Night Shift Work_ Understanding Its Health Impacts and Effective Prevention Strategies

Night Shift Work: Understanding Its Health Impacts and Effective Prevention Strategies

Night shift work, especially in rotating shifts, can drastically impact one’s physical and mental health. It disrupts the body’s internal clock, sometimes referred to as the circadian rhythm, which is responsible for regulating the body’s sleeping and waking cycle along with the various other physiological processes that typically occur when we sleep at night such as the release of hormones like melatonin, human growth hormone, and cortisol. This disruption creates a breeding ground for metabolic disease, mental health issues, gastrointestinal conditions and many more health problems (see study).

When we work against the circadian rhythm, such as in the case of night shifts, our bodies experience a form of added stress and over the course of time, slowly leads to disease.

Unfortunately, night shifts and rotating shifts are sometimes unavoidable, such as in the case of doctors, nurses, hotel workers, diner workers, police, and emergency services. 

Establishing a sleep schedule with night shifts while attempting to maintain a normal life is where we hit a bit of a roadblock, as this task can be a bit challenging. While some people may feel as though they can easily switch between working at night on their work days and remaining awake during the day on their off days, they may not realize the minute but critical impact it is having on their health long-term.

In this article, we discuss what night shifts do to the body, but more importantly, what can be done about it and how to establish a sleep schedule to help fight against the negative impact it has on one’s health.

How Night Shifts Affect The Body

Sleep Deprivation & Fatigue

Sleep deprivation is known to negatively impact cognitive function, mood, and energy levels. Night shift workers tend to get less sleep and experience extended bouts of fatigue which impacts their physical strength and mental alertness, especially after work. In fact, in one study, 57% of night shift workers reported either having an accident or near-miss when traveling home from night shifts (see study).

Hormone Dysregulation

Melatonin, the sleep-inducing hormone, is released just before going to bed. Human growth hormone, which helps our body rebuild and recover from wear and tear, is released while we sleep. Cortisol wakes us up and is released just before waking time. Not sleeping on time throws this cycle off and our bodies respond by pushing out higher amounts of cortisol. While this hormone is important for certain aspects of physiology, excess of this hormone negatively impacts metabolic, immune, and cardiovascular health. Sleep deprivation also leads to reduced melatonin production. Long-term this can potentially cause chronic sleep issues.

Cardiovascular & Metabolic Disease

Night shift workers tend to have a significantly increased risk of developing cardiovascular and metabolic disease such as hypertension, atherosclerosis, ischemic heart disease and diabetes type II (see study). Dysregulation of the circadian rhythm results in impaired glucose metabolism and insulin sensitivity which increases the risk of weight gain, obesity, and this plays a consequential role in the development of diabetes. Night shift also results in a decrease of leptin, the hunger-suppressing hormone; and an increase of ghrelin, the hunger-inducing hormone – this causes an increase in appetite and cravings which can potentially cause one to consume more calories than needed.

Mental Health Issues

Lack of sleep or irregular sleep patterns interfere with neurochemistry which can alter our mood and emotions. As mentioned earlier, sleep deprivation and night shift work results in reduced melatonin production. This occurs due to the impairment of the synthesis of melatonin from an amino acid known as tryptophan and the neurotransmitter serotonin. Serotonin levels decrease, which results in a neurochemical state that is typically seen with depression and anxiety. Studies have shown that night shift workers have a significantly increased risk of developing depression (see study). 

Research has also suggested that the isolation that typically comes with night shift work may also be one of the causes of depression in night shift workers.

Immune Dysregulation

Interference with the circadian rhythm disrupts the proper release of immune proteins known as cytokines. As mentioned earlier, night shift work can result in prolonged elevation of cortisol levels. This hormone, when chronically elevated, suppresses immune function and increases one’s susceptibility to infections (see study). Prolonged cortisol elevation can also increase inflammation and has been linked to the development of autoimmune diseases – these are conditions in which the immune system attacks the body itself.

Gastrointestinal Issues

Studies have shown that night shift workers tend to complain 2-5 times more than daytime workers of conditions such as constipation, heartburn, distension, and disturbed appetite as well as more severe disease such as chronic gastritis or peptic ulcers (see study).

Cancer Risk

Of all the health conditions associated with night shift work and sleep-deprivation, the link to cancer may be the most concerning. In a systematic review and meta-analysis of 61 clinical studies, night shift work was found to increase the risk of developing several types of cancer in women – specifically breast cancer, skin cancer, and gastrointestinal cancer (see study).

What Can Be Done About It?

Strategic Sunlight Exposure

The exposure of oneself to sunlight can help offset the biological clock by delaying the induction of sleep for a while after exposure. By avoiding exposure after your shift and before sleeping, you can prevent a delay in the onset of sleep. After waking up, try to get as much sunlight exposure as possible to help keep you awake for longer.

Maintain a sleep schedule

The worst thing you can do is to switch between shifts, so if possible, try your best to keep the same schedule even on your off days. Some regularity is better than no regularity. The body is not able to constantly change sleep-wake cycles without resulting in health issues. It may also be good to take naps before your shift to prevent fatigue in the morning by relieving some of the sleep debt. It is best to sleep soon after your shift as this can also help with strategically exposing yourself to sunlight.

Consume Melatonin-Rich Foods

Since night shift can reduce the production of melatonin by inhibiting its synthesis, it would be good to help your body get the benefits of this hormone by consuming melatonin-rich foods such as tart cherries, walnuts, and kiwis. Each of these foods contain a considerable amount of melatonin and have been found to be highly effective for improving sleep quality, onset time, and duration in clinical trials (see study). They should be consumed an hour before going to bed as they have a strong sedative effect. Do not drive or operate heavy machinery after consuming these foods, especially if you have just come off a night shift.

Exercise Regularly

Exercise is an effective tool for regulating metabolic health and preventing the development of metabolic and cardiovascular disease. Resistance exercise specifically has been found to improve blood sugar levels, insulin levels, and insulin resistance in patients with diabetes type II and to prevent diabetes by improving prediabetic conditions (see study). Exercise also gets your heart pumping, blood flowing, and helps with vasodilation – this assists with maintaining cardiovascular health. Exercise should be done prior to going to work rather than after as it can cause a temporary increase in adrenaline which may be problematic if you plan to sleep soon after.

Reduce Stress & Stress Hormones

Given that night shift and sleep issues can significantly increase the stress hormone known as cortisol for prolonged periods of time, measures must be taken to reduce this hormone. Stress reducing activities such as nature walks and Mindfulness meditation have been found to improve stress hormone levels (see study 1 and 2). Herbs known as adaptogens such as Ashwagandha and Holy Basil have also been found to reduce cortisol levels and to improve overall metabolic health (see study). Both of these herbs are used in Ayurvedic medicine along with other herbs, formulas, and minerals that compound their effects and can provide many other benefits for overall health.

The Use of Ayurveda

Ayurveda preaches the importance of preventing disease via the use of diet, lifestyle, herbs, and other health-promoting methods.

As mentioned in previous articles, Ayurveda explains human physiology from the viewpoint of doshas or bio-energies, namely Vata, Pitta, and Kapha. When these are in balance, the body remains healthy. When they go out of balance, it causes illness.

Night shift work causes Vata and Pitta to increase immediately, while Kapha increases over the course of time as you continue to work during these hours. The derangement of these doshas are what play a role in the development of metabolic, cardiovascular, mental, and gastrointestinal disease. 

Additionally, night shift work causes the digestive fire, known as agni, to weaken. This results in a buildup of metabolic waste and an increased rate of developing illnesses.

The way to counter these problems is to consume a diet suitable for controlling all three doshas, practicing yoga, consuming digestion boosting herbs and spices, and using herbal formulas that are tailored to your specific condition and constitution. For this, the help of an Ayurvedic doctor or practitioner may be needed.