[409] - Is Night Shift Bad for Your Health?

0:00Is night shift actually bad for your health? Well, if you Google that question, the answer can get pretty frightening and very quickly. Heart disease, diabetes, obesity, sleep problems, mental health, cancer. And I'm not going to sit here and tell you that the science is wrong. Night shift is biologically challenging. But I think there are two really important parts of this conversation that are often missing. The first is this. Just because you feel good working nights doesn't necessarily mean that you're biologically aligned to them. And the second, when we study the health effects of night shift, what happens when we actually teach shift workers how to work with their biology instead of constantly working against it? Because both of those are very different questions and that is what I want to talk about today. Because it doesn't have to be this way.

1:06For far too long, we've accepted for two. Poor sleep, burnout and declining health as simply part of working in a 24-7 environment. I don't believe they are. Whether you're a shift worker, trying to feel better or a leader responsible for the people who keep your organisation running around the clock, you're in the right place. Welcome to a healthy shift. I'm Roger Sutherland and after more than four decades of working 24-7 shifts with Victoria Police, followed by years of studying nutrition, circadian biology, human performance and working with literally thousands of shift workers, I've made it my mission to change the conversation around shift work. Because healthier people create stronger teams and stronger teams build better organisations and it all starts by understanding how to work with your biology and not against it. Let's get into today's episode.

2:08Alright, let's grab a coffee, let's sit down, have a chat and talk about one of the questions that comes up all the time. Now I'm not going to deny, I stalk the forums on Reddit, I stalk the Facebook groups on obviously the night shift groups on Facebook. And this is a common question that a lot of people ask, is night shift actually bad for you? And a lot of people ask it and I also see that many, many people say, I thrive, I'm doing really well, I'm actually better on night shift than I are in anything else. But is night shift actually bad for you? Well, I want to start by being really clear and I'm going to say this from the outset. If you're looking for me to tell you that night shift is perfectly healthy and all this research is nonsense, I'm absolutely not going to do that. I am a veteran shift worker, I live this for four decades, right? Rotating 24, seven shifts in policing a highly stressful job for 40 years.

3:11But I also, I understand the science. And biologically we are not designed to be awake, working, eating, exposed to artificial light throughout the biological night and then sleeping during the biological day. Let's simplify it because that is the reality. Our circadian system evolved around the light and dark cycle, light and activity during the day and darkness and sleep at night. And night shift asks us to turn a lot of that upside down. Now research links night shift work and circadian disruption with increased risks across a range of health outcomes. And we've got extremely good biological reasons for taking those associations seriously. But this is where I think the conversation needs to get more interesting because I hear this all the time. But Raj, I've been on permanent night shifts for 10 years and I'm fine or me personally

4:16I feel better on nights and I don't argue with that person. If you feel good, you feel good. Now I'm not sitting across the table from you telling you how you feel. But there's a distinction that I really, really want you to understand and it's important that you do. Feeling adapted and being circadianly adapted are not necessarily the same thing and that's important. There was a review looking signed specifically at permanent night workers in their melatonin rhythm which is one of the markers we use to understand the timing of the circadian rhythm. Now fewer than 3% showed complete circadian adjustment to night work. Less than 1 in 4 showed what the research has considered substantial adjustment. Now let's just re-back that over a second and let's think about it. So 3% showed complete circadian adjustment.

5:17Three people out of 100. But less than 1 in 4 showed what the researchers considered to be a substantial adjustment. Now these weren't people who had just done their first night shift. These are permanent night workers. So when somebody says my body is used to it, well maybe part of your behaviour are and maybe you've become very good at functioning at night. Maybe you've actually learnt how to sleep better during the day. Maybe psychologically you prefer the quieter environment. Maybe your family circumstances actually suit nights and all of those things can be absolutely true. But that doesn't automatically mean that your internal biological clock has completely moved to match your night work schedule. In fact the evidence is actually told us that for majority of the people it doesn't. And there's a very simple reason for this.

6:19What do most permanent night workers do when they're not working? They live. They go outside. They see daylight. They spend time with their kids. They go to the shops. They have lunch with someone. They might go back to sleeping at night on their days off. And light is one of the strongest signals to your circadian system. So your body keeps getting reminders that daytime is daytime and night time is nighttime. And that's why I don't love the phrase of adapted to nights. I'd rather say you've learnt how to function on nights and those are not necessarily the same thing. And this matters because subjective feeling isn't always a perfect measure of what's happening internally and biologically. You can feel okay and still be circadianly miss alone. So that is my first point and it's an important point. So please understand that. But point number two is where I think the conversation gets really interesting because

7:21when people tell shift workers night shift is bad for you, my immediate question is okay. So what are we going to do with that information? Because I can guarantee to you hospitals aren't closing at 5pm. Police aren't knocking off because the sun went down. Ambulances aren't stopping. And factories aren't necessarily stopping either. Mining doesn't stop. Aviation doesn't stop. Transport doesn't stop. There are literally millions of people who are still going to have to work tonight. So telling them night shift is unhealthy, okay now one. And this is where I think there's a massive gap between the science and the actual shift worker. A lot of our understanding of night work comes from two broad types of research. We've got controlled laboratory studies where researchers simulate night shift so they can carefully measure what happens biologically. And then we have observational and field research involving people who actually work shifts.

8:21Now both of these are valuable. But neither automatically answers the question that I personally care very deeply about. What happens when we take a real world shift worker and actually teach them how to organise their life around the biological challenge that they're facing. Because think about how most people start shift work. You get a job, you get shown the workplace. Here's your uniform, here's the equipment. This is how you operate the computer, here's the policy, here's roster, here's where you park. This is who you report to off you go. But the biggest issue that we have today and this is the one that I'm trying to address is how many organisations sitting you shift worker down and say, okay. Your roster is going to challenge your circadian biology. I want to teach you how to manage your light exposure. Let's teach you how to sleep after nights. Let's talk about your caffeine timing. Let's talk about when you're eating at 2am.

9:22Let's talk about what you do when you finish the shift and let's talk about movement. And let's talk about transitioning you between shifts and days off. I can almost guarantee if you're listening to this and you're a shift worker, I would 99.9% guarantee that no one has had that conversation with you. And if they have, I want you to message me through the show notes. There's a position there for you to text and message me and tell me that you got that conversation and training because I would almost guarantee that you didn't. And this is the problem in shift working environments today. We teach every one everything about their job but we don't teach them how to do any of what I just spoke about. And then years later we actually study the shift worker and then we discover they're sleeping poorly, they're eating irregularly, they're relying heavily on caffeine, they're struggling

10:23with their weight, their fatigue and metabolically compromised. And some of that is the unavoidable biological challenge of night work. Absolutely. But there's a question that I think deserves a lot more attention. How much of the total risk could be modified if we actually taught people how to do shift work better? Now we don't have a clean scientific answer to that, not yet we don't. And I want to be very clear about that. I can't tell you. Do these four things or night shift become healthy? That'd be rubbish. Night shift still creates circadian misalignment, it doesn't matter which way you go about it, it does. But do we have evidence that individual interventions can make a difference? Now meal timing is a fascinating example of this because we know that controlled night work studies have shown that when people eat matters. In one recent simulated night shift trial, changing food timing alerted the impact of night

11:28work on glucose metabolism. Another controlled study found that keeping meals in the daytime prevented the rise in average glucose seemed when participants ate during simulated night work. Now does that prove that every shift working completely fast or night? No. I do encourage it, but I don't insist on it. But it does tell us something really important. Behaviour matters, timing matters, light matters too, sleep matters. And there is evidence that interventions directed at shift workers can actually improve some sleep outcomes. Although the quality and consistency of that evidence varies considerably depending on the infant intervention. We're still in a very early stage of shift work research. So we have to stop thinking about these two as choices. One, night shift is bad or night shift is fine. That is far too simplistic.

12:29We can't ask those questions. The better question is, night shift creates a biological challenge. What can we realistically do to reduce the unnecessary additional load? And this is where I sometimes jokingly call shift workers the ultimate self-sabotus. And I don't mean that critically. I don't. Because I was literally one of them. I did it for decades. We finish a night shift and we walk straight out in the morning, right daylight. We get home absolutely exhausted and sit on the couch scrolling on our phone. We have caffeine too late in the shift. We eat large meals in the middle of a biological night. We get home and we think that we need a couple of drinks to switch off. We sleep in a room that is just too bright, too warm or too noisy. We wake up and then we stay indoors. We barely see daylight. We skip movement because we just don't feel like moving. We're exhausted.

13:30And then we get frustrated because we're tired, we're hungry, we're gaining weight. And we don't feel like ourselves. But nobody ever taught us any different. And that's the bit that matters. This is not about blaming the shift worker. How on earth can you implement something that you have never been taught? And that's why I get frustrated when shift work, education amounts to go to seven to nine hours sleep. Great. When? I've just finished the 12 hour night shift. I've got a 45 minute drive home. I've got two kids I've got to get ready for school. Then the neighbor starts mowing the lawn at 10 o'clock in the morning. That's their right. My biology is actively promoting weight funnister in the day. So tell me how. And you see, there's the gap. Science can tell us what circadian misalignment does. It can tell us what happens to glucose metabolism. It can tell us what light does to our circadian system. And it can also tell us about sleep pressure and melatonin and cortisol.

14:33But the person standing in front of me doesn't need a lecture on molecular biology. What they need me to say is, okay, so you start work at 7 p.m. and you finish at 7 a.m. You've got a 35 minute drive each way. You've got kids. You want to train through times a week. Let's work out what this actually looks like to you. Let's see how we can achieve what we can with what we've got. And that's where lived experience becomes so important. Not instead of science, alongside it. The science gives us the guard rails, but lived experience helps to make it practical. And when you bring both of those together, suddenly the shift worker understands why they're doing something. And that is incredibly powerful. Because I'm not interested in giving you another list of 10 night shift hacks. What I really and truly want you to understand is, why does light matter? Why does darkness matter? Why does meal timing matter? Why does caffeine timing matter?

15:33Why does movement matter? Why does consistency matter? Because once you understand the why, it then gives you an opportunity to make much better decisions when your roster inevitably changes. And then you could work with it. And this is why I don't accept the idea that the most, the only useful message for a night worker is, night shift is bad for you. Imagine telling someone, the work you need to do to pay your mortgage is damaging your health and then walking your way. What are they supposed to do with that? I want the conversation to be, yeah, night shift creates biological challenges. No, feeling good doesn't necessarily mean that you're biologically alone. And no, I cannot promise you that optimizing your lifestyle removes long-term risk of night work. But there are behaviours that we can change. And there are environmental signals that we can change. And there are things that we can stop making harder than they already are.

16:34And that is a very different message. And this is ultimately why I do what I do. I've spent more than four decades working around the clock. I know what it's like to be standing there at three o'clock in the morning. I know what it's like to drive home when you're exhausted. I know what it's like when the rest of the world doesn't understand your roster. I now, I also understand the science behind what was happening to me. And my role to bridge those two and my role is to actually bridge both of those worlds now to take the circadian biology, sleep science, coronary nutrition and behaviour change evidence and translate it into something that you can actually use on Tuesday night when you're heading into work. Because here's what I've learnt. A lot of shift workers aren't doing shift work badly because they don't care about their health. They're doing things that work against them because nobody's ever shown them another way. And once you understand where you're working against your biology, you can start making

17:36better decisions. Not perfect decisions, just better ones. You can improve your sleep environment and you can become more strategic with daylight. You can rethink when you're reading and you can use caffeine instead of letting caffeine use you. You can build movement into your roster rather than trying to follow a Monday to Friday exercise plan. You can also stop trying to live like a day worker who happens to work at night. And none of that makes night shift biologically neutral. Now I want to finish there because that's the most important distinction in this entire episode. I'm not trying to make night shifts sound harmless. It isn't. I'm trying to make the person working night shift feel more informed. Because the science tells us there is a risk. But science also gives us clues about where we can intervene. And there's still a huge amount we need to learn about how much difference, comprehensive, practical long-term education can make to the health of real shift workers.

18:38And that is the research that I want to see more of. I want to be part of. I want to conduct. I want to do. Not just what happens when humans work against their circadian biology. We know that that's a problem. I want to know what happens when those humans are properly educated, supported and taught how to minimise the things that they can control. Because until we answer that properly, I think we're missing a very important part of the night shift conversation. So is night shift bad for your health? Biologically, it presents real challenges and is associated with real health risks. But this is not the end of the conversation. And me, that's where the conversation starts. Because if you're going to work nights anyway, you deserve to know how to do it better. And it doesn't have to be as hard as we're making it. Thanks for joining me. I'll catch you on the next one. If today's episode resonated with you, don't let the conversation stop here.

19:41Share it with a colleague, a manager, a friend, a leader. Or someone who has the opportunity to improve the lives of people working in a 24-7 environment. Because real change starts with awareness. And awareness changes conversations. And conversations change organisations. And organisations change lives. So thank you for spending this time with me. And until next time, I want you to remember this. It doesn't have to be this way. Take care of yourself and take care of each other.