Night work: how to make it easier and safer

Who are night workers?

In the 24-hour society, night work has become increasingly central. There are many activities that have also increased the employment of workers for night shifts: supermarkets, restaurants, bars, nightclubs, call centers, etc. However, for some professions, working at night has always been unavoidable. Just think of doctors, nurses (who often work "shifts"), workers in the security sector (police, security guards), transportation (truck drivers, public transport drivers, taxi drivers) or press officers.
Night workers can be divided into full shift workers (those who take turns on the three shifts) and atypical schedule workers, those who wake up very early (bakers) or go to sleep very late (bartenders, waiters, and, in general, those working in the entertainment industry).
Doctors, then, in addition to having night shifts, may have night on-call, a situation that forces them to sleep in their own beds but in an alert condition, with lowered sleep quality.

The risks of night work

The risks of night work are many, but can be divided into short and long-term risks.

Short-term:

• Falling asleep in the workplace, a very dangerous eventuality if you are doing work that involves responsibility for yourself and others;
• The Daytime sleepiness, the first side effect of sleep deprivation, which in turn causes distractions, inaccuracies, and errors that can lead to driving or work accidents (example, sleep-deprived truck drivers who travel for many hours carrying often even dangerous loads);
• Injuries, increased by lack of concentration and attention;
• In the health professions, not to be underestimated is the risk of errors for the patient and the lowering of the quality of care in general, especially at the end of the shift and in the 3 to 5 o'clock time slot, a time which several studies have confirmed is when there is more likelihood of making mistakes.

Long-term:

• Increased cardiovascular and oncological risk.

Alterations in the circadian rhythm, the mechanism that regulates the body's physiological processes (such as sleep) have the effect of reducing the production of melatonin. Since melatonin has a protective effect on our body (antioxidant), situations of reduced melatonin secretion promote the occurrence of cancer diseases. Recent studies conducted on nurses have also shown that sleep deprivation increases the risk of cardiovascular disease.
The more years of night shifts, the greater the risk of incurring these diseases.

• Cognitive decline (lower concentration, alertness, memory, and responsiveness), reversible, however, five years after the interruption of the sleep-wake rhythm.
• Higher incidence, in women,of irregular menstrual cycles and an increased risk of spontaneous abortion,prematurityandunderweight births.

You can make it easier and safer to work at night that some small steps:

Work management

1. Try to take as many restorative breaks as possible during the shift and, if possible, also take short 10-20 minute naps. If this is not possible, it is advisable to dose your energy well so as not to arrive too tired at the end of the shift;
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2. Avoid leaving the most boring and repetitive tasks at the end of the shift;
3. Keep your shifts as regular as possible, looking for the pattern that best suits your needs;
4. In the case of full shifts, avoid early shifts that start too early;
5. Try to keep as many lights on and as bright as possible to keep the mind alert and counteract fatigue.

Pre-shift sleep management

1. Try taking short naps in the afternoon, before the night;
2. The day before the night shift, sleep a little later and wake up a little later.

Post-shift sleep management

For the night worker, the best time to sleep is in the morning, without setting an alarm clock.  However, it would be recommended to try to sleep no more than three hours, to avoid compromising the sleep-wake balance. Where possible, it is helpful to take a one-hour nap in the afternoon.

Create conditions of absolute darkness

1. When returning from a night shift, do not expose yourself to sunlight (it inhibits the production of melatonin, which, in addition to the pathological risk, regulates sleep) but wear sunglasses until you return home;
2. Keep blinds down or equip yourself with opaque curtains;
3. Do not use TVs, computers, smartphones, tablets and other electronic devices;

Create conditions of absolute silence

1. Choose the quietest room in the house;
2. Ask one's family members to cooperate to respect the silence and promote sleep;
3. If family members are not cooperative or in case of noise due to external factors (neighbors, maintenance work, traffic, airplanes) purchase and use earplugs;
4. Use a mask to cover the eyes so that sunlight does not penetrate;
5. Put your cell phone in airplane mode to avoid calls.

Create comfort conditions

It may seem obvious, but it is most important to choose a comfortable mattress and pillow suitable for one's position while sleeping.

Management of eating behavior and volitional habits

Eating better, along with moderate physical activity, not only reduces cardiovascular and cancer risk, but also improves quality of life and helps to better manage the negative effects of night work. Moreover, when night work is performed, it is not only the sleep-wake rhythms that are altered, but also the metabolism. This mismatch, in extreme cases, can give rise to health problems and overweight. Planning meals carefully helps you stay more alert during working hours and relax more easily when it comes time to sleep.

Following are some tips for improving sleep quality:

Eating behavior

1. Try to eat and drink before sleep so that you are not awakened by pangs of hunger or thirst;
2. Try to chew well and eat slowly, choosing easy-to-digest foods such as salad, rice, pasta, bread, fruits and vegetables, avoiding more processed foods;
3. Avoid large meals before bedtime; if very hungry, eat light, healthy snacks to ensure proper digestion and not feel too weighed down;
4. Keep hydrated, without overdoing water intake just before bedtime, to avoid having to wake up in the middle of the night as a result of urinary urge;
5. Try to bring, before the night shift, food prepared from home so that you can eat appropriately.

Willful Habits

1. Quitting smoking lowers stress levels and decreases the likelihood of incidence of certain diseases, consequently improving health;
2. Avoid alcohol, which may facilitate falling asleep, but drastically reduces sleep quality;
3. Drink caffeine (coffee, tea or coca-cola) intelligently: it is an excellent ally for staying alert during the shift, however, be careful not to overdo it with large amounts at the beginning of the shift. Better to take small doses but spread out over time. Caffeine intake, then, should be stopped at least six hours before the scheduled rest.

Finally, it is advisable not to exercise before bedtime and not to take sleeping pills, which, like alcohol, allow you to fall asleep quickly, but often induce low-quality sleep and, in addition, leave you groggy for hours.

It is always recommended that night workers seek the advice of their primary care physician to monitor, over time, their health status and the presence of any alarm bells.