circadian rhythms and shift work

[drboris]

I was recently doing a search on this forum and I happened to come across a discussion on overnight shift work. One person briefly mentioned that messing up your circadian rhythm (a.k.a. night shifts) decrease a persons life span!!!!

That kind of scared me and makes me really consider EM because of the inevitable and inescapable night shifts.

Quinn, this question seems to be right up your ally!

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[DrQuinn]

Others might be able to better detail you on this topic, especially the upper level residents or some attendings...

but I remember reading an article a year or so ago, perhaps it was in the Annals of Emergency Medicine, about circadian rhythms and night shifts. I dont' really remember what the results were but it seemed to be a pretty detailed article.

I actually prefer nights, and as a "young" attending I plan on working more nights than anything else. As I become an "older" attending, I'll work less and less nights (less and less overall) just because I plan on pursuing other interests besides EM.

Q, DO

 

[roja]

I agree. I prefer nights. I feel like I sleep better with less hours and can thus get stuff done in the late afternoon.

And besides, all you need is a little ambien to knock your rythem into order.

 

[jalabert]

I'm not familiar with studies on health care personnel, but I am aware that some, looking at police or paramedic personnel doing shift work, have shown a much higher incidence of cardiovascular disease in these individuals compared to the general population. An accepted belief is that it is not the night shift per se, as much as non-regular shifts that do mess up the sleep cycle. So, a consitent night shift would be okay, because your sleep cycle would adjust. It has also been argued that the stress of the job (policeman) plays a role in this. One could also argue that there is likely a fair amount of stress in a high volume ED as well, although it is a different kind of stress. It is also possible that some lifestyle factors such as diet and activity level play a role, but these would also be factors for the average health care worker.

That being said, lots of things decrease life span, so, what can you do. It's not like your going to have a regular sleep cycle going into IM, or surgery.

 

[DrQuinn]

Originally posted by jalabert
One could also argue that there is likely a fair amount of stress in a high volume ED as well, although it is a different kind of stress. It is also possible that some lifestyle factors such as diet and activity level play a role, but these would also be factors for the average health care worker.

That being said, lots of things decrease life span, so, what can you do. It's not like your going to have a regular sleep cycle going into IM, or surgery.

I actually prefer the night shifts because i think its less stress. Sure it might be a bit harder to get a stat MRI at some institutions, but usually the drug seekers are less, and the patients you get tend to actually be SICK (not just hte people who want off work that day). Not to mention, I think there are more abdominal pains at night, and I LOVE working up abdominal pain.

Q, DO

 

[Sessamoid]

Originally posted by jalabert
An accepted belief is that it is not the night shift per se, as much as non-regular shifts that do mess up the sleep cycle. So, a consitent night shift would be okay, because your sleep cycle would adjust.

It may be an accepted belief, but I don't think it's backed by science. The studies I've heard about night shift work showed a decrease in life span even in people who worked permanent nights. So it's not the constant shifting of the circadian rhythm that's the cause, but something else about working only nights.

 

[jalabert]

Originally posted by Sessamoid
It may be an accepted belief, but I don't think it's backed by science. The studies I've heard about night shift work showed a decrease in life span even in people who worked permanent nights. So it's not the constant shifting of the circadian rhythm that's the cause, but something else about working only nights.

Can you post your citations please?

 

[Sessamoid]

Originally posted by jalabert
Can you post your citations please?

gonna have to go do a search. it's been a long time. Mind you these are all obviously retrospective observational studies. No case-controlled tests here. Blinded tests are obviously out of the question. I think the study I remember was for coal miners, so the increased mortality may be trauma related. Night shift workers are clearly not as clear-minded and their reactions are slower than day shifters.

 

[DrQuinn]

Didn't the Annals of EM have an article on Circadian Rhythm a year or so ago? I believe that's where I read one article about it... I suppose I could just get up and look on the shelf but there's no "search" function on the shelf.

Q, DO

 

[Apollyon]

Originally posted by QuinnNSU
Not to mention, I think there are more abdominal pains at night, and I LOVE working up abdominal pain.

Q, DO

You, moderator, are a tool.

 

[jalabert]

Originally posted by QuinnNSU
Didn't the Annals of EM have an article on Circadian Rhythm a year or so ago? I believe that's where I read one article about it... I suppose I could just get up and look on the shelf but there's no "search" function on the shelf.

Q, DO

Come on. Can't Johnny Mnemonic and Neo just jack into the net or the matrix and find what their looking for?

 

[DrDre']

Just saw your perdu en paradis. Very cool. Moi, Je suis perdu en enfer...

 

[jpgreer13]

Abdominal pain just means he gets to do more pelvic exams.

 

[DrDre']

Can't we skip the pelvic and diagnose by history and the pathognomonic "shuffle"?

 

[Apollyon]

Originally posted by DrDre'
Just saw your perdu en paradis. Very cool. Moi, Je suis perdu en enfer...

Ah...c'est dommage. C'est seulment un peu des annees, en tout.

Comme les francaises disent: Zat iz zee bummaire!