工作輪班好痛苦，5個策略來應對

　　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.

　　根據(jù)勞工部2014年的數(shù)據(jù)，大約有1500萬人在全職從事晚班、夜班、循環(huán)輪班或雇主安排的不規(guī)律的工作。輪班工作對睡眠、生活質(zhì)量與健康有一系列的負面作用，包括世界衛(wèi)生組織對其可能致癌的一項評定。那么，這與癌癥有什么聯(lián)系?有一項這樣的主流理論認為：在不合適的時間里暴露在藍光下，可能會擾亂我們身體本身的抗癌能力。

　　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:

　　睡眠藥物診斷的圣經(jīng)《睡眠障礙國際分類第三版》將輪班工作障礙定義如下(必須包含如下全部標準)：

　　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.

　　有報告顯示：伴隨著睡眠總時間的減少，失眠且/或嗜睡與重復的工作計劃和正常睡眠時間重疊有關。

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

　　與輪班工作安排有關的癥狀至少已經(jīng)存在三個月。

　　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(工作與休息天數(shù))的睡眠曲線與腕動儀監(jiān)測顯示一個受影響的入睡和蘇醒模式。

　　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.

　　入睡與/或蘇醒紊亂不能用現(xiàn)存的睡眠紊亂、藥物或神經(jīng)紊亂、精神錯亂、藥物使用、較差的睡眠衛(wèi)生，或者物質(zhì)使用紊亂來更好地解釋。

　　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：與我們?nèi)旌虬l(fā)展的經(jīng)濟相隨，輪班工作是存在的。這里有一些幫助你管理工作輪班并保護你睡眠和健康的小竅門：

　　1. Go to the Cave

　　1. 擁有自己的私人空間

　　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.

　　超人有他的孤獨堡壘，當晚班結束白天睡覺時，你也需要你的私人空間。我們的視網(wǎng)膜含有內(nèi)在感光神經(jīng)元細胞，它暴露在哪怕是一分鐘光亮下也會向我們的大腦發(fā)信息以使其蘇醒。用黑色垃圾袋遮住窗戶或?qū)ζ溥M行遮黑處理。移除或遮住所有臥室內(nèi)發(fā)光的電子設備?；蛘咭部梢耘渲靡粋€遮眼罩使你在睡眠使遠離光線。

　　2. Sleep Is Sacred

　　2. 睡眠應得到尊重

　　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.

　　所有在家的人必須尊重你睡眠的重要性。我記得曾治療過一名病人。他和妻子有兼職電子商務，不幸地是在他的“保護性睡眠時間”他被UPS分配接收包裹任務。召開家庭會議討論睡眠對你的健康是如此重要，并擬定一個計劃，以減少7-8小時睡眠時間內(nèi)可能的噪音及其他打擾。使用噪音減輕機對抗白天增加的環(huán)境噪音。

　　3. Naps

　　3. 打個小盹

　　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.

　　如果你不能在一個地方獲得理想情況下7-8小時的睡眠，用打盹補充睡眠缺失是下一個最好的選擇。夜班職員在回家的路上，由于他們的生理節(jié)奏被打亂，摩托車事故風險會增加。如果認為沒睡覺就開車回家有問題，你可以出發(fā)前在工作的地方或者車里打個小盹。

　　4. Anchor Sleep

　　4. 固定時間睡眠

　　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.

　　出于成為社會一部分的本能，大部分夜班工人根據(jù)休息天數(shù)“調(diào)整”他們的入睡/蘇醒計劃，意味著他們白天保持蘇醒，夜里睡覺。這會破壞你的晝夜節(jié)奏，導致睡眠缺失、白天瞌睡和疲勞。“固定時間睡眠”是這樣一個概念，在工作和休息日同樣的時間框架里重合4小時。所以，舉例說明，如果當你當班時通常在早上9點到下午5點休息，那就試著在不當班時從早上5點睡到下午1點。你的身體會很好地報答你。

　　5. Medication

　　5. 藥物

　　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.

　　刺激性藥物在應對輪班工作障礙中發(fā)揮了比較重要的作用。這些藥物只能在你嘗試過以上4種方法后仍飽受困擾時試用。Provigil是食品藥品監(jiān)督局批準的治療輪班工作障礙的覺醒促進藥物(機理未知)。因為它是處方藥并且是附表四的控制藥物，所以你需要找醫(yī)生開具。Provigil已被廣泛接受，但包括頭疼和焦慮等常見的副作用。藥物理論上有血壓升高的風險，但從心血管來講，它通常比譬如利他林和阿得拉更安全。重要的是，婦女需要注意Provigil能降低口服避孕藥的功效，所以需要采用另一種避孕方法。

　　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.

　　輪班工作障礙對美國勞動大軍來講是一個大問題。經(jīng)濟趨勢顯示它將更可能成為一個越來越突出的問題。幸運地是，你可以采取步驟積極地減少它對健康的負面影響。