According to 2004 data from the Bureau of Labor Statistics, almost 15 million Americans work full-time on evening shift, night shift, rotating shifts, or other employer-arranged irregular schedules. Shift work has been shown to have a number of negative effects on sleep, quality of life, and health, including a rating as a “probable carcinogen” by the World Health Organization. What’s the connection with cancer? A leading theory is that exposure to blue light during inappropriate times of the day may disrupt our bodies’ natural cancer-fighting abilities.
根據(jù)勞工部2014年的數(shù)據(jù)，大約有1500萬(wàn)人在全職從事晚班、夜班、循環(huán)輪班或雇主安排的不規(guī)律的工作。輪班工作對(duì)睡眠、生活質(zhì)量與健康有一系列的負(fù)面作用，包括世界衛(wèi)生組織對(duì)其可能致癌的一項(xiàng)評(píng)定。那么，這與癌癥有什么聯(lián)系?有一項(xiàng)這樣的主流理論認(rèn)為：在不合適的時(shí)間里暴露在藍(lán)光下，可能會(huì)擾亂我們身體本身的抗癌能力。
Shift work disorder is defined by the International Classification of Sleep Disorders, Third Edition (the diagnostic bible of sleep medicine) as necessarily having all of the following criteria:
睡眠藥物診斷的圣經(jīng)《睡眠障礙國(guó)際分類(lèi)第三版》將輪班工作障礙定義如下(必須包含如下全部標(biāo)準(zhǔn))：
There is a report of insomnia and/or excessive sleepiness, accompanied by a reduction of total sleep time, which is associated with a recurring work schedule that overlaps the usual time for sleep.
有報(bào)告顯示：伴隨著睡眠總時(shí)間的減少，失眠且/或嗜睡與重復(fù)的工作計(jì)劃和正常睡眠時(shí)間重疊有關(guān)。
The symptoms have been present and associated with the shift work schedule for at least three months.
與輪班工作安排有關(guān)的癥狀至少已經(jīng)存在三個(gè)月。
Sleep log and actigraphy monitoring for at least 14 days (work and free days) demonstrate a disturbed sleep and wake pattern.
至少14天(工作與休息天數(shù))的睡眠曲線(xiàn)與腕動(dòng)儀監(jiān)測(cè)顯示一個(gè)受影響的入睡和蘇醒模式。
The sleep and/or wake disturbance are not better explained by another current sleep disorder, medical or neurological disorder, mental disorder, medication use, poor sleep hygiene, or substance use disorder.
入睡與/或蘇醒紊亂不能用現(xiàn)存的睡眠紊亂、藥物或神經(jīng)紊亂、精神錯(cuò)亂、藥物使用、較差的睡眠衛(wèi)生，或者物質(zhì)使用紊亂來(lái)更好地解釋。
Unfortunately, with our 24/7 economy, shift work is here to stay. Here are some tips to help you manage the situation and protect your sleep and health:
不幸地是：與我們?nèi)�天候發(fā)展的經(jīng)濟(jì)相隨，輪班工作是存在的。這里有一些幫助你管理工作輪班并保護(hù)你睡眠和健康的小竅門(mén)：
1. Go to the Cave
1. 擁有自己的私人空間
Superman had his Fortress of Solitude, you need your cave when sleeping during the day after a night shift. Our retinas contain intrinsically photosensitive ganglion cells which send messages to our brains to “wake up” when exposed to even minute amounts of light. Cover all of your bedroom’s windows with black trash bags or blackout window treatments. Remove or cover all bedroom electronics that emit visible light. Alternatively you can invest in a quality eye mask to shield you from light while sleeping.
超人有他的孤獨(dú)堡壘，當(dāng)晚班結(jié)束白天睡覺(jué)時(shí)，你也需要你的私人空間。我們的視網(wǎng)膜含有內(nèi)在感光神經(jīng)元細(xì)胞，它暴露在哪怕是一分鐘光亮下也會(huì)向我們的大腦發(fā)信息以使其蘇醒。用黑色垃圾袋遮住窗戶(hù)或?qū)ζ溥M(jìn)行遮黑處理。移除或遮住所有臥室內(nèi)發(fā)光的電子設(shè)備。或者也可以配置一個(gè)遮眼罩使你在睡眠使遠(yuǎn)離光線(xiàn)。
2. Sleep Is Sacred
2. 睡眠應(yīng)得到尊重
Everyone in the household must respect the importance of your sleep. I remember treating a patient who had a side e-commerce business with his wife and was unfortunately tasked with accepting packages from UPS during his “protected sleep time.” Have a family meeting to discuss why sleep is important to your health and formulate a plan to minimize noise and other disturbances while you are getting your 7-8 hours. Use white noise machines to combat ambient noise, which usually increases during daytime hours.
所有在家的人必須尊重你睡眠的重要性。我記得曾治療過(guò)一名病人。他和妻子有兼職電子商務(wù)，不幸地是在他的“保護(hù)性睡眠時(shí)間”他被UPS分配接收包裹任務(wù)。召開(kāi)家庭會(huì)議討論睡眠對(duì)你的健康是如此重要，并擬定一個(gè)計(jì)劃，以減少7-8小時(shí)睡眠時(shí)間內(nèi)可能的噪音及其他打擾。使用噪音減輕機(jī)對(duì)抗白天增加的環(huán)境噪音。
3. Naps
3. 打個(gè)小盹
If you can’t get the recommended 7-8 hours in one block, making up the deficit with naps is the next best thing. Night shift workers are at increased risk of motor vehicle accidents while driving home from work, due to their circadian rhythms being disrupted. If you think you might have a problem with sleepiness on your drive home, take a brief nap at work or in your car prior to departing.
如果你不能在一個(gè)地方獲得理想情況下7-8小時(shí)的睡眠，用打盹補(bǔ)充睡眠缺失是下一個(gè)最好的選擇。夜班職員在回家的路上，由于他們的生理節(jié)奏被打亂，摩托車(chē)事故風(fēng)險(xiǎn)會(huì)增加。如果認(rèn)為沒(méi)睡覺(jué)就開(kāi)車(chē)回家有問(wèn)題，你可以出發(fā)前在工作的地方或者車(chē)?yán)锎騻�(gè)小盹。
4. Anchor Sleep
4. 固定時(shí)間睡眠
With a natural desire to be a part of society, the majority of night shift workers “flip” their sleep/wake schedule on their days off, meaning that they transition to staying awake during the day and sleeping at night. This can wreak havoc on your circadian rhythms, resulting in sleep deprivation, daytime sleepiness and fatigue. “Anchor sleep” is a concept that refers to overlapping at least 4 hours of sleep during the same timeframe on your work days and your off days. So, as an example, if you normally sleep from 9 a.m. to 5 p.m. when you’re on duty, try to maintain a schedule on your days off where you sleep from 5 a.m. to 1 p.m. your body will thank you.
出于成為社會(huì)一部分的本能，大部分夜班工人根據(jù)休息天數(shù)“調(diào)整”他們的入睡/蘇醒計(jì)劃，意味著他們白天保持蘇醒，夜里睡覺(jué)。這會(huì)破壞你的晝夜節(jié)奏，導(dǎo)致睡眠缺失、白天瞌睡和疲勞。“固定時(shí)間睡眠”是這樣一個(gè)概念，在工作和休息日同樣的時(shí)間框架里重合4小時(shí)。所以，舉例說(shuō)明，如果當(dāng)你當(dāng)班時(shí)通常在早上9點(diǎn)到下午5點(diǎn)休息，那就試著在不當(dāng)班時(shí)從早上5點(diǎn)睡到下午1點(diǎn)。你的身體會(huì)很好地報(bào)答你。
5. Medication
5. 藥物
Stimulating medications play an important role in managing shift work disorder. These medications should only be tried if you’re still suffering even after all of the above actions have been attempted. Provigil (generic name modafinil) is a “wakefulness promoting medication” that is FDA-approved for shift work disorder. It is a prescription drug and a Schedule IV controlled substance, so you’ll have to speak with your doctor about it. Provigil is generally well-tolerated, but common side effects include headaches and anxiety. There is a theoretical risk of the medication increasing blood pressure, but it is generally felt to be safer from a cardiovascular risk standpoint than stimulants such as Ritalin and Adderall. Importantly, women need to be aware that Provigil can reduce the efficacy of oral contraceptives and may need to employ a second method of contraception.
刺激性藥物在應(yīng)對(duì)輪班工作障礙中發(fā)揮了比較重要的作用。這些藥物只能在你嘗試過(guò)以上4種方法后仍飽受困擾時(shí)試用。Provigil是食品藥品監(jiān)督局批準(zhǔn)的治療輪班工作障礙的覺(jué)醒促進(jìn)藥物(機(jī)理未知)。因?yàn)樗�是處方藥并且是附表四的控制藥物，所以你需要找醫(yī)生開(kāi)具。Provigil已被廣泛接受，但包括頭疼和焦慮等常見(jiàn)的副作用。藥物理論上有血壓升高的風(fēng)險(xiǎn)，但從心血管來(lái)講，它通常比譬如利他林和阿得拉更安全。重要的是，婦女需要注意Provigil能降低口服避孕藥的功效，所以需要采用另一種避孕方法。
Shift work disorder is a significant problem for the American workforce, and economic trends suggest that it will likely be a growing problem. Thankfully, you can take steps to be proactive in minimizing the negative effects of shift work on your health.
輪班工作障礙對(duì)美國(guó)勞動(dòng)大軍來(lái)講是一個(gè)大問(wèn)題。經(jīng)濟(jì)趨勢(shì)顯示它將更可能成為一個(gè)越來(lái)越突出的問(wèn)題。幸運(yùn)地是，你可以采取步驟積極地減少它對(duì)健康的負(fù)面影響。