Technological advances have led to an increasing demand for around-the-clock operations, with shift work now accounting for about 20% of the workforce in some industrialized countries. The human body is naturally programmed to be active during the day and to rest at night. Shift workers, especially those who work at night, may find that the irregular work schedules not only disrupt their family and social life, it also affects their health.

Night Shift Work

How does shift work affect the body?

Our body has an internal clock regulating things like sleeping, waking, digestion, hormone secretions, body temperature, blood pressure, tissue repairs and even emotion to act in a daily cyclic manner, known as the circadian rhythm. The rhythmical processes tend to complement each other and also work in harmony with exogenous factors such as clock time, social activities, meals and light/dark cycle.

This flow of body activity is necessary for an optimally functioning body. When the circadian rhythms are disrupted, for example by shift work or crossing time zones, they become desynchronized. The body’s natural patterns, for example sleeping, hormone regulation and body temperature, no longer correspond to each other or to the external environment. This results in fatigue and disorientation which are typically described as “jet-lagged” feelings.

If the internal clock is repeatedly desynchronized, and the body cannot realign itself to the new rhythm, it will not only affect job alertness or performance, but also creates health consequences, particularly sleep disturbances, gastrointestinal disorders, and greater risk of developing cardiovascular disease.

Generally, the jet-lagged feeling varies among shift workers; different rhythms adjust at different rates as well. No remedy can provide immediate relief and is suitable for everyone. The most important thing is to acknowledge the negative impact that shift work has on one, and schedule a lifestyle less disrupting to one’s own circadian principles. There are many individual strategies to help adapt to shift work.

Get the rest you need

Chronic fatigue is a usual complaint of shift workers, since daytime sleep is less deep and refreshing as that taken during the night. Pay special attention to your sleep environment and preparation for sleep. Try to set a sleep routine that works best for you. Learn some relaxation techniques to aid sleep; avoid stimulants such as caffeine and nicotine several hours before sleep; arrange a dark, cool, quiet place to promote sleep; avoid interruptions from phone calls or family members; naps (last 10 to 20 minutes) just before work or on a break during working helps increase alertness and improve mood.

If your sleep problems are persistent and severe, find a health professional for evaluation and treatment. Remember that sleeping pills or wake-promoting medication should only be used under professional advice.

Protect your stomach

Shift workers are more likely to have gastrointestinal or digestive complaints, such as irregular bowel movements, excessive gas, abdominal distention, a low appetite, stomach pain, indigestion and heartburn. It is not surprising that bad eating habits have been blamed: irregular meal times, overeating, too much fast food, inadequate fresh vegetables and fruit. Moreover, excessive coffee, smoking and psychological stress also leads to these problems.

A healthy and regular diet is very important for shift workers; they should choose the right foods to eat, with the usual balance of vegetables, fruit, lean meat, fish, dairy products, grains and bread; drink plenty of water; eat crackers or fruit instead of junk food during work breaks; limit the intake of salt, caffeine, alcohol, and heavy, greasy foods. Night workers should eat lightly throughout their shift and have a moderate breakfast, which can reduce indigestion and ensures a better sleep during the day.

In TCM understanding, gastrointestinal problems are mainly related to spleen and stomach disharmonies. Physicians stress harmonizing their qi movement when treating the problems, and herbs like magnolia bark, tangerine peel, clove, immature bitter orange and villous amomum fruit are often used in the preparations. Furthermore, each shift worker”s complaint may vary, due to different triggering factors or the involved organs, physicians will further consider the individual needs.

For example, stress disturbs the harmony between the liver and stomach, and it is this that makes people feel bloated, have stomach pain and belch. Bupleurum root, white peony root and nutgrass rhizome are added to preparations to resume the normal relationship between the two organs. Overeating heavy, greasy foods will lead to malodorous belching, anorexia, gas or irregular bowels. Herbal prescriptions will contain medicated leaven, hawthorn fruit and malt to aid the breakdown of food.

Constant stomachache and distention may indicate weakness in the stomach and spleen; this may be also accompanied by a poor appetite, limb coldness and loose bowels. Astragalus root, pilose asiabell root and largehead atractylodes rhizome should be selected for replenishing qi and reinforcing the stomach and spleen in these cases. The physician might suggest taking certain tonics to strengthen the digestive system, as the secretions, movements and the mucus lining of the digestive tract usually take some time to resume full health.

Keeping an eye on internal harmony

Shift work may play a role in the development of cardiovascular problems, since blood pressure and the pulse follow a circadian rhythm. Studies have shown that the incidences of hypertension and high cholesterol levels are more frequent among shift workers. They should try to adhere to a healthy lifestyle, including a balanced diet, regular exercise, avoid smoking and drinking, in order to maintain an adequate level of fitness.

Moreover, a desynchronized biological clock results in hormonal and metabolic changes that make health problems like obesity, diabetes, asthma and hyperthyroidism more difficult to control. If you are taking any medication, you need to see your doctor more frequently and have checkups on a regular basis.

In TCM theory, the body’s physical form belongs to yin while the body’s activities or functions belong to yang. Shift workers tend to overly consume their blood and essence which are the major constitutions of the body’s yin. This causes a yin deficient disharmony, and the relative excess of yang can easily generate fire pathogens irritating the internal organs. As a result, shift workers are likely to feel “heat” with experiences like mouth dryness, bloodshot eyes, sticky secretions in the throat and hoarseness. TCM yin-nourishing and cooling methods help stabilize the internal environment, while medicinal dishes are usually recommended for restoring a balanced state which has been disturbed due to shift work.

Foods beneficial for them are white fungus, lily bulb, wolfberry fruits, red dates, sesame, lotus seed, lotus root, pears, tomato, water chestnut, Chinese cabbage, soybean sprout, black bone chicken, duck, fish sound, oyster, conch, eels, animal bone marrow and pond loach. Some simple recipes as below:

  • Hypertension accompanied with dizziness, headache and a flushed face
    Prepare 250gm lean pork meat and 10gm selfheal fruit spike (Xiaku Cao  or 夏枯草), simmer with 2000ml of water for 90 minutes, add salt to taste, drink the soup and eat meat.
  • High cholesterol with fatigue, heaviness in the head and low appetite
    Prepare 50gm hawthorn fruit (Shan Zha or 山楂), 50gm lotus leaf and 50gm coix seed(Yiyi Ren or 薏苡仁), decoct for 30 minutes as tea.
  • Hypertension with hot flashes and limb numbness
    Prepare 30gm wolfberry, 15gm walnut, 15gm tall gastrodia tuber (Tian Ma or 天麻) and 500gm pork rib, crush the herbs slightly and boil all ingredients for 90 minutes to make soup.
  • Blurred vision, dizziness, ear ringing and limb coldness
    Prepare 30gm kelp (Kun Bu or 昆布), 30gm seaweed, 200gm soybean and 500gm pork rib, and make into a stew.
  • Hypertension, thirst and hot flashes
    Prepare 250gm fresh chopped kudzu root (Ge Gen or 葛根) and 500gm pond loach (Ni Qiu or 泥鳅), and boil to make soup. This is also suitable for people with sore necks.

Promote the integration of body and mind

Mental health is also a concern of shift workers. They are more likely to view their jobs as stressful, since sleep deprivation and fatigue usually affect their performances. Shift workers have to make more of an effort to take part in social activities and family life than those who work normal schedules; sometimes the lack of regular social contact can easily make such workers feel lonely and isolated, thus leading to higher rates of substance abuse and emotional problems.

Shift workers need to ensure that family and friends understand that shift work is a lifestyle; they should be more considerate about your situation and avoid potential interruptions, particularly when you need to sleep. Leisure activities, physical fitness and relaxation techniques are effective in reducing the stress, making life easier and enhancing on-the-job alertness.

In TCM, emotional stress impedes the qi flow of the body and prevents the liver playing its role. The primary function of the liver system is to coordinate and create an orderly internal environment. Long-term stress leads to disharmony between the body and mind, weakens the shift workers’ natural resistance, and makes them likely to develop various functional disorders. TCM focuses on the liver when trying to relieve the ill effects of stress.

As how each of the conditions may differ from person to person, TCM regimes are therefore customized individually, but they always aim at dispersing liver and smoothing qi flow to relieve emotional strain. Commonly used herbs are bupleurum root, peony root, tangerine peel, nutgrass rhizome, Sichuan lovage and bitter orange peel, these herbs help soothe the body under emotional strain.

To sum up, shift work is a reality in many workplaces where 24-hour service is necessary. Inside the body, over 100 kinds of physiological functions are acting a daily cyclic manner that requires a high degree of interaction to produce subjective feelings of wellbeing.

The human body can never truly adapt to night work; disturbances in these rhythms impact the family and personal life of shift workers and leads to health problems. Individual lifestyle changes such as making schedules from a circadian perspective, having good sleep hygiene, a healthier diet and reduction of stress are essential to the general health of shift workers and ensure better job performances.

 

A Shift Worker’s Guide To Good Health

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