Sleepiness/fatigue in the work place can lead to poor concentration, absenteeism, accidents, errors, injuries, and fatalities. In the USA, shift work sleep disorder results in the loss of thousands of lives and approximately $18 billon annually. The tragedies of Chernobyl, Three Mile Island, Space Shuttle Columbia, and the Exxon Valdez all occurred during the night shift and were attributed to human fatigue. There are 22 million Americans who work at least half of their hours from 1800-0600 hours. The issue becomes more alarming considering that shift workers are often employed in the most dangerous of jobs, such as law enforcement, firefighting and emergency medical services.

Shift work sleep disorder (SWSD) is characterized by excessive sleepiness when performing nighttime work and insomnia during daytime sleep opportunities. Shift work schedules include night shifts, evening shifts, split shifts, rotating shifts, and extended duty hours. It occurs when the normal 24-hour circadian rhythm is compromised. This cycle regulates sleeping, waking, digestion, secretion of adrenalin, body temperature, blood pressure, pulse and many other important aspects of bodily function, as well as thought processes, human emotion and behavior. These rhythmical processes are coordinated, typically, to allow for high activity during the day and low activity at night. Disturbance of circadian rhythms can affect concentration, motivation, and reaction time (particularly at night), resulting in an increased risk of accident and injury. While individual sleep requirements are inborn, studies have shown that most adults need seven to nine hours of sleep. Only 1 in 100 needs only 4½ hours or less.

• 80% of shift workers feel tired during their night shift.
• 60% believe they doze off at work about once per week.
• 20% fall asleep on the night shift.
• 60-70% of shift workers complain of problems with sleep disturbances and sleepiness.
• Sick leaves are reported in 63% of night shift workers compared with 34% in permanent day workers.
• 25% of shift workers have SWSD
• People with SWSD are twice as likely to have a work-related accident.

The primary complaint for people with SWSD is excessive sleepiness. Other symptoms include insomnia, disturbed sleep schedules, reduced performance, difficulties with personal relationships, irritability, depressed mood, anxiety, impatience, feelings of loneliness/isolation, and frequent illness. There are also significant increased health hazards for shift workers including heart disease (50% higher incidence), ulcers (50% higher incidence), increased levels of blood glucose, triglycerides and cortisol, hypertension, obesity, and menstrual irregularities. SWSD may worsen existing conditions of asthma, diabetes, epilepsy and depression. It may also contribute to sleep disorders that surface later in life, including sleep apnea and narcolepsy.

Survival Techniques for the Staying Alert on the Night Shift

• Drink a caffeinated beverage early in the shift.
• Night shift workers hit their lowest period between 0400-0500, so plan accordingly.
• Take short breaks throughout the shift. Try to exercise during breaks: take a walk, shoot hoops in the parking lot, or climb stairs.
• Talk with partners who can be on the lookout for signs of drowsiness in each other.
• Don't leave the most tedious or boring tasks to the end of your shift when you are apt to feel the drowsiest.
• Naps as short as 20 minutes can maintain or improve alertness, performance and mood. Some people feel groggy or drowsy after a nap. These feelings usually go away within 1-15 minutes, while the benefits of the nap may last for many hours.

Maintaining your Health, Happiness and General Well-Being