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:

Pharmacokinetics and pharmacodynamics of acetylsalicylic acid after intravenous and oral administration to healthy volunteers

Nagelschmitz J, Blunck M, Kraetzschmar J, Ludwig M, Wensing G, Hohlfeld T

Clinical Pharmacology: Advances and Applications 2014, 6:51-59

Published Date: 19 March 2014

Population pharmacokinetics of olprinone in healthy male volunteers

Kunisawa T, Kasai H, Suda M, Yoshimura M, Sugawara A, Izumi Y, Iida T, Kurosawa A, Iwasaki H

Clinical Pharmacology: Advances and Applications 2014, 6:43-50

Published Date: 4 March 2014

Association between sleep disorders, obesity, and exercise: a review

Hargens TA, Kaleth AS, Edwards ES, Butner KL

Nature and Science of Sleep 2013, 5:27-35

Published Date: 1 March 2013

The periodicity of sleep duration – an infradian rhythm in spontaneous living

Wong SN, Halaki M, Chow CM

Nature and Science of Sleep 2013, 5:1-6

Published Date: 18 January 2013

Impact of lifestyle and technology developments on sleep

Shochat T

Nature and Science of Sleep 2012, 4:19-31

Published Date: 6 March 2012

Detemir as a once-daily basal insulin in type 2 diabetes

Nelson SE

Clinical Pharmacology: Advances and Applications 2011, 3:27-37

Published Date: 18 August 2011