mood disorders after night shift...

In the past months I realized that I´m really suffering from slight mood disorders after night shifts. It really alternates between hypomania and some depressive symptoms. What does that mean? I did a research on medline on this and found some interesting articles:



Impact of nap length, nap timing and sleep quality on sustaining early morning performance. Kubo T, Takeyama H, Matsumoto S, Ebara T, Murata K, Tachi N, Itani T., Ind Health. 2007 Aug;45(4):552-63. :

"Taking a nap earlier or later did not affect the neurobehavioral performance tests, although participants slept more efficiently during naps later in the night shift. A negative effect of a nocturnal nap during the night shift on subsequent daytime and nocturnal sleep was not observed in the sleep architecture. It still remains unclear whether slow wave sleep plays an important role in sustaining early morning performance. In terms of work safety and sleep health, the results suggest that a longer and later nap is beneficial during night shifts."




Residents who stay late at hospital and how they perform the following day., Liu CC, Wissow LS., Med Educ. 2008 Jan;42(1):7-9. :

"Compared with paediatric residents who left on time, those who stayed late reported feeling less fulfilled; if their clinic was in the afternoon, they also reported more fatigue. CONCLUSIONS: The care of critically ill children may make paediatric residents more liable to remain at work after the end of their shift. The clinical interactions of such residents were more dominant and less patient-centred. Helping paediatric residents to learn to manage their work while under clinical stress could promote better adherence to guidelines on working hours and have a positive impact on patient care."



Daily and yearly burnout symptoms in Israeli shift work residents., Tzischinsky O, Zohar D, Epstein R, Chillag N, Lavie P., J Hum Ergol (Tokyo). 2001 Dec;30(1-2):357-62. :

"The results revealed that sleep duration, Work Load and the interaction between them, explain the Negative Mood the day after the night shift. However, positive mood, and fatigue were not affected by sleep duration or workload. In general, after one year of residency, residents become more stressed, less involved in the job, and had a high level of burnout and psychosomatic symptoms. However, after the second year, the burnout symptoms were almost the same as at the beginning except for the level of stress that remained high. Sleep duration was unrelated to the burnout symptoms."



Who is too old for shift work? Developing better criteria. Gander P, Signal L., Chronobiol Int. 2008 Apr;25(2):199-213. :

"Sleep becomes more fragmented with increasing age, but the functional significance of this remains unclear. Among younger adults, experimental sleep fragmentation leads to increased sleepiness and degradation of performance and mood. Greater sleep loss is reported by older long-haul pilots, as well as other older shift workers, compared to younger people working similar duty patterns. Experimental sleep restriction causes a degradation of performance and mood that is cumulative and dose-dependent. In addition, a recent large-scale flight simulation study indicates that the duration of sleep obtained by individual pilots is an independent predictor of crew performance in a two-person cockpit. Based on these considerations, we propose that fatigue and sleep-related issues should become a standard part of fitness-for-work medical assessments, particularly for older shift workers. A multi-layered approach is proposed, with a routine structured sleep history leading to referral to specialist sleep services where appropriate. Criteria for specialist referral and medical retirement should be related to the workplace risk represented by an older worker. Additional research is needed to develop and validate sleep-related criteria for assessing fitness for work. For example, a better understanding of the effects of sleep fragmentation on the waking function of older workers might lead to a fragmentation threshold for fitness for work. The potential negative effects of unemployment and early retirement also need to be taken into account when considering the options for managing the occupational health and safety needs of older shift workers."




So, there is some explaining content...

You know what... I´ve realized, that I once loved night shifts, because I was very curious and loved the atmosphere at night in hospitals. There was some tension in the air and you could get more experiance and security in your desicisons...
Now the situation has changed, I do it for the money and also for finshing work, which I left during the regular time... and this changing motivation effects also the time after night shifts...

Good night everybody. I´ll see you soon. :-)