Working nights can have many negative effects on your health. Diabetes, heart disease, obesity and back pain, these are just some of the conditions that night shift work can cause.
We rely on these night time superheroes for so many essential things that keep our society going. This blog looks at how night shift work can impact your circadian rhythm, what the potential implications of that disruption are for your low back, and what you can do to counter those negative effects.
Who Works The Night Shift?
According to the U.S. Census Bureau more than 9 million Americans regularly work nights. This amounts to approximately 6% of the total US workforce. The American Psychological Association puts this number closer to 15 million if you include those who regularly rotate in, and out of night shifts.
Night shift workers often fill some of our most essential roles including truck drivers, emergency room and hospital personnel, law enforcement, and the fire department. Night shift workers make up a large portion of our front line workers and we wouldn’t be able to function without them.
How Does Night Shift Work Impact Health?
Unfortunately, night shift work has also been connected with some serious health implications. Night shift work has been shown to disrupt the body’s circadian rhythms that govern our sleep-wake cycles. This disruption of our body’s “internal clock” can lead to health conditions like an increased risk of developing diabetes, heart disease, obesity, and chronic pain conditions like low back pain.
What Is A Circadian Rhythm?
Circadian rhythms are 24 hour cycles that occur in all of the cells of our bodies that regulate many of the essential functions and processes that our bodies need to stay healthy.
Most living things follow circadian rhythms including animals, plants, and humans. There are many different circadian rhythms that occur in the body and that affect physical, mental, and behavioral changes throughout a 24-hour cycle.
A Clock In Your Spine?
Recent studies have found that the intervertebral discs between our vertebrae in our spines actually have their own internal circadian clocks. These clocks are regulated by age and small proteins called cytokines that control the growth and activity of some of our immune system cells. These clocks have been linked to disc degeneration (we will talk more about that later!).
All of these rhythms are synchronized with a “master clock” that is located in the brain. This master clock is directly influenced by environmental cues like light and darkness. This is why one of the most commonly recognized circadian rhythms is the sleep-wake cycle.
Why Are Circadian Rhythms Important?
When our circadian rhythms are in alignment and working smoothly they can help ensure that we get good, restorative sleep. This quality sleep is important for a whole range of health outcomes like our physical and mental health.
Unfortunately, when our circadian rhythms are not in sync, one of the first problems to occur is insomnia.
How Does Night Shift Work Affect Spine Health?
For some time it has been recognized that the height, water content, osmotic pressure and other mechanical characteristics of our intervertebral discs have a particular circadian rhythm.
Did you know that your height actually changes throughout the day? When we lose fluid from the discs that cushion our spine, we lose height. More than 50% of high loss (and therefore fluid loss) occurs within one hour of us getting up. A full 80% happens within 3 hours.
Our spinal discs (cushions) have a diurnal (day/night) cycle that generally looks like 16 hours of being awake and putting pressure on our spines, followed by the recommended 8 hours of recovery - sleep. During the recovery period fluid flows back into the discs between the spine.
What happens then is another extraordinary body process called autophagy.
What Is Autophagy?
In a nutshell, autophagy is where old, tired cell proteins are broken down and destroyed and then recycled for other important cell functions. Cells get cleaned and fixed and put to use again. How clever is that? Autophagy operates on a molecular clock and it only happens at night when you are resting. Fasting has also been found to help autophagy which is why it works best at night when we are sleeping and not eating.
What is important to know is that one of the proteins most associated with autophagy has been found to have a circadian rhythm that is controlled by the brain. Unfortunately, this circadian rhythm has also been found to be negatively impacted by a lack of sleep. Interrupted sleep was discovered to suppress autophagy and even recovery sleep didn’t help it reach its previous levels.
How Does Night Shift Work Affect Circadian Rhythms?
Recent studies have begun to explore the impacts of night shift work on our circadian rhythms and on our overall health. Some studies done on mice have found that there is a higher risk of disc degeneration when the circadian rhythms were disrupted, such as occurs in shift work. These studies support the idea that shift work may be a contributing factor for an increased risk of developing degenerative intervertebral disc diseases (IDD) and increase the risk for low back pain.
Are Night Shift Workers Being Left In The Dark?
Recently data have emerged showing that prolonged intensive physical work (for 12 months) impacted circadian rhythm genes and induced IDD even in normal environments. When the researchers added a light-dark cycle disruption to the working environment this effect was made even worse.
How Can You Fix It?
Essential workers are, well, essential. We rely so much on the incredible people who staff various night shift jobs around the nation and to leave them with no answers would be terrible. While there is no doubt that working the night shift is not ideal for your health and that it can definitely be a risk factor for many health problems, like low back pain, there are some things that night shift workers can do to try and combat these challenges.
4 Ways To Help With Circadian Rhythm Disruption And Prevent Back Pain
1. Focus On Regulating Sleep Schedules
While it might be challenging to do (especially if you have to help out with family responsibilities), maintaining a regular sleep schedule is key. Night shift workers should try to stay on the same sleep schedule every day of the week - even on your days off.
The more you can keep a regular schedule, the better your body will learn to deal with this sleep pattern. The faster your body can learn what your schedule is, the better your quality of sleep will be.
How To Do It:
Switching from night sleeping to day sleeping just throws your body clock off and it never has time to get into a regular pattern. Your body literally never knows when you are going to sleep so it can’t prepare to do the important biological processes that it needs to do.
If you simply can’t do this - maybe you are a pilot or you work rotating shifts - try adjusting your sleep time before your schedule change. On the last few days of your current shift, try pushing out your bed time and waking time by 1-2 hours each day. This will help signal to your body that there is a change coming which might not be so abrupt when you switch over to evenings or days.
If you simply can’t regulate your schedule or prepare for a new one, melatonin might be an option for you. Melatonin is a hormone that the brain releases at night (in response to darkness). Melatonin has been found to help with circadian rhythms.
If you are flying, changing time zones, or switching schedules, taking melatonin might help since studies have found that it is very effective at helping people with jet lag.
While melatonin has been found to be safe in healthy adults, you should definitely read the dosage and directions and only take the recommended amount. Recently hospital systems have reported an alarming increase in melatonin poisoning amongst children, so if you have children in the home you should be particularly careful.
3. Light Therapy
Something that has been tested and that is completely safe and often effective is light therapy. Studies have shown that using intentional exposure to bright light is an effective way to adjust your sleep cycle.
Light therapy takes special artificial bright lights and exposes your eyes to intense (but safe) amounts of light. If you are trying to reset your circadian rhythm, ideally you would use light therapy in the evening, either before your shift, during your shift, or both. Then, when you need to start winding down your “day” you would turn the light therapy off, and make sure that you also avoid daylight on your way home. Wearing dark sunglasses can help with this.
How Light Therapy Works
There are lots of different makes, models and sizes of light boxes that you can purchase and they are not very expensive. It is important to note that light therapy is different from the stark overhead lighting often found in office buildings.
Therapy lamps are designed to produce a certain level of something called LUX. LUX is a measurement of light-level intensity or illumination. While typical office lights can help our sleep-wake cycles, they don’t have enough LUX to impact medical conditions like circadian rhythms or depression.
Light therapy boxes have been proven to help with medical conditions like seasonal depression, seasonal affective disorder, and circadian rhythm disruption. Sessions don’t need to be very long and can be as short at 15 to 30 minutes. Depending on your body and your specific needs you might need more than one session per day. Finding the right time and the right duration will be key to managing your sleep.
4. Sleep Hygiene
Developing good sleep habits is essential to combating the negative effects of night shift work. Plan your sleep schedule and don’t let other tasks and chores get in the way of your schedule. Plan errands and home repairs for after your sleep. Make your sleep a priority - not a luxury.
Avoid eating big meals right before bed, as well as avoiding caffeine or alcohol as those will definitely cause you to have a more restless sleep. Save your morning coffee for when you wake up and before you head to work. Then make sure you don’t have caffeine too close to the end of your shift.
Having a nice dark room with black out curtains can also help you to stay asleep. You might want to invest in some sound proofing for your room or a white noise machine to help block out those unwanted daytime disruptions. It is also important to put away your cell phone or turn off blue-light emitting devices a couple of hours before bed.
Don’t start your shift sleep deprived. Injuries and mistakes are common when we are tired, and depending on your job these could be life-threatening. If necessary, take a nap before work or during your shift to help you stay alert.
Our bodies are incredible! They do so much for us that we don’t even know or fully understand. As we learn more about them, we are able to see how our environment impacts our health in both good, and bad ways. Some things we have control over, while other things will require some flexibility and creativity on our part.
The biopsychosocial model takes our environment into account and sees just how our daily activities impact health conditions like low back pain. The good news is that as we learn how the environment affects us, we can also come up with solutions and workarounds so that we don’t have to suffer these negative effects.
We hope that you found this article helpful!