The topic of fatigue management comes up in most shift work environments. For those new to working shifts it's one of those things "others" talk about, yet once one starts doing shift work, it soon hits home with a vengeance. Sleep deprivation can easily sneak up on us, and we become irritable at the smallest thing.
The past two decades or so I've worked shifts, with one aspect being the coaching of new entrants to my segment of the transport industry (fuel haulage). We're given an overview on fatigue management, yet the practical application of strategies to manage fatigue will vary among individuals.
So my intent here is to share my experiences, good and bad, with the view to aiding new shift workers. I've done this in one on one coaching situations, so I figured it's about time to commit this basic approach to a record of sorts.
First of all, let's be upfront about shift work. It's completely against human nature and it shortens your life, according to studies not mentioned by firms who will engage you in shift work. Do your own looking up and it'll astound you, just be sure to verify who's paying for the study.
So you find yourself doing shift work. A positive attitude will get you a fair way, you gotta work this way so let's find the best way to deal with it. Can we trick the body into this weird and wonderful way of working? Short answer has got to be a firm no! But we can help it cope.
The elements that I manipulate are my sleep environment, my food and fluid intake, my exercise routine and my connection to the world at large.
Sleep environment.
Dark curtains in a ventilated room, to create that "illusion" of it being night time. I sleep with ear plugs in, not easy at first, but they're very effective at dulling ambient noises normally associated with daytime activities, so in effect they help with the illusion of it being night time. Yes at first they create a thumping effect in your skull, so take the time to find the plugs with the right density foam for you. A visit to a safety shop will let you pick a few samples for your own trial and error. Once you get this right, the blissful distance from ambient noise this creates makes the effort worthwhile.
Food and fluid intake.
Simple in theory, yet it's the hardest to get right. On night shift, I'm very careful about slowing down my energy intake at least two to three hours before finish time. Last thing I want is to arrive home with my tummy full of food, as that's going to keep me buzzing for an hour or two more. Same with fluid, you won't get a decent sleep if you have to get up for a pee in the second hour. A sneaky trick I've employed at times is to take a casein (protein) shake of a half dose immediately before bed, it feeds the body gently, thus letting me work on my beauty sleep.
Exercise routine.
This has varied greatly over the years. For me it's mostly about maintaining strength and flexibility. If you have the intention of achieving a body builders physique while doing shift work, I'd suggest you're having a fanciful dream. Can you maintain a sensible level of fitness while doing shift work? Yes, but it will take a degree of discipline. The timing of any exercise, for me at least is before I go on night shift or right after getting home from day shift. As a rule I'd work out every second day. As with food and fluid, having a big workout session after getting home from a night shift will likely not allow you to get to sleep in time to get enough rest for the subsequent night shift. I've tried it, and for me it just doesn't work, unless that exercise is a good workout between the sheets with an enthusiastic lover...
Connection to the outside world.
Righto, now we're getting to the business end of fatigue management. For an office worker, imagine getting that wrong number call at 02.37 and then not being able to go back to sleep properly? Welcome to the world of shift work. My cell phone gets switched to silent when I go to bed, the landline I can't hear in my bedroom anyway, and until my alarm goes off my wife doesn't wake me. Yes, she's learned the hard way to let grumpy sleep. Is this approach unreasonable? To me it's not, for unless I get enough quality sleep, the accumulation of sleep debt will take me to a state where I will not be able to function properly. How this manifests itself varies, but suffice to say I will come across as grumpy long before I recognize it in myself...
So the elements I've outlined above are what I walk thru with someone new to shift work.
Let me share some of the things I've learned along the way, both personally and from talking to colleagues.
Shift patterns matter.
The current routine in my line of work seems to be a standard 3/3/3 routine. 3 days followed by 3 nights then 3 days off. The reason this is the most common shift pattern seems to be based on it being the easiest for most folks to "cope" with. In days gone by, I've worked a 5/2/5/3 pattern, which is 5 days 2 off 5 nights 3 off, but this can be hard for those who don't sleep well during the day as "coping" with 5 consecutive nights is a stretch under those conditions. The incident rates in the 5/2/5/3 routine suggest fatigue creeps in, then folks start to mess up, more so than in the 3/3/3 routine. One aspect where I don't like 3/3/3 is the 24 hour break between days and nights. The "sudden" change from sleeping nights to sleeping days is what catches most folks out initially. My coping mechanism is to go to bed relatively early on my last day shift, arise quite early on the day of my first night shift, then go back to bed for a snooze of at least two hours prior to night shift.
Social activities.
So you think you can go on "operation dinner out" until 11pm then start work at 4am? Sure, you can deal with this once in a while. In my younger days I can attest to having been guilty of this somewhat regularly, but now I'm in my mid forties, a good rest prior to work takes precedence. Partaking in social events requires a bit of planning, sometimes swapping or dropping a shift is preferable to working whilst fatigued.
Peer pressure/family pressure.
Say you're new to shift work and your mates at the rugby club still want you partake as per normal with club activities... Bit like dinner out, you'll work out soon enough that burning the candle at both ends has consequences.
One funny story relates to a wife not "getting" the fact that sleeping after the last night shift is not the same as "being lazy". So we had a function where a few of us drivers were getting awards, and the wives were present. Now my wife learnt a long time ago that my sleep is precious, and in order for harmony to remain in our house, to let me manage my sleep. So picture my dearly beloved talking with the wife of a guy new to shift work, about sleeping etc. The new guys' wife was quite proud of the fact that she got the lazy s.o.b. out of bed after his last night shift before midday to mow the lawns or something. My wife just calmly stated that she'd never do that, for sleep is precious and it was akin to me waking her up at 4am to make dinner. Quite a learning experience for the other woman, and in the weeks to follow my new colleague thanked me for this, even though it was an unprompted conversation the women had.
Alcohol and drugs.
Touchy subject for some I guess. Personally I don't use drugs, but have worked alongside guys who displayed various signs of such. Nowadays the testing regime quickly weeds out (no pun intended) the chronic users of illicit substances. Someone who is into the synthetic crap will in theory slip by the testing regime, but their behaviour will generally highlight them in other ways.
Alcohol seems far more of a problem, because it's seen as innocuous on account of it being legal. So we all know the type, couple of beers after each shift, get a bit hammered on days off and come to work looking the worse for wear? No amount of fatigue management is gonna help this type, and they inevitably dig a hole for themselves in one way or another.
So what about the guys who don't really understand how their use of alcohol is depriving them of good quality sleep? Well, I had to learn this myself. Never been a big drinker, but I went thru a stage in my early shift work days of "using" a beer at the end of my night shift to settle myself down to sleep. Except it didn't actually end up working like that. The practical result was I had to take a pee an hour or so after getting to sleep, then it seemed like the sleep itself wasn't actually as restful as one would imagine, simply on account of the body wanting to rid itself of this poison (alcohol) that I'd introduced prior to bedding down. In later years, fatigue management training laid this out, and my personal experience had already confirmed this.
So do I drink nowadays? Yep, but I'm a very modest drinker. I will stress that I never drink within a shift cycle, as in if I'm on days today and days tomorrow, I won't drink tonight, at all. The last dayshift, going into the 24 hour break I'll have a drink if I feel like it, and on days off obviously. Part of this discipline stems from a personal approach of always having 12 hours between "bottle and throttle" which has more to do with my biking habits than work.
Alcohol is a diuretic obviously, and like coffee, will work to dehydrate you and this in turn has an effect on your sleep. There is a reason why sleep deprivation is such an effective interrogation technique in the real boy scouts, so why would I want to subject myself to even a mild form of such by my own actions?
Sleep debt.
Weird topic to some, but once you grasp the concept that you can't "save up sleep in advance" but you can sure build up a "sleep debt" by not getting enough sleep during subsequent sleeps, it'll make managing your sleep and thus fatigue much easier.
So you're planning operation dinner out in three nights. Can you save up sleep in advance? Of course not, but if you're gonna go on this op, at least set yourself up with no sleep debt going into it. That way your recovery from the sleep debt you incur will be brief.
The shift work routine of 3/3/3 thus quickly shows itself as the most workable compromise, for it accommodates the symptom of sleep debt the best. Most folks can cope with three night and then recover on their days off. Personally I actually preferred the 5/2/5/3 routine, in hindsight that's because I was sleeping quite well, coupled with the easier transition from days to nights. Never mind the fact that with a 15 day cycle the number of transitions in sleeping pattern is less than with a 9 day cycle.
Holidays and time off.
Shift work can become a grind, more so than a nine to five routine, simply because you're forcing the body to go against nature. A regular break from this somewhat enforced routine of sleeping when the body naturally wants to be awake, and vice versa, is as important as proper fatigue management itself. Not until you've worked shifts for a few years do you really appreciate the "luxury" of sleeping normally at night for two or three consecutive weeks. Just be careful not to take too long a break or you'll find yourself looking for a daytime job...
Sickness.
So the cold and flu season strikes, well it does each year regardless of what anyone wishes. So you're already forcing the body to go thru an unnatural sleep/wake routine, do you think you can also cope with the added pleasure of cold and flu bugs floating in the air? Haha, good luck. The stress one imposes on the body of working shifts, especially if one isn't doing too well with fatigue management, can manifest itself in becoming more susceptible to cold and flu bugs. Personal experience confirms this, and having seen many guys be felled by cold and flu, it's easy to see how those who do well at managing their fatigue also seem to fare better in cold and flu season. Why? Well, I'd just put it down to the body being less stressed when fatigue is managed well, thus having a bit to spare when confronted with cold and flu bugs. Not scientific of course, but hey, personal experience.
Extra shifts or longer hours.
So let's take another touchy subject in some circles. Legal requirements left alone for a minute, let's lay out the number of hours worked in a 3/3/3 routine. For a normal 12 hour shift, that's a total of 72 hours on duty in a 9 day cycle. There's 24 hours off between days and nights, then 60 hours during the theoretical 3 days off. In theory it also takes two nights of unrestricted sleep to recover from a sleep debt, so the 3/3/3 routine in itself becomes the maximum one could/should work to keep fatigue under control. But let's say the workload is high and we're short of staff, so in order to "do our bit for the team" we'll work an extra day at the front end of our routine or an extra night at the tail end. You then end up with only one night of unrestricted sleep, thus your ability to shake off or recover from a sleep debt is compromised. Never mind the silly request to work a dayshift on your middle day off, having just read thru the above, you'd know by now I just laugh off such requests nowadays... I mean, I'm working on average 56 hours per week already, managing my sleep in a socially compromised lifestyle and you want me to work more hours? No wonder us drivers are too often seen as grumpy sods.
Hope this hasn't put anyone off from doing shift work, for the positives of having days off during the week are real, as long as the big picture approach to working rotating shifts is right.
