Our body has an internal clock regulating things like sleeping, waking, digestion, hormone secretions, body temperature, blood pressure, tissue repairs and even emotion to act in a daily cyclic manner, known as the circadian rhythm. The rhythmical processes tend to complement each other, they also work in harmony with exogenous factors such as clock time, social activities, meals and light/dark cycle. This flow of body activity is necessary for an optimal functioning body. When the circadian rhythms are disrupted, for example by shift work or crossing time zones, they become desynchronized. The body's natural patterns, for example sleeping, hormone regulation and body temperature, no longer correspond to each other or to the external environment. This results in sleep problem, fatigue and disorientation which are typically described as "jet-lagged" feelings.

 

If the internal clock is repeatedly desynchronized, and the body cannot realign itself to the new rhythm, it will not only affect job alertness or performance, but also creates health consequences, particularly sleep disturbances, gastrointestinal disorders, and greater risk of developing cardiovascular diseases.

 

Generally, the jet-lagged feelings vary among shift workers, and the realigning rates of body’s rhythmical processes are greatly different as well. There is no signal remedy that can provide an immediate relief and is suitable for everyone. The most important thing is to acknowledge the negative impacts that shift work has on one, and schedule a lifestyle less disrupting to one's own circadian rhythm. There are many individual strategies to help adapt to shift work.

 

Chronic fatigue is a usual complaint among shift workers, as daytime sleep is less deep and refreshing as that taken during the night. Pay special attention to your sleep environment and preparation for sleep. Try to set a sleep routine that works best for you. Learn some relaxation techniques to aid sleep; avoid stimulants such as caffeine and nicotine several hours before sleep; arrange a dark, cool, quiet place to promote sleep; avoid interruptions from phone calls or family members. It is advised to take naps (last 10 to 20 minutes) just before work or during breaks at work, this helps increase alertness and improve mood. If your sleep problems are persistent or severe, find a health professional for evaluation and treatment. Remember that sleeping pills or wake-promoting medications should only be used under professional advice and for short-term.

 

Click to see how TCM manage insomnia 

 

Shift workers are more likely to have gastrointestinal or digestive complaints, such as irregular bowel movements, excessive gas, abdominal distention, a low appetite, stomach pain, indigestion and heartburn. It is not surprising that bad eating habits have been blamed: irregular mealtime, overeating, too much fast food, inadequate fresh vegetables and fruits. Moreover, excessive coffee, smoking and highly stressful also lead to these problems. Healthy and regular meals are very important for shift workers; they should choose the right foods to eat too that covers a wide selection of vegetables, fruit, lean meat, fish, dairy products, grains and bread; drink plenty of water; eat crackers or fruits instead of junk food during work breaks; limit the intake of salt, caffeine, alcohol, and heavy, greasy foods. Night workers should eat lightly throughout their shift and have a moderate breakfast, which can prevent indigestion and ensure a better sleep during the day.

 

In TCM understanding, gastrointestinal problems are often associated with spleen and stomach disharmonies and physicians aim at harmonizing their qi movement when treating the problems, herbs like magnolia bark, tangerine peel, clove, immature bitter orange and villous amomum fruit are often used for this purpose. Due to different triggering factors or the involved organs, shift workers may have different complaints, physicians will further consider the individual needs. For example, stress disturbs the harmony between the liver and stomach, and it is likely to have bloating, stomach pain and belching, herbs like bupleurum root, white peony root and nutgrass rhizome are added to preparations to resume the normal relationship between the two organs. Overeating heavy, greasy foods will lead to food stagnation, and have symptoms like bad breath, heartburn, acid reflux, anorexia, vomiting, bloating, gas or constipation; the herbal prescriptions will contain medicated leaven, hawthorn fruit and malt to aid the breakdown of food. Constant stomachache and distention may indicate weakness in the stomach and spleen, which also accompanied by a poor appetite, limb coldness and loose bowels; herbs like astragalus root, pilose asiabell root and largehead atractylodes rhizome should be selected for replenishing qi and invigorating the stomach and spleen in these cases. Sometimes, physicians might suggest the Chinese patent remedies (herbal supplements) for regular consumption, in order to strengthen the digestive system, as the secretions, intestinal movements and the mucus lining of the digestive tract usually take some time to resume full health.

 

 

Shift work may play a role in the development of cardiovascular problems, since blood pressure and the pulse follow a circadian rhythm. Studies have shown that the incidences of hypertension and high cholesterol levels are more frequent among shift workers. They should try to adhere to a healthy lifestyle, including a balanced diet, regular exercise, avoid smoking and drinking, in order to maintain an adequate level of fitness. Moreover, a desynchronized biological clock results in hormonal and metabolic changes that make health problems like obesity, diabetes, asthma and hyperthyroidism more difficult to control. If you are taking any medication, you need to see your doctor more frequently and have checkups on a regular basis.

 

In yin yang theory, the body's physical form belongs to yin while the body's activities or functions belong to yang. Shift workers tend to overly consume their blood and essence which are the major constitutions of the body's yin. This causes a yin deficient disharmony, and the relative excess of yang can easily generate fire pathogens, irritating the internal organs. As a result, shift workers are likely to feel "heat" with experiences like mouth dryness, bloodshot eyes, sticky secretions in the throat and hoarseness. TCM yin-nourishing, lubricating and cooling methods help stabilize the internal environment, while medicinal dishes are usually recommended for restoring the disharmonies due to shift work. Foods benefit for them are white fungus, lily bulb, wolfberry fruits, red dates, sesame, lotus seed, lotus root, pear, tomato, water chestnut, Chinese cabbage, soybean sprout, black bone chicken, duck, fish sound, oyster, conch, eels, animal bone marrow and pond loach. 

In TCM, emotional stress impedes the qi flow of the body and prevents the liver playing its role. The primary function of the liver system is to coordinate and create an orderly internal environment. Long-term stress leads to disharmony between the body and mind, weakens the shift workers' natural resistance, and makes them likely to develop various functional disorders. TCM focuses on the liver when trying to relieve the ill effects of stress. As how each of the conditions may differ from person to person, TCM remedies are therefore customized individually, but they always aim at dispersing liver and smoothing qi flow to relieve emotional strain. Commonly used herbs are bupleurum root, white peony root, tangerine peel, nutgrass rhizome, Sichuan lovage and bitter orange peel, these herbs help soothe the body under emotional strain.

 

To sum up, shift work is a reality in many workplaces where 24-hour service is necessary. Inside the body, over 100 kinds of physiological functions are acting a daily cyclic manner, requiring a high degree of interaction to produce subjective feelings of wellbeing. The human body can never truly adapt to night work; disturbances in these rhythms not only impact the family and personal life of shift workers, but also lead to health problems. Individual lifestyle changes such as making schedules from a circadian perspective, having good sleep hygiene, a healthier diet and reduction of stress are essential to the general health of shift workers and ensure better job performances.