Vail Daily health feature: Working ‘til the wee hours
In Eagle County, working the traditional 9 a.m. to 5 p.m. grind is seen as a rarity, not the norm. Some locals may choose to work nights or irregular hours in order to spend more time outdoors during the day, but many may not realize the impact this can have on one’s health. While we tend to think of shift workers as those who work overnight, shift workers can be classified as anyone who works changing shifts, late evenings or outside of the typical 6 a.m. to 6 p.m. work day.
CLOCKING INTO OUR CIRCADIAN RHYTHMS
Working from when the sun is low in the sky to well into the nighttime can cause disruptions in the body’s circadian rhythms, which tend to follow a 24-hour “clock” influenced by our exposure to darkness and light. Anytime we tell our circadian clocks to “screw it” and follow our own schedule, sleep disruptions can occur.
“There are actually many circadian clocks in our body,” said Dr. Rebecca Adochio, endocrinologist at Vail Valley Medical Center in an email. “Our central circadian clock in the brain is governed by day/night cycles and light exposure, while the peripheral clocks, (such as) stomach, fat tissue and liver, are governed by food intake and other factors. The negative affects of poor sleep are exacerbated when there is misalignment between these clocks.”
According to Adochio, these sleep disruptions can have a hormonal affect, which could cause decreased insulin sensitivity, lower leptin levels (which promote satiety or feeling full after eating) and higher ghrelin levels, which stimulates hunger. This may explain why shift workers are potentially at a greater risk for certain health issues, such as type 2 diabetes and cardiovascular disease.
“Shift workers, compared to day workers, have higher BMIs, increased waist-to-hip ratio, increased diastolic blood pressure, increased triglycerides and increased insulin resistance,” Adochio said. “Sleep disruption leads to (these) hormonal changes, which in turn drive us to crave and consume not only more food but often higher caloric foods that are less healthy, thus compounding the problem.”
MENTAL HEALTH CONCERNS
Derek Peck, emergency services dispatcher and hiring manager for Vail Public Safety Communications Center, has been working overnights or on a rotating shift schedule for eight years. Peck said for many who choose a career in the EMS (Emergency Medical Services) field, adjusting to a shift work schedule is not easy.
“Our bodies like natural patterns and consistency,” Peck said. “(Our sleep patterns) are something we’ve developed extremely early in life. Even if you consider going into shift work at age 18 or 19, that’s 18 years of your body being in (one) pattern.”
For Peck, in his first few years working overnights he said he suffered from not being able to sleep at night and found himself more apt to grab some fast food after a shift or eat unhealthy snacks. He also noticed the affect shift work had on others, which made him want to adopt a healthier lifestyle.
“For me, my biggest motivation was seeing all my employees and staff at the time also be affected by it,” Peck said. “(I saw) an increase in irritability and depression. I just realized that wasn’t the path I wanted to take … I needed to make a change.”
As hiring manager, Peck often counsels those new to shift work on the potential health risks. Peck said while the physical aspects of the job can be managed with diligent sleep habits, mental health is the number one issue shift workers struggle with.
“Long term, you’re going to be looking into more cardiac-related (health problems) and the overall health of the entire body, but short term it’s mental health by far,” Peck said. “You can take the best employee and stick them on a night shift and they may suffer from having struggles with memory or their general ability to focus. In the world of EMS, police and fire, (shift work) does affect their ability to cope with situations that may be extremely stressful.”
Just last month, an EMS paramedic at Denver Health Medical Center, Debbie Kibel-Crawford, committed suicide. KUSA-TV 9News out of Denver reported that, according to her family, the stress of the job may have contributed to Kibel-Crawford’s decision to end her life. Will Dunn, clinical manager at Eagle County Paramedic Services, has been doing shift work for over 25 years. Dunn said from his experience, it’s difficult to discern if the mental health problems EMS shift workers face are related to sleep issues, or if it’s the emotional toll handling crisis or traumatic situations can take on someone throughout the course many years.
“It’s debatable to know if it’s the stress of the job, dealing with emergencies day in and day out that’s causing (mental health issues), or potential sleep deprivation,” Dunn said. “We don’t know.”
KEEPING AWAKE, AND AWARE
Dunn pointed out that for those in the emergency medical services field, there’s an awareness of how working late nights, overnight or even 24- or 48-hour shifts can affect both your physical and mental health, with systems and support in place for those who may have trouble adjusting to the schedule. However, for those who work in restaurants and hotels, there might be less discussion of how working late and having a constantly changing schedule can affect your health.
“It’s not uncommon to have a shift drink and have the shift meal that’s afforded to you when working in a restaurant,” Dunn said, who grew up in Eagle County and worked in the hospitality industry when he was younger. “A friend of mine … started working in a new kitchen at night in the valley with a bunch of guys who like to ski and mountain bike during the day. (He said) this was the first kitchen he’s worked in where they weren’t drinking at night.”
For even those who don’t work in EMS or at a hospital, shift work is becoming more common across the nation, as coffee shops now open at 5 a.m. and 24-hour grocery stores and gas stations have come to be expected. Peck said it’s not just the employees themselves who need to be monitoring the physical and mental effects of shift work.
“Employers need to keep cognizant as to trying to keep a schedule as consistent as they can for employees,” Peck said. “Across the nation, management and co-workers need to be (aware) of their own and how they’re being impacted by shift work, and recognize depression early on.”
For many, the perks of a four days on, three days off schedule outweigh the fatigue or restless nights (or days) that come with the job. Peck said it’s possible for your body to switch to a different schedule, and maintaining a fit, active healthy lifestyle can be key to getting a good night’s sleep, even during the day.
“It’s like any change,” Peck said. “Once you can adapt or overcome the effects of it at first, it can be quite rewarding. Personally for me, I stick with it because I love what I do, and I thankfully have the ability to accommodate, as far as my personal life. I (also) work with a team that’s quite supportive and understanding.”
The late-night diner may never close, but at some point our eyes must. Many of us may not have control over our work schedules, but we do have a say in how it affects our health, both in the short run and long term.