing . We are actually going to sleep Because , coming home from a stressful shift , listening to doof-doof music , walking into the house with all the lights on , turning the light on in the bathroom , cleaning our teeth in the brightest light in the house , and then climbing into bed and scrolling our phone , and then rolling over and can't work out while we can't go back to sleep .

Speaker 1 15:48

Have a think about that one , because this is one of the main reasons why people really struggle to get to sleep and stay asleep . There is no doubt in relation to this at all and shift workers this one here is the odd sleeping schedule . The challenges that we face as shift workers and individuals with irregular sleep schedules are just insane . Now , what we need to do is I understand that on night shift , we can't maintain a regular sleep schedule . We also can't when we're flicking from afternoon shifts to day shifts or we're doing disco shifts or quick changeovers or swing shifts , etc . This is one of the things that causes us massive problems . But what we can do is we can try and stay as regular as we possibly can by going to bed within a few hours of the time we normally would and getting up within a few hours of the time we normally would .

Speaker 1 16:41

If you've done two or three day shifts and then you do an afternoon shift and then you decide that what you're going to do is have a sleep in that day ,

Optimizing Sleep for Shift Workers

Speaker 1 16:48

I need you to understand you will not catch up on that sleep . What you're doing is you are further compromising your circadian rhythm by staying in bed , get up early , get on with the day , have yourself a nap between 12 and 2 for 30 minutes , just to release a sleep pressure and stay in sync with your natural day and night circadian rhythm , and this is what is literally going to help you to thrive and not just survive . This is one of the biggest self-sabotaging things that I see shift workers doing , and what they do is they do these few day shifts , then they get an afternoon shift and then they have some days off and they decide that they're going to sleep in until 9 or 10 o'clock on those days off to catch up on sleep . And you don't catch up on sleep . You further compromise your circadian rhythm and I need to make that really , really clear to you Now .

Speaker 1 17:41

Age and physical conditions the changes in our sleep patterns and sleep wake cycles as we age also changes . It is common that from the time that we are about 10 to 12 years of age , right the way through until we are in our late 40s , that we tend to be what is known as a night owl , which means we go to bed later and we get up later . But as we get older , so we start to change into what's known as a morning luck , where we get up earlier and we go to sleep earlier . If I had a look at your parents or your grandparents , this is what actually happens and it's a natural evolution of our species that we actually do this . All right , so what we need to do is we need to work in with what our circadian rhythm is . You don't try and force yourself to go to bed early if you are a night owl , you try and stick with much of the same schedule . But as we get older , so we do start to go to bed earlier and want to get up earlier and get on with the day , and I would argue we get smarter and we can get up and get on with the day , pure and simple , most productive in the morning . But the most important thing is we need to keep it regular , because the more regular it is , the more you will actually thrive . And also , we also have different conditions as we age as well . Trust me , I know Chronic pain , acid reflux . We have neurological disorders on sleep . We need to address these things , but these things are addressed through doctors , but this is the sort of thing that will impact us on our sleep as we age . Okay , so that just about wraps this one up .

Speaker 1 19:27

In conclusion , let's just go over briefly the things that we have . I've discussed shift work sleep disorder . This is the one that mainly affects us . Insomnia I just touch on insomnia . I don't go into great detail in insomnia because it's a very complicated issue and it's something that I'm not even qualified to really go into what insomnia is . But I know that a good physician will actually refer you onto a sleep specialist or even a psychologist where they can do competency-based therapy for insomnia , which can really really help .

Speaker 1 20:05

Now the next one was mental health conditions . Mental health conditions if you've ever noticed with your physician if you are suffering from PTSD , anxiety or depression , one of the first questions they will ask you is what's your sleep like ? And there's a reason for that because there's a bilateral access in relation to this . Mental health impacts on sleep . Sleep impacts on our mental health in a massive big way , so we have to make sure that we've got that covered . Sleep apnea is also something that I don't fully understand , which is why I literally just touched on that . Restless legs can be sorted with something like magnesium to relax the muscle . There's no direct link between magnesium and sleep , but if magnesium helps to rest your legs , then let's go with that , because that will help to improve your sleep as well . So that's another way .

Speaker 1 20:56

We talked about nocturia , which is something that you can see a doctor about , which is , you know , our frequent urination overnight , which can be a problem , and our sleep hygiene , our odd sleeping schedule and just the age , all right . So what I want to do is I really do encourage listeners to assess their own sleep pattern . Have a look at your own sleep pattern and , armed with the knowledge that I've just given you , consider seeking professional help if you're experiencing chronic sleep disturbances . If you believe you are ticking all the boxes , then it's really , really important that you go and see a physician in relation to it , and a reminder to prioritise your sleep hygiene and adopt healthy sleep habits , because this is literally what will help you to achieve much better sleep , which , in effect , will bring you a much better overall well-being . And , most importantly , if you are suffering from sleep issues , then your first stop must be your physician . Don't go and ask Jenny at the office what she takes , because Jenny is making a huge mistake and , instead of accepting a prescription of a sleep medication from your doctor , I highly suggest that your first protocol would be to seek a referral and go and see a sleep specialist to work with you personally on your issue .

Speaker 1 22:21

In Australia here , we can actually get that on a health plan , which means it will cost you nothing to do so . Go and have a chat with your physician and don't let him just write it off as oh , that's what you get for shift work , because that's not the case . It is something that you can literally go and speak to a sleep specialist about . And how's that ? Because there's a lot of people that do do really really well on shift work and sleep All right . So thanks for tuning into this episode of a healthy shift and don't forget you must make sure you subscribe or hit that follow button for more tips on improving your sleep and thriving in your daily life , especially as a shift worker , and that's what this podcast is all about . Now , my next episode will be on how to wake up less frequently when you're a shift worker . It's so frustrating , isn't it ? So make sure that you hit the follow button and turn on your notifications so that you get notified when that new episode drops . And that's a wrap for today . So if you've got anything out of that , please make sure you rate and review . There's two more episodes to come , folks , which is how to wake up less frequently and then how to go back to sleep .

Speaker 1 23:38

Fellow shift workers , your health , and in particular , your physical health , is a non-negotiable . It's a foundation that allows you to excel in your career and enjoy life beyond the workplace . Remember , this is about having more energy to do the things that you love outside of your shift working life , and by taking these evidence-based steps , you won't just be surviving , you will be thriving . Keep pushing forward and remember I'm here to support you every step of the way . Stay committed to prioritizing your body and prioritizing your well-being and , as always , please remember to be patient and kind to yourself as you navigate the challenges of shift work and prioritize your mental health and well-being . Thank you for listening . If you enjoyed this episode , be sure to subscribe so you get notified whenever a new episode is released . It would also be ever so helpful if you could leave a rating and review on the app you're currently listening on . If you want to know more about me or work with me , you can go to a healthyshiftcom . I'll catch you on the next one .