September 2002 Volume 83 Number 9 "serving the protectors"

The shift-workers’ search for a good night’s sleep

That lovely Sunday morning sleep-in is a pleasure that shift-workers do not often enjoy.

To stay awake, our bodies use a 24-hour cycle (circadian rhythm), which also helps us get to sleep.

Sleep is a very important part of our normal lives; it is so important that, without it, we cannot survive. Although this seems obvious, there is a lot of research and discussion among the scientific community about how much sleep we need, and whether we can make up for missed sleep.

There is also the issue of shiftwork – how best to recover from it and how to survive working around the clock. Some people say you never recover from shiftwork.

Shiftwork is not the only aspect of your job that makes it harder to sleep. There are other things in police work that prevent sleep. Studies published this year in the USA show that police officers receive the “double whammy” when it comes to sleeping badly.

Not only does shiftwork affect police more profoundly than it affects other shift-workers, but police also have increased nightmares. The research suggests that the normal stress of police work is, along with shiftwork, the cause of the poor, all-over (global) sleep.

On top of shiftwork is the “critical-incident exposure” or “trauma exposure”. These are known to make for bad sleep, and the more times they occur, so, too, will the rate of bad dreams or nightmares increase.

Are poor sleeping and shiftwork things you get over as you age? The bad news is that your sleep is always going to be worse if you have been a shift-worker. For shift-workers, the effect is permanent. It gets worse as you get older and you get sleep disturbances more often, but you learn to get back to sleep quicker.

Women seem to be affected more as they get older, but there is some improvement after retirement. The effect, however, seems never to disappear completely.

In trying to find ways to adjust to the difficulty of sleeping, various factors have been investigated. One of these factors seems to be the number of hours worked, with a clear worsening of poor sleep if work increased over a 48-hour week. If the stress increased, there was an even worse effect, particularly when the pressure was that of “having to hurry”.

To adjust to this, you should try to look at the hours of work you perform and the pressure under which you believe you are working. If you can finish the work without too much time pressure, you should cope better. Moreover, research has shown some improvement occurs in sleeping if you add your own “style” to your work.

When looking at ways to help people adjust their shifts to cope better, it emerges that each of us has his or her own way of coping. By allowing people a say in their own shiftwork, they will cope better. The style of shift should be adjusted to your own rhythm. Because of the impossible task of adjusting all the shifts to suit each individual, various studies have shown that you can measure the improvement in sleeping if the shift-worker participates in the roster design. The point of allowing for people to report on their shift preference is that they will know their own body and how they can cope.

Various types of shifts ranging from rotating six- or eight-hour shifts to 12-hour blocks were studied. The key issues seem to be more about the physical demands of the job, whether it is boring or monotonous, or whether there is conflict involved in the work. The workers who have been reported to have the most problems are prison guards, nurses and police.

Because the body’s internal clock follows a 24-hour cycle, shiftwork causes a desynchronization that has effects on health. The individual difference in your own ability will affect how much your body can adjust to shiftwork. If you believe there are some things that you can cope with better than others in your shiftwork cycle, it is important to discuss them with your fellow workers and friends. If you can adjust some of these, it will decrease the side effects of the shiftwork that we know will occur.

The other effects on the body – apart from increased psychological problems, errors and accidents – are on the stomach, heart and women’s reproductive cycles. All of these are reasons to have a healthy sleep pattern if possible. These days, is it known as sleep hygiene?

To help sleep hygiene, there has been a lot of discussion about medication. To date, there has been no proof that the problems associated with shiftwork can be overcome with sleeping tablets. A normally occurring compound called Melatonin was thought to be an answer but has not shown consistently good effects.

Melatonin is known to be produced from that part of the brain which responds to light stimuli. This would explain some of the benefit from daylight helping sleeping patterns to get back to normal. Other sleeping tablets have also been disappointing and might produce sleep that does not correct the other parts of the brain cycle that are affected by the shiftwork.

If possible, find natural ways to help adjust to the shiftwork, but remember that shiftwork – and police work especially – will always cause some disruption to your ability to sleep.

Awareness of your own particular way of responding to shiftwork, and trying to find a shift that suits your body, will help to limit the damage shiftwork does to you. Talk to colleagues and friends so that you can be well supported in your work. For many reasons, it is important to sleep well.

Your questions answered

Dr Pearce will answer questions on any health issue important to you. For his response, write to or fax the Police Journal with your question. Those who write need not identify themselves.

• Police Journal, PO Box 6128, Halifax St, Adelaide, SA, 5000
• Internal dispatch, post code 168
• Fax: 8231 0855

If you prefer to correspond by e-mail, send messages to the associate editor
(brettwilliams@policejournalsa.org.au).

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