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Posted by Dr. Alison McAllister on Tuesday, 31 October 2017

Cortisol Patterns For Graveyard (Shift) Workers


If you come by ZRT on Halloween you’re likely to be greeted by a witch, vampire, zombie or other nightcrawler. We take our decorations and dressing up seriously around here, and finding people in costume processing your labs or taking your calls is par for the course.

Laughing aside (and let me tell you, some costumes are hilarious) those who live their lives by night – on the graveyard shift – can really struggle.

Two primary challenges for people who work at night are energy and fatigue. This is largely due to the pineal gland and its interaction with light that triggers and enforces our body’s pre-programmed circadian rhythm – which produces high cortisol in the morning and then drops throughout the day until the lowest value at night. For those who work graveyard shift that normal circadian rhythm must be re-established, and for many people it doesn’t happen.

Here are a few tips that we’ve collected to help patients who are denizens of the dark:

Better to embrace the night than go back-and-forth

Workers who can fully switch to being up at night tend to do better in flipping their cortisol circadian patterns than those who go back-and-forth. We know that wake-up  and bedtimes do better with consistency, so it's not surprising that keeping those constant – even if flipped – is better for our brains and cortisol levels.

Support nocturnal patterns        

The trick to helping patients who are graveyard shift workers is to support them on the daily rhythm they are in.

Cortisol that is lower than optimal upon awakening and, yet, is too high at bedtime is a common pattern in individuals working nights. This often leads to fatigue during working hours and then struggling to fall asleep and stay asleep during resting hours.

The trick to helping patients in this situation is to support them on the daily rhythm they are in. This may mean that they are doing adrenal stimulant therapies at 8pm to help wake up and again at midnight, and then taking phosphatidylserine or magnolia prior to bedtime to slow down.

Observe the dark (and light)

Because melatonin production is essentially turned off by light, it makes sense that morning light helps wake us up. Likewise, when light – especially blue light – hits our eyes at night, we get more stimulated. So, using a seasonal affective disorder (SAD) light upon awakening can really help someone who has to work nights. If they can also use full spectrum lights during the day at their work or encourage the company to change their florescent bulbs to full spectrum lights, it can also make a difference in being alert throughout the day. 

In opposition, around bedtime you should use dim lights, turn on your phone’s night screen, and decrease any phone, computer, tablet and TV usage to start to increase the melatonin production. Black-out curtains, ear plugs and sound proofing are all great tools. Taking melatonin at the time of desired sleep can also help the circadian switch.

Working graveyard shift can be hard, and studies have shown it is also not good for our health. Part of this is because people often live half-way between worlds when it comes to cortisol production. However, there is a series of simple measures we can take as health care providers to help our night-dwelling patients have better energy, less fatigue, better quality sleep, and improved work and social outcomes.

Happy Halloween! Don’t stay up all night.

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Tagged in: Adrenal / Cortisol Sleep