Good sleep practices may boost performance in older shift workers

Older people working nights may feel more alert and sleep longer if indeed they stay up longer after moving away from work, then stay static in bed for a complete eight hours, getting up closer to the beginning of their shift, a tiny trial suggests.

For older employees assigned to a simulated overnight shift, timing sleep so they woke up nearer to the start of their next shift also resulted in better performance in work tasks, the study team reports in Occupational and Environmental Medicine.

Shift work has persons functioning at the same time when their internal systems promote sleep, the researchers write. This may affect older adults more because they have reduced capability to sleep throughout the day.

Past research has found that night workers tend fall asleep immediately after leaving work, and wake up many hours before their shifts start, so they've been awake longer when work commences compared to an average day worker.

"We realize the longer a person is awake, the more sleep pressure they build up," said senior author Dr Jeanne Duffy of Brigham and Women's Hospital in Boston and Harvard Medical School.

"We wanted to test if placement of sleep closer to the next night-shift would reduce sleepiness," Duffy said.

To see if behavior changes alone would change lives altogether sleep and work performance, the authors recruited two sets of nine adults each, ranging in age from mid-50s to early 60s. All participants spent 8-hour simulated work shifts in a lab at Brigham and Women's clinical research center but slept in the home.

All the participants "worked" for four day-shifts from 7 a.m. to 3 p.m., got a day off, and worked four night-shifts from 11 p.m. to 7 a.m. Through the shifts, researchers administered tests and tasks to determine sleepiness, attention and performance.

Participants could go to sleep if they wanted after day shifts. After night shifts, one group was instructed to remain out of bed until at least 1 p.m. then stay in bed for eight hours wanting to sleep. The other group was only told to delay going to bed until 1 p.m.

Predicated on sleep diaries and activity monitors, researchers discovered that prior to the analysis and while working day shifts, both groups spent roughly the same amount of time in bed and asleep: roughly 8 hours and just short of 7 hours, respectively.

During night shifts, however, the group instructed to stay in bed for 8 hours did so and got as much sleep because they had before, as the group given no instructions spent less and less time everyday during intercourse while working night shifts.

For Duffy, a fascinating result was that whenever participants were instructed to sleep only in the afternoon and stay in bed for eight hours, they were able to average two hours more sleep daily than the comparison group.

The authors discovered that all of the participants were susceptible to losing focus on the night time shift when compared to the day, however the group that followed the sleep instructions performed somewhat better.

"The impact of night shift work on sleep deprivation, insomnia and downstream cardiovascular and mental health outcomes is so profound the American Association of Sleep Medicine has generated the diagnosis of Shift Work Sleep Disorder," said Dr Amanda Hassinger of the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, NY, who wasn't mixed up in study.

Years after retirement, persons who suffer from this syndrome retain poor sleep patterns associated with stroke, heart attacks, hypertension and type-2 diabetes, Hassinger noted.

"If we are able to find the essential areas of sleep health that result in better overall health, we are able to design safer staffing models and shifts that make night employees healthy, happy and optimize the standard of their work," she added.