Shift workers need sleep schedule

DEAR READER: In yesterday’s column, I discussed the health hazards of shift workers – particularly those who work evening and night shifts. More than 9 million people in the United States are shift workers.

When I was in medical training, boy, was I a shift worker! During my internship, every other weekend I would wake up on Saturday morning and drive to the hospital. The next time my head touched a pillow was Monday evening. In between, it was nonstop.

I’m glad those days are over for me. And that they’re also over for today’s interns, who get a lot more sleep than I and my colleagues used to. That’s a good thing, given what we now know about how sleep deprivation affects a person’s ability to think – and how important it is for doctors to be able to think.

Nevertheless, I’ll admit that I sometimes reminisce with colleagues that I trained with, and compare our experience to that of today’s trainees. When we reminisce, we refer to ourselves as the “iron men” (few women were in medicine then). And we refer to the experience of today’s trainees as “lifestyle-intensive.”

Some shift workers have trouble concentrating and focusing during the evenings or nights they are working. Once, when I was an intern and feeling like a zombie, I asked a well-rested colleague how I appeared to him. He replied, “You’re coherent, but that’s about it.”

Sleep specialists that I talk to recommend what my grandmother would have recommended: a strong cup of coffee, early in the shift. (My grandmother might also have said, “You need to be a sleep specialist to give such advice?”)

However, caffeine doesn’t do it for everyone. Another option is a stimulant medicine called modafinil. One careful study of over 200 shift workers showed that 74 percent of those given this medicine, compared to just 36 percent of those given a sugar pill, had at least minimal improvement in their ability to concentrate. However, many of them remained impaired despite the treatment.

It is really important for shift workers who need to get their sleep during the daytime to do the following:

– Work with your employer to make your shift schedule steady: not nights for several days, then evenings, then nights, then days. Make it the same shift every day for several weeks.

– Make sure your bedroom has strong light-blocking shades and that no sunlight creeps into the room from around the edges of the shades. Even a little sunlight can discourage your brain from sleeping.

– Reduce any noise. For many shift workers, that involves the use of soft rubber earplugs.

– If you can’t sleep for at least seven consecutive daytime hours, try at least to get four hours shortly after arriving home, and another three to four hours later in the day.

– If you can’t sleep the minute you arrive home – for example, if you have to help get the kids off to school – then begin sleeping right afterward.

– Try to make your sleep schedule a regular one, starting and ending at the same time(s) each day.