5个策略应对工作轮班带来的睡眠与健康问题

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.

根据劳工部2014年的数据，大约有1500万人在全职从事晚班、夜班、循环轮班或雇主安排的不规律的工作。轮班工作对睡眠、生活质量与健康有一系列的负面作用，包括世界卫生组织对其可能致癌的一项评定。那么，这与癌症有什么联系?有一项这样的主流理论认为：在不合适的时间里暴露在蓝光下，可能会扰乱我们身体本身的抗癌能力。

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:

睡眠药物诊断的圣经《睡眠障碍国际分类第三版》将轮班工作障碍定义如下(必须包含如下全部标准)：

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.

有报告显示：伴随着睡眠总时间的减少，失眠且/或嗜睡与重复的工作计划和正常睡眠时间重叠有关。

The symptoms have been present and associated with the shift work schedule for at least three months.

与轮班工作安排有关的症状至少已经存在三个月。

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(工作与休息天数)的睡眠曲线与腕动仪监测显示一个受影响的入睡和苏醒模式。

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.

入睡与/或苏醒紊乱不能用现存的睡眠紊乱、药物或神经紊乱、精神错乱、药物使用、较差的睡眠卫生，或者物质使用紊乱来更好地解释。

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：与我们全天候发展的经济相随，轮班工作是存在的。这里有一些帮助你管理工作轮班并保护你睡眠和健康的小窍门：

1. Go to the Cave

1. 拥有自己的私人空间

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.

超人有他的孤独堡垒，当晚班结束白天睡觉时，你也需要你的私人空间。我们的视网膜含有内在感光神经元细胞，它暴露在哪怕是一分钟光亮下也会向我们的大脑发信息以使其苏醒。用黑色垃圾袋遮住窗户或对其进行遮黑处理。移除或遮住所有卧室内发光的电子设备。或者也可以配置一个遮眼罩使你在睡眠使远离光线。

2. Sleep Is Sacred

2. 睡眠应得到尊重

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.

所有在家的人必须尊重你睡眠的重要性。我记得曾治疗过一名病人。他和妻子有兼职电子商务，不幸地是在他的“保护性睡眠时间”他被UPS分配接收包裹任务。召开家庭会议讨论睡眠对你的健康是如此重要，并拟定一个计划，以减少7-8小时睡眠时间内可能的噪音及其他打扰。使用噪音减轻机对抗白天增加的环境噪音。

3. Naps

3. 打个小盹

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.

如果你不能在一个地方获得理想情况下7-8小时的睡眠，用打盹补充睡眠缺失是下一个最好的选择。夜班职员在回家的路上，由于他们的生理节奏被打乱，摩托车事故风险会增加。如果认为没睡觉就开车回家有问题，你可以出发前在工作的地方或者车里打个小盹。

4. Anchor Sleep

4. 固定时间睡眠

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.

出于成为社会一部分的本能，大部分夜班工人根据休息天数“调整”他们的入睡/苏醒计划，意味着他们白天保持苏醒，夜里睡觉。这会破坏你的昼夜节奏，导致睡眠缺失、白天瞌睡和疲劳。“固定时间睡眠”是这样一个概念，在工作和休息日同样的时间框架里重合4小时。所以，举例说明，如果当你当班时通常在早上9点到下午5点休息，那就试着在不当班时从早上5点睡到下午1点。你的身体会很好地报答你。

5. Medication

5. 药物

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.

刺激性药物在应对轮班工作障碍中发挥了比较重要的作用。这些药物只能在你尝试过以上4种方法后仍饱受困扰时试用。Provigil是食品药品监督局批准的治疗轮班工作障碍的觉醒促进药物(机理未知)。因为它是处方药并且是附表四的控制药物，所以你需要找医生开具。Provigil已被广泛接受，但包括头疼和焦虑等常见的副作用。药物理论上有血压升高的风险，但从心血管来讲，它通常比譬如利他林和阿得拉更安全。重要的是，妇女需要注意Provigil能降低口服避孕药的功效，所以需要采用另一种避孕方法。

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.

轮班工作障碍对美国劳动大军来讲是一个大问题。经济趋势显示它将更可能成为一个越来越突出的问题。幸运地是，你可以采取步骤积极地减少它对健康的负面影响。