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Health effects of overnight gigs
Hi all, is there any research out there on the long-term health effects of 1 on/2 off overnight gigs? Most of the research is probably focused on full-time night shift workers or chronic jet lag. I realize this schedule is pretty radiology-specific but I’m wondering if anyone has looked into this or similar schedules where you’re bouncing back and forth over longer periods of time.
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42 Replies
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Working nights increases cortisol levels. Im sure it does a lot of other bad things too but really thats all you need to know. Would you want to submit your body to years of increased cortisol? Me neither.
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it’s not radiology specific– I know police who have had similar rotating day/night shifts. Probably others.
I don’t have references or details handy, but I think there is research and I think it’s negative. Try google.
I will say, as someone who has become much more health conscious in the past 2 years, that sleep is absolutely key. Yes there are others things that you also have to do (eat well, exercise), but if you don’t get good sleep it all falls apart.
This all becomes increasingly important the further age 30 gets in the rear view mirror in my experience.-
Switching circadian rhythms and not getting sunlight during normal morning hours is terrible for your health and causes insidious damage. Switching your light/dark, sleep/awake, and eating/fasting cycles messes up your cell metabolism and hormones and increases cortisol. It almost certainly causes premature coronary disease (number cause of death) and messes up your immune system, thereby increasing your risk of cancer and infections.
By working 1 week on and 2 weeks off night shifts, you are trading in near term gains for long term life expectancy loss.
Satchin Panda is one scientist who comes to mind who has done work on circadian disruptions. This is one of his articles.
“Whereas circadian rhythms generally refer to ~24-hour oscillations that occur in the absence of external timing cues, daily or diurnal rhythms apparent during normal living conditions emerge from interactions between the internal circadian clock and timing cues, which include light and food. Accordingly, a consistent daily pattern of eating and fasting maintains normal circadian physiology, whereas frequent disruptions in daily activity-rest and eating-fasting rhythms (as occurs in shiftwork) ([link=https://www.science.org/doi/full/10.1126/science.aah4967?casa_token=p0phKWP4G-EAAAAA%3AI7rgjsVJL3ug9ZRev83rsXWP36L0OZKq_Q_qRI8ZV-N4H0nBAC5-eOW-AZ49PJHE10UjcpMZl5ty3fE#core-R5][i]5[/i][/link]) or genetic disruption of circadian clock in rodents predisposes to metabolic diseases ([link=https://www.science.org/doi/full/10.1126/science.aah4967?casa_token=p0phKWP4G-EAAAAA%3AI7rgjsVJL3ug9ZRev83rsXWP36L0OZKq_Q_qRI8ZV-N4H0nBAC5-eOW-AZ49PJHE10UjcpMZl5ty3fE#core-R6][i]6[/i][/link]). Certain diet regimens (e.g., the frequent eating of energy-dense food) and aging can dampen these daily oscillations and predispose one to metabolic diseases.”
[link=https://www.science.org/doi/full/10.1126/science.aah4967?casa_token=p0phKWP4G-EAAAAA%3AI7rgjsVJL3ug9ZRev83rsXWP36L0OZKq_Q_qRI8ZV-N4H0nBAC5-eOW-AZ49PJHE10UjcpMZl5ty3fE]https://www.science.org/d…Z49PJHE10UjcpMZl5ty3fE[/link]-
Removed due to GDPR request
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What if you consistently stay on a nights schedule year round, so that you’re not constantly switching between days and nights? Getting adequate sleep, exercising and eating healthy, and getting a little bit of sunshine in the late afternoon/early evening when you wake up. And also prefer this schedule mentally to an 8a-5p.
Would that theoretically offset the potential negative health effects and increased cortisol of nights? This is an honest question.
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It’s probably better than switching circadian rhythms, but I imagine it’s worse than having a constant “normal” day schedule.
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Common sense tells one that such schedule is bad for your health. How bad likely varies from individual to individual.
If I was single and young, I can let myself fantasize about a 1 on 2 off schedule where I spent the 2 weeks off abroad in Asia and kept a relatively stable sleep schedule when returning to the US to do overnights taking advantage of time zone differences. Could be sweet for at least 1-2 years. Might also be terrible, I dont know.
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None of those are sustainable and they don’t pay rads enough already, let alone paying overnight premiums. Again, the tax disincentives make it a no brainer.
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deep nights gig sound better than the really are for most people.
Like BHE mentioned, the rest you get after a shift is usually pretty bad for me when I’ve done it. I work till earlier hours and still find it messes up my schedule by the end of the block.
Other issue I have experienced or gotten from other night jobs is that you are a “luxury item” that can be easily be gotten rid of. Your value to the group is no more than the secretary answering the phones. You are worth “X” and aren’t worth than a penny more than “X”.
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There is no good research as in a double blind controlled study over multiple decades or human lifespan.
Same reason no good research demonstrating any particular diet or exercise is optimal. Too hard and too expensive to do these studies.
So youre left with a bunch of associational studies, animal model extrapolations and inferential opinions.
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inferential opinion: working nights made my diet unhealthy, decreased libido, took time away from helping the kids with schoolwork, made me unmotivated to lift, train, or do much in the way of self-development
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I think it depends on other things. If u have a supportive wife, I’d prefer 7on/14off. If I am a loner or have poor family relations, it may be preferable to work 200+ shifts per year and make sure that no one disturbs me after midnight.
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There are some things you don’t need to do studies on. Yes, some things in life are that obvious.
By the way, many things [i]can [/i]be done in life, but that doesn’t mean any given person [i]should [/i]do them. As we all know, there are consequences to all decisions – so yes, choose wisely. -
I could switch my night job to a day job by moving to Hawaii. Don’t want to pay 10% extra tax, but more importantly Hawaii is too far away from things. Otherwise 10% isn’t much.. but I also heard in Hawaii they got deadly jelly fish and tiger sharks, much worse than what we have on the east coast. The biggest down side no direct flights to euro
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Plus everything is more expensive – real estate, gas, milk, etc.
The weather is attractive this time of year when it’s cold and rainy/icy.
Quote from Apple1919
I could switch my night job to a day job by moving to Hawaii. Don’t want to pay 10% extra tax, but more importantly Hawaii is too far away from things. Otherwise 10% isn’t much.. but I also heard in Hawaii they got deadly jelly fish and tiger sharks, much worse than what we have on the east coast. The biggest down side no direct flights to euro
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Personally, I cant think of a single week where I did nights and it didnt make me skip some of my lifting sessions, or Jiu Jitsu attendance, or volunteer work, or classes I teach, or desire to spend time with kids. Thing with helping kids with homework is that its something I enjoy doing myself even when I dont enjoy it. For me , when you get a string of days off after a bunch of nights, the extra time off doesnt make up for the time lost. Life just kind of passes you by during those string of nights and you cant get them back. Its not like the goal of time off is only recovery from work or out of own vacation such that you can group it together, for me time off is to allow me to have a daily routine where I dont miss out on things.
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Quote from nightradd
What if you consistently stay on a nights schedule year round, so that you’re not constantly switching between days and nights? Getting adequate sleep, exercising and eating healthy, and getting a little bit of sunshine in the late afternoon/early evening when you wake up. And also prefer this schedule mentally to an 8a-5p.
Would that theoretically offset the potential negative health effects and increased cortisol of nights? This is an honest question.
seems to me that would likely be decent. Most of us aren’t getting a lot of sunlight during the day anyway so don’t see why it would be much different than day shifts.
I suspect (don’t know) that it’s the constant switching that is the biggest problem. Also, a sig % of those I know (including me) who did occasional overnight shifts (1-2 weeks at a time) had a lot of trouble sleeping during those blocks. So you shift over, work nights, get 4-5 hours of fitful sleep between shifts, and are just exhausted the rest of the time. That was not uncommon, and was absolutely miserable.
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Good observation.
Quote from 67ED5CC042435
Humans are supposed to sleep at night.
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I did extensive hands on research during residency. Never again.
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My experience similar to others.
While actually doing the overnight shifts was stressful enough, the recovery had it’s own stress, a large part of which was how the recovery interfered with my “normal” life.
Overnight work was the primary reason I left my first gig; after 40, I could no longer handle it from a mental, emotional, and physical standpoint.
As Clint reminds us: “A man’s got to know his limitations.”
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Doing night gig was one of the worst experiments I did. Never again…
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Will we ever get to a point where the volume of work at night exceeds the workers willing to do the work? Or will the price just continue to climb and climb to draw workers out, like a moth to a flame.
With telerad companies unable to consistently provide acceptable TATs and prevent rads in the hospital from getting woken up to read, we seem to be approaching some breaking point.
Maybe I am wrong but it seems like fewer and fewer trainees coming out want to work at night. Maybe if a med student says they want to do nighthawk as a career that will be an edge when it comes to getting into training programs or even going before that, getting into med school. Just like students applying to med school in past who said they wanted to do primary care might have gotten a little bit of an edge.
Quote from Voxel77
Doing night gig was one of the worst experiments I did. Never again…
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Nights suck. I did plenty , weeks at a time, in residency. I promised I would never do that to myself again.
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As a late mid career radiologists who has worked for a few employers with such requirements was never informed of the health effects of shift work and after hours call back despite the science being in. Is this negligent on behalf of my employers?
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Even late shifts to later in the night suck … but high demand yes. The VA is looking better and better into the twilight of the career (or early career/FIRE)
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I was way more exhausted constantly during residency coming in at 8:30 and leaving at 5 pm than I am working 7 on 14 off overnights. Never been a morning person, I can never wake up before 12-1p even if I’m off and traveling in a different time zone or whatever. Just the way my body works. I plan on doing nights until retirement.
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12-1p? Wow, I’m glad I’m not you. You gotta know what suits you, though.
People who stay up until 12 midnight or later have always seemed to me to be the people that can’t sleep, in general, and have issues along those lines.-
Some people only sleep 5 hours a night and dont suffer any ill effects.
Maybe some minority of individuals have different gene expression that allow them to tolerate or even thrive at night.
Night gathers, and now my watch begins. [] I am the sword in the darkness. I am the watcher on the walls. I am the shield that guards the realms of men. I pledge my life and honor to the Nights Watch, for this night and all the nights to come.
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That’s me. 5hrs and my eyes open.
No ill effects. Yet. I’m sure my number will get called. It always does for everyone. Eventually.
Quote from golden gate
Some people only sleep 5 hours a night and dont suffer any ill effects.
Maybe some minority of individuals have different gene expression that allow them to tolerate or even thrive at night.
Night gathers, and now my watch begins. [] I am the sword in the darkness. I am the watcher on the walls. I am the shield that guards the realms of men. I pledge my life and honor to the Nights Watch, for this night and all the nights to come.
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I feel the exact same way. Some people are just not wired to work 8a-5p. I am one of those people. I much prefer evenings and nights. Everyone is different and that’s perfectly fine. There’s 24 hours in a day and radiology is 24/7 anyway.
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I pretty consistently get 8-8.5 hours of sleep going to bed at 10a and waking up at 6-7p. No problems sleeping during the day or night, it’s just that I never get tired before 6 am or so.
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Carving your own schedule that fits yours body rhythm is golden.
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you will always be in very high demand w/ that work schedule.
Quote from nighthawker
I pretty consistently get 8-8.5 hours of sleep going to bed at 10a and waking up at 6-7p. No problems sleeping during the day or night, it’s just that I never get tired before 6 am or so.
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Worked out well so far. I knew I wanted to be an overnight guy since R2 way back when when the first 7 on 14 off jobs started appearing.
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If you can not get (or pay enough for) dedicated night folks, then your only choice is to share the night calls and take a week off after nights.
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Ever think due to demand and service for hospitals, who over-image and it (amazingly) will likely get worse, the policies will change so people can read from locations that are non-US to be able to cover 12-8am shifts, or similar?
It’s amazing how dependent the US health care system is on (almost strictly) radiology. A friend was telling me that a neuro service for a hospital was tele-neuro … you should hear what they order … the ER physician can’t just click a button like those guys do, and decide to push tpa or not? -
Quote from nighthawker
Worked out well so far. I knew I wanted to be an overnight guy since R2 way back when when the first 7 on 14 off jobs started appearing.
In the ACR job post listings now 7 on, 21 off remote from anywhere
[link=https://jobs.acr.org/job/one-week-on-three-weeks-off-7-8-hour-remote-shifts-night-radiologist-for-la/68392152/] ONE Week On, THREE Weeks OFF! 7-8 hour remote shifts, Night Radiologist for LA [/link]
SpotlightPreferredMember Company -
Quote from IGotKids2Feed
Quote from nighthawker
Worked out well so far. I knew I wanted to be an overnight guy since R2 way back when when the first 7 on 14 off jobs started appearing.
In the ACR job post listings now 7 on, 21 off remote from anywhere
[link=https://jobs.acr.org/job/one-week-on-three-weeks-off-7-8-hour-remote-shifts-night-radiologist-for-la/68392152/] ONE Week On, THREE Weeks OFF! 7-8 hour remote shifts, Night Radiologist for LA [/link]
SpotlightPreferredMember Company
Curious what they are offering. Being east coast and covering west nights is rough.
Maybe worth it on a per night/hour basis, but can’t imagine the salary being much. -
“And you make just enough to cover your credentialing fees!”
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Chronotype shifts over one’s life — from morningness to eveningness over the course of childhood, with eveningness peaking around 16-17 (good argument for later school start times). As adults, the opposite occurs, with middle aged and elderly sleeping and waking progressively earlier. Lot more 35 year old rads willing to do nights than 75 year old rads, that’s for sure.
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Yea I am hoping 7 on 21 off is the new trend. I’m happy at my current job but I would possibly switch for 21 off.
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I was like that and then after hitting 50, I needed to sleep by 10pm. Strange how it just happened so abruptly.
Quote from nightradd
I feel the exact same way. Some people are just not wired to work 8a-5p. I am one of those people. I much prefer evenings and nights. Everyone is different and that’s perfectly fine. There’s 24 hours in a day and radiology is 24/7 anyway.
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