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Struggling to keep up with shift work? Ask for help!

In the eight years I've been at Montefiore, I've seen a very busy community that thrives because of the dedicated workers who take care of patients 24/7. Running a quality medical institution requires its workers to be on their game, regardless of whether it is 4pm or 4am. And in our society of being on-call at all hours of the day and night, we often feel that it is considered "weak" to admit that we can't cope with being "on" all the time.

In my practice at the Sleep-Wake Disorders Center, I've started to see more and more Montefiore associates as patients over the years who are recognizing that they aren't adjusting to their shifts. They refuse to see it as a weakness and instead ask for help.

I recently saw a nurse who started working the night shift after many years working in a different 9-5 career. She was struggling with staying alert and awake at night, while also having trouble staying asleep during the day. She feared that she would make mistakes at work and she also was concerned about missing out on time with her family. All of this was beginning to affect her mood as well as attention and concentration.

To help, she and I worked on protecting her time during the day for sleep and discussing with her family how things can get done while she sleeps. We also created a personalized bed/wake time, napping, caffeine, and bright light exposure program that was practical for her to implement daily. After a few months of following the program, she had more energy and alertness while working and was able to sleep soundly at home.

Our bodies have circadian rhythms that biologically program us to be awake during the day and asleep at night. When we are asked to work shifts outside of the traditional 9-5 day, we go against what our body is naturally meant to do. Although some people have no issue working shifts, many find it extremely difficult and can develop shift work sleep disorder (SWSD). Symptoms of SWSD include weight gain, gastrointestinal problems, insomnia, headaches, work absenteeism, irritability, sleepiness at work, insomnia at home and issues with attention and concentration. Many shift workers miss out on social events and are at an increased risk for workplace accidents, errors and depression.

A cure does not exist for SWSD, but effective treatments are available. Although not always practical, the best treatment option is to work the same shift every day and keep the same sleep schedule, seven days a week. And they should try to limit any interruptions such as housework, appointments and phone calls during the times they are supposed to be asleep.

I see too many patients with SWSD who suffer in silence, fearful that they'll lose their jobs – working off hours despite feeling miserable at times. The more we take SWSD seriously, the more people will hear about it and seek treatment without feeling stigmatized. There is no shame in asking for help if you are struggling with adjusting to your shift – proper treatment will help not only you but those you work with as well. That nurse I told you about, and many of my other patients, would agree!

Shelby Harris, PsyD, is director of the Behavioral Sleep Medicine Program, Sleep-Wake Disorders Center at Montefiore Medical Center. She also is assistant professor, The Saul R. Korey Department of Neurology, and assistant professor, Department of Psychiatry and Behavioral Sciencesat Albert Einstein College of Medicine.

Posted by blogmoderator on 10/18/2013 at 9:55 AM Add Comment