Practical Tips for managing health, safety, and performance during shift work


Nature of Science and Sleep, published by Dove Medical Press, calls particular attention to one of its recently published articles: “Shift Work: Health, Performance and Safety Problems,Traditional Countermeasures and Innovative Management Strategies to Reduce Circadian Misalignment.”

There are three mechanisms which 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

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.

The authors of this medical analysis 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.

The authors 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.

The authors 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.

"Drs. Smith and Eastman are to be congratulated on an excellent review of the important topic of shift work in relation to health, safety and performance. Moreover, they have a number of very insightful comments and thoughtful practical tips for managing shiftwork and circadian misalignment. This strategic approach has not been done so comprehensively or so well in the past," says Dr. Steven A Shea, Editor-in-Chief, Nature of Science and Sleep.

Authors Dr. Mark R. Smith and Dr. Charmane Eastmane began their written observations while at the Biological Rhythms Research Laboratory at Rush University Medical Center in Chicago, IL, USA. Dr. Eastman is a Professor in the Behavioral Sciences Department and Director of the Biological Rhythms Research Lab, and received the 2012 Excellence in Applied Circadian Rhythm Research Award from the National Sleep Foundation. Dr. Eastmane has been doing research on human circadian rhythms for over 25 years and has received several grants from NIH and the CDC over the years.

Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep.

Dove Medical Press Ltd is a privately held company specializing in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine.

Updated 23 July 2014