Back to Browse Journals » Nature and Science of Sleep » Volume 4

Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment

Authors Smith MR, Eastman CI

Published Date September 2012 Volume 2012:4 Pages 111—132

DOI http://dx.doi.org/10.2147/NSS.S10372

Received 13 July 2012, Accepted 21 August 2012, Published 27 September 2012

Mark R Smith, Charmane I Eastman

Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL, USA

Abstract: There are three mechanisms that may contribute to the health, performance, and safety problems associated with night-shift work: (1) circadian misalignment between the internal circadian clock and activities such as work, sleep, and eating, (2) chronic, partial sleep deprivation, and (3) melatonin suppression by light at night. The typical countermeasures, such as caffeine, naps, and melatonin (for its sleep-promoting effect), along with education about sleep and circadian rhythms, are the components of most fatigue risk-management plans. We contend that these, while better than nothing, are not enough because they do not address the underlying cause of the problems, which is circadian misalignment. We explain how to reset (phase-shift) the circadian clock to partially align with the night-work, day-sleep schedule, and thus reduce circadian misalignment while preserving sleep and functioning on days off. This involves controlling light and dark using outdoor light exposure, sunglasses, sleep in the dark, and a little bright light during night work. We present a diagram of a sleep-and-light schedule to reduce circadian misalignment in permanent night work, or a rotation between evenings and nights, and give practical advice on how to implement this type of plan.

Keywords: circadian rhythms, night work, bright light, phase-shifting, sleep, melatonin

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

Linertová R, Abreu-González R, García-Pérez L, Alonso-Plasencia M, Cordovés-Dorta LM, Abreu-Reyes JA, Serrano-Aguilar P

Clinical Ophthalmology 2014, 8:1515-1522

Published Date: 14 August 2014

Zerumbone-loaded nanostructured lipid carriers: preparation, characterization, and antileukemic effect

Rahman HS, Rasedee A, How CW, Abdul AB, Zeenathul NA, Othman HH, Saeed MI, Yeap SK

International Journal of Nanomedicine 2013, 8:2769-2781

Published Date: 2 August 2013

Enhanced in vivo osteogenesis by nanocarrier-fused bone morphogenetic protein-4

Shiozaki Y, Kitajima T, Mazaki T, Yoshida A, Tanaka M, Umezawa A, Nakamura M, Yoshida Y, Ito Y, Ozaki T, Matsukawa A

International Journal of Nanomedicine 2013, 8:1349-1360

Published Date: 9 April 2013

Hepatocyte-targeting gene transfer mediated by galactosylated poly(ethylene glycol)- graft-polyethylenimine derivative

Wang YQ, Su J, Cai WW, Lu P, Yuan LF, Jin T, Chen SY, Sheng J

Drug Design, Development and Therapy 2013, 7:211-221

Published Date: 26 March 2013

Is Duane retraction syndrome part of the VACTERL association?

Akar S, Gokyigit B, Kavadarli I, Demirok A

Clinical Ophthalmology 2013, 7:581-585

Published Date: 20 March 2013

Clinical and histomorphometrical study on titanium dioxide-coated external fixation pins

Koseki H, Asahara T, Shida T, Yoda I, Horiuchi H, Baba K, Osaki M

International Journal of Nanomedicine 2013, 8:593-599

Published Date: 5 February 2013

Biocompatibility of magnetic Fe3O4 nanoparticles and their cytotoxic effect on MCF-7 cells

Chen DZ, Tang QS, Li XD, Zhou XJ, Zang J, Xue WQ, Xiang JY, Guo CQ

International Journal of Nanomedicine 2012, 7:4973-4982

Published Date: 14 September 2012

Delivery of a transforming growth factor β-1 plasmid to mesenchymal stem cells via cationized Pleurotus eryngii polysaccharide nanoparticles

Deng WW, Cao X, Wang M, Qu R, Su WY, Yang Y, Wei YW, Xu XM, Yu JN

International Journal of Nanomedicine 2012, 7:1297-1311

Published Date: 14 March 2012

Tolerability of NGX-4010, a capsaicin 8% patch for peripheral neuropathic pain

Peppin JF, Majors K, Webster LR, Simpson DM, Tobias JK, Vanhove GF

Journal of Pain Research 2011, 4:385-392

Published Date: 14 November 2011

Ciclesonide: a safe and effective inhaled corticosteroid for the treatment of asthma

Timothy J Schaffner, David P Skoner

Journal of Asthma and Allergy 2009, 2:25-32

Published Date: 25 February 2009