It’s Called the Graveyard Shift for a Reason

A new study confirms that shift workers — people who work late nights, irregular hours or mixed night-and-day schedules — are at higher risk of heart attack and stroke

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People who work irregular schedules or work outside of normal daytime hours are at higher risk of heart attack, stroke and other coronary events, according to a new study published this week in the British Medical Journal.

This study is not the first to show a link between shift work and heart health, but it is the largest-ever analysis of its kind. It pools together results from 34 previous studies on the topic, with a combined 2 million study participants from across the industrialized world, estimating that shift workers are at 23% greater risk of heart attacks than the other workers, 5% greater risk of ischemic strokes and 24% greater risk of all coronary events combined (a category that includes heart attack but not stroke). Shift workers also had slightly higher overall death rates than average, but those results were not statistically significant.

(MORE: Working the Night Shift May Boost Breast Cancer Risk)

In their analysis of shift work, the study’s authors included any regularly scheduled work outside of normal daytime hours — such as evening shifts, night shifts and early-morning shifts — as well as on-call or casual shifts, split shifts or irregular working hours, no matter what time of day that work typically occurred. In Canada (where many of the new study’s authors are based), about one-third of the workforce is engaged in shift work.

What’s not clear, however, is why those workers have worse heart health. Shift workers may be engaged in a wide range of industries, from retail to health care to transportation, and they may be highly skilled employees, like medical doctors, or relatively unskilled, like fast-food workers.

In their paper, the researchers write that shift work can disrupt sleep cycles and circadian rhythms, and that many night-shift workers in particular report insomnia, which is an independent risk factor for heart attack.

(MORE: Why Shift Work and Sleeplessness Lead to Weight Gain and Diabetes)

But irregular working hours can also be a source of stress. Erratic schedules make it tougher for people to organize convenient child care, to keep doctor’s appointments or simply to plan leisure time with friends and family. Fluctuations in income that come from irregular shifts can also be stressful for anyone on a budget.

Studies like this are always complicated, however, in that it’s never completely obvious that shift work alone is the main culprit. Studies do typically try to adjust (using statistics) for other factors that may make shift workers different from other workers. But a woman who works as a grocery-store clerk may lead a very different life than one who works as an office receptionist, even if they are both 50-year-old nonsmokers with a high school diploma. In their research paper, the authors say they believe their results are not strongly biased by outside lifestyle factors, however, since adjustments for smoking and for socioeconomic status — measures of occupational class and education — did not alter their results very much.

(MORE: Is Social Jet Lag Making You Fat?)

Most important, the researchers feel their findings have serious real-world implications. Of course, most people doing shift work won’t find it easy just to switch to a new work schedule. But even though we don’t know why shift work is linked to heart attack and stroke, the researchers write, people can take steps to protect themselves. “[P]eople who do shift work should be vigilant about risk-factor modification,” they write.

In other words, be extra careful to lead a healthy lifestyle: watch your diet and activity levels, keep your blood pressure in check and limit any smoking.

MORE: Night Shift: 10 Surprising Businesses You Can Patronize at 3 a.m.

31 comments
pacificbodyboarder73
pacificbodyboarder73

Luckily I have a job at night that allows me to get revenge on the jerks in the daytime that wake me up. I love to be noisy at night at work. Bang your head! Wake the dead! Lol

hannah
hannah

the title is a little scary. 

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elizabeth taylor

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HoneyBoom
HoneyBoom

I am a shift worker in a hospital. Now what I have noticed is, when your time is up, you die. Don't matter what killed your as s, don't matter how many risk factors you had, you is dead. And death is another chapter of life, don't fear it.

Reva Madison
Reva Madison

One of the things that gets very little mention, about the lives of shift workers, is the fact that the rest of the world thinks they do not exist.  Or at least if was that way a few short years ago, but times have improved a bit- but not enough.   Articles usually come up with the fact that shift workers are in the lower socio-economic part of the population, with its associated lower pay, etc.  That is not necessarily so.  There are literally hundreds of types of jobs that must be done, around the clock.  I wrote a letter, back in the early 80s, to the BBC and the government board which was responsible for it.   The reason for the missive:  I worked shift work which had a shift from 4PM to midnight.  The BBc figured that no one was up past that time, so promptly shut down their TV service at 12 PM, leaving me, and the rest of the countries shift workers, without TV services, which we were paying for with our annual license costs. 

  The letter contained a listing of positions which included persons, both whom worked straight nights, and those who worked rotating shifts.  This list contained people such as:  doctors, nurses, police, maintenance persons, hotel and motel workers, pilots, other airline workers, railway engineer and other staff,  plumbers, electricians, telephone operators and line maintenance personnel, factory workers ( a very large percentage of goods come from factories with at least two shifts, even in these days of financial problems).  After our days work, there was no TV broadcasts, for those who had missed the days news, and entertainment.    It is just not human nature to get off work, go home, eat and immediately go to bed.  With restaurants closed, movies closed, and no shops open, what else  was there to do?   

This is the type of thing that is also a problem with life, during a career when one must work shifts.  Getting phone calls from salesmen in the middle of the day.  Neighbors out at your midnight (noon local) with mowers, excessive traffic moving up and down the roads, etc.  All that, and it is no wonder that shift workers have poorer sleep habits, and health, than do those who do the exact same jobs during the day.  Oh, and most shift workers also shift workdays as well, meaning we work weekends, holidays, etc. that are extra days off for the normal employees.  Yes- we did get paid more - given night differential, Sunday pay and Holiday pay, but, here at retirement time, my sleep periods still havent been straightened out, a decade later.  

Today, TV runs 24 hours a day, big box stores are open 365 days a year,  24 hours a day.  Fast food shops are open so one can somewhat eat out. You can catalog shop 24 hours a day.   So things have improved in that respect.  The phone still rings in the middle of the day, the movies close before midnight, etc. Your children will still be home and need care on weekends, and younger ones, all week long.   As long as there are shift workers, there will be sleep problems, and social issues, and health problems caused by all this.  

Gizzy N
Gizzy N

I think the biggest reason off-shift workers have health issues is because much of the rest of the world cannot - or will not - accommodate us.   This despite the fact that they have no trouble availing themselves of the services and benefits of there BEING night workers to begin with. 

My husband is a night owl - so he prefers either a 2-10 or 10-6am shift.  He designs and builds industrial robots and, fortunately, plants are often open 24/7 so he's been able to work evenings/nights most of his career.  I have a circadian rhythm sleep disorder anyway, so for me, it's most natural to sleep during the day and be up at night. 

We're fortunate because we're in synch with one another - I'm self-employed as a programmer and work from home, so our being on the same schedule is easy.  We're accustomed to our schedule after many years, and it's natural for us. 

We've had to be firm - and sometimes, even rude - with family amp; friends to make them understand that no, we can't just forgo a "night's" sleep to fit their day-dwelling schedule.  If it's unreasonable for me to expect a day-dweller to have T-giving dinner at 3am with us, it is EQUALLY unreasonable for them to expect us to show up at a time that falls in OUR "middle of the night." 

We've all learned that either there is a compromise, or we simply don't show.   We're not going to risk our health or our jobs because a family member or friend can't accept that, like them, we work for a living and need our rest too.

We sleep with fans running in our bedroom year round... the constant air movement helps keep the room cool even as the summer sun beats on that side of the house, and the noise (with windows closed) drowns out most sounds outside.  We use curtains throughout the house that block sunlight - not just in the bedroom.  We removed the doorbell and hung a sign indicating that visitors may knock (or leave packages with a neighbor) but are unlikely to get a response - and fortunately, we can't hear the knocks in the bedroom.  Phone ringers are off.  One trusted neighbor has a key - in a true emergency, he can (and has - like during a tornado warning) let himself in and come upstairs to wake us up.  In turn, our closest neighbors rest easier knowing we are up at night and can sort of "keep an eye on things" on our street. 

My best friend has the ability to log into our computers and tablets from his house and set off a very LOUD alert.  Should an event such as 9/11 happen again, or a family emergency (the family knows that to reach us, they'd have to call him - added benefit that they're unwilling to call him for silly things that can wait LOL and he won't wake us unless it actually IS an emergency), he has the ability to reach us and let us know via the computers/tablets.

We've lived like this for so many years that it would actually be much more stressful to try and live as day-dwellers at this point.  This is what is natural for us, and we've learned to structure our lives around it.  It really can be done - but it takes research (what doctors have the earliest/latest office hours, for example), and it does mean taking a very firm stance when it comes to family and friends. 

My father-in-law had the most difficult time accepting all of this.  He was the reason we started shutting off the ringer and removed the doorbell.  He would call, or show up, repeatedly and insistently.  We sat him down one day and spelled it out:

"You go to sleep at 10pm.  You wake up at 6am amp; have breakfast, etc.  You are at work at 8am.  You leave work at 5pm.  You have dinner at 6pm.  You are back in bed at 10pm.

We go to sleep between 2 amp; 4am.  We wake between 10am amp; noon (depending on doctor appointments, etc.).  We are at work at 2pm.  We stop work at 11pm.  We have dinner at midnight.  We are back in bed at 2 or 4am (again, depending on doctor appointments, etc.).

Our schedule is no different from yours, save that it is rotated to begin and end roughly 6 hours later than you.  If you call us to chat at 9am, that's like us calling you to chat at 3am.  If you call at 8pm, you're calling in the midst of our work day - same as if we called you at 2pm.  If you will not show respect for our schedule, then why should we show respect for yours?"

That settled that once and for all.

Eric Andrews
Eric Andrews

Unfortunately, shift work is a necessary evil.  Do you want to be having a heart attack, only to show up at the ER and it's closed for the evening?

Rick Kowal
Rick Kowal

I did 3rd shift for about 6 months.  I loved it at first, didn't have to deal with people and the bs associated with it.  However, about 3 months into it, I started to get seriously depressed due to lack of human interaction. I ended up getting put back on the day shift eventually due to staffing needs.  Unfortunately, the damage was already done.  My girlfriend, friends and family and I started to get distant when I was on the overnight shift. She ended leaving me since she thought we weren't communicating like we did before, and my friends and I haven't been the same since.  So yeah, I kind of look back at the whole experience as a totally unhealthy thing. I guess maybe its different for everyone. I always thought it would for me, because I am kind of an antisocial person, but I guess I was wrong.

judy415
judy415

As a clinical psychologist, I began to notice with my private practice patients several years ago that those who worked the "graveyard shift" for years almost invariably suffered from some degree of depression or anxiety.  I don't have any solid research evidence to confirm the connection, but the observation has seemed to hold to an uncanny degree.  Wonder what the experience of some of you has been?

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Bryan Turner
Bryan Turner

These health problems definetly stem from the BS we have to go through to live with normal people.  

I worked for 4 years 3rd shift, my sleep consisted of 4 hours after unwinding then having to wake up to spend time with my wife, then sleeping another 2 hours prior to getting ready for work.  On weekends I would stay up all night (my version) so that I could sleep one night with my wife, then stay up another 24 hours to get back on nights.

Recently I have started working second shift at a new job and I have been 100% better because my wife works for the same employer, on the same shift, and same days.

P.S. Another great way I have relieved my stress is not having any kids; needless to say less stress leads to better health.

Duane Albert
Duane Albert

I worked graveyard for awhile and I think trying to adapt to regular off  hours for family is the problem, I worked as a machinist for 38 yrs.  and preferd days only,  that

is my input,,,

eldorado59
eldorado59

I have worked shift work for 35 years . What is the problem ? At least I have a job.

Guest
Guest

The pension to put with Bs? Priceless. 

LynxCreek
LynxCreek

I've worked nights and overnights for decades. The problem isn't the hours I work, it's the hours I don't work.

It doesn't matter if every human being in a 500 mile radius knows I sleep days, they still feel perfectly entitled to waking me up during the day. The ones that unknowingly wake me up the first time, inevitably do it again and again; often making some inane wisecrack like "wake up, sleepy head." I've always wanted to wake them up at 4am to insist they sign for a package.

I'm forced to stay awake to see doctors, go to the bank or any other business that operates 9 to 5. (Which is most of them.) Family holidays or travel? Total nightmare. Would you enjoy a turkey dinner in the middle of the night?

Oh, and don't even get me started on how judgmental people are about night owls. We're all lazy, apparently, because we're not "early risers"....as if sunrise itself was the source of all work ethics?

Robert Yocum
Robert Yocum

I worked in a automotive factory. some time had to got to 3rd. nice a quite. and no managment idiots to annoy me.

Nathan Cline
Nathan Cline

So basically just throw your hands up in the air, shrug your shoulders, and continue staring down the barrel of the gun.

André Kruger
André Kruger

I work the ER as emergency physician. Love the night shifts. So much less bloody bureaucrats to breathe down your neck 

Guest
Guest

Sounds like you have a stressful job, if so? Welcome to the club. 

Nathan Cline
Nathan Cline

Sorry that your living standards are so low

Sergioqfh
Sergioqfh

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bellaluna30
bellaluna30

Ah, yes; the grocery shopping, banking, appointments, etc...that, despite being off work at 7 a.m. had to wait until 9.  (Not the grocery shopping, but still.)

Combined with the garbage trucks (3 - 4 days a week, driven by someone who thinks winding out the hydraulic dumping arm is a requirement, natch), the car alarms so sensitive they react to a mouse fart, screaming children, the 5 ice cream trucks that cruise through two or three times (EACH) per day, the darn landscapers and those infernal blowers, and those insensitive people who think booming car stereos are a status symbol are enough to drive a person crazy.

arkansasjoe
arkansasjoe

agreed.

ive had to start putting my phone on Airplane Mode when i go to bed at 0700.

you get all your texts and voicemails when you turn it back off.

but, it is still a pain going out and running errands when i want to be sleeping...

bellaluna30
bellaluna30

You were lucky.  I worked at a 24-hour pharmacy, from 10 pm to 7 am, 5 nights a week, and our management made sure they annoyed us plenty.  They'd stay until we got there, show up at 5 or 6 in the a.m., and/or leave us notes.

CatSh
CatSh

I've seen the problem with shift work first-hand. The problem is not so much working the night shift, but trying to shift to normal hours over the weekends to be with family. The worker ends up exhausted most of the time. Exhausted people don't feel like running to the gym before or after work. They eat poorly and generally just try to get through the day.

I imagine if you pulled out people who have no family and socialize with people on the same schedule, you would find they adapt quite well.

Nathan Cline
Nathan Cline

And you're proud of that are you, Boomer?

LynxCreek
LynxCreek

Earplugs and white noise are the only things that help. (Simplynoise.com is pretty great for white noise.) The key to earplugs is putting them in right; read the instructions and practice. I sleep with headphones on (over the earplugs!) playing white noise really loudly all night.

This combination will block out even the loudest fire alarm...and therein lies the problem. You'll need a "shake awake" alarm clock designed for the deaf, or put a cell phone alarm on vibrate and put it under your pillow. The vibration wakes me up.

Of course, if you have kids or other safety/security concerns, rendering yourself deaf while you sleep isn't an option.

Guest
Guest

No. Thankful.