This article has been reviewed for accuracy by our peer review team which includes clinicians and medical professionals. Learn more about our peer review process.
While the majority of Americans have jobs that allow them to be in bed by midnight, it’s estimated that 20 percent of the workforce drag themselves to work from midnight to eight in the morning. Who are these people and how do they manage to get enough sleep?
Unfortunately, many shift workers don’t get enough sleep. They also suffer higher rates of high blood pressure, high cholesterol, diabetes and depression compared to “9-to-5” workers. In addition to being susceptible to various physical and mental problems, shift workers are also at risk for developing a dependency on stimulants.
Jobs that employ more shift workers than other professions include police officers, truck drivers, firefighters, warehouse workers, hospital employees and factory workers. While some people prefer working nights and adapt more easily, others have no choice due to family responsibilities, access to transportation or because they make more money as a shift worker. Many workers who must work third shift or 12-hour shifts begin taking stimulants to stay awake during work hours but then become addicted to stimulants.
What is Third Shift Syndrome?
Also called shift worker syndrome, third shift syndrome is designated as an actual disorder in the latest edition of the International Classification of Sleep Disorders (ICSD-3). Symptoms of shift worker disorder include:
- Trouble falling asleep and/or staying asleep
- Getting less than five hours of sleep each day
- Difficulty sleeping normally on the weekends or on non-work days
- Forgetfulness/inability to concentrate
- Recurring illnesses due to reduced functioning of the immune system
The root cause of shift worker syndrome is “circadian misalignment.” During the day, the brain is kept in a constant state of arousal by the circadian system, a sleep-wake cycle regulated by a region of the brain known as the “hypothalamus.” When the retina’s photoreceptors perceive incoming light (mostly sunlight), this sends signals to the brain telling it to remain “awake.”
Then, around dusk, the pineal gland begins releasing melatonin to prepare the brain and body for sleep. People who are regularly active during the day and asleep at night naturally produce melatonin only in the evening. For shift workers, though, this release of melatonin is inhibited, because they receive constant exposure to light during night hours.
Numerous studies indicate that shift work increases the risk of metabolic disorders, heart disease, gastrointestinal problems, cancer and mental illness. One longitudinal study evaluated the brains of people who had worked nights for a decade and found their brains showed signs of premature aging. Additionally, shift workers crave sugar and carbohydrates because they lack the energy they would have if they slept normally. The combination of circadian misalignment and poor diet further contributes to higher rates of obesity, diabetes and other chronic diseases in shift workers.
Warehouse Work and Stimulants
Shift workers such as warehouse forklift drivers, truckers and even nurses may start taking caffeine pills on particularly rough nights where they can’t stay awake. Eventually, caffeine pills can lead to experimenting with stronger stimulants provided by a co-worker or friend who also works nights. Stimulants frequently abused by shift workers include caffeine, energy drinks and Adderall.
The Dangers of Energy Drinks
A so-called energy drink contains triple the amount of caffeine in a cup of coffee, sugar and legal stimulants such as taurine and guarana. Like caffeine, taurine and guarana not only increase alertness but also elevate energy levels and cause spikes in heart rate and blood pressure. You can overdose on energy drinks if you keep drinking them without giving your body time to metabolize and excrete stimulants.
Thousands of people seek emergency treatment every year for potentially life-threatening side effects of an energy drink overdose. Severe dehydration, irregular heartbeat and panic attacks can cause shock, unconsciousness and even heart failure when too many energy drinks are consumed in a short period.
Adderall and Shift Work
Mostly prescribed to treat narcolepsy or ADHD, Adderall is a powerful stimulant that significantly elevates levels of dopamine and norepinephrine in the brain. Also called the “study drug,” Adderall is a frequent drug of abuse among college students who need to finish a paper on time or are cramming for an exam. Although Adderall is a prescription medication approved by the U.S. FDA for treatment of ADHD and certain neurological disorders, it is still a highly addictive stimulant that initially induces psychological dependence. Shift workers abusing Adderall not only like the fact it keeps them alert and awake for 12 hours but that it also causes a sense of euphoria and well-being.
Contrary to what students and others believe, Adderall does not increase intelligence or creativity. Some shift workers who don’t have much trouble adjusting to an upside-down sleep schedule take Adderall anyway because they think it enhances cognition. However, studies have found an adverse correlation with Adderall use and complex memory tasks. In other words, Adderall may make you feel wide awake but you are just as prone to errors or making wrong decisions while working at night.
An Adderall addiction can happen with two or three weeks of taking the drug regularly. Eventually, Adderall users become physically addicted to Adderall and suffer withdrawal symptoms when they try to stop taking it. What makes an Adderall addiction worse for shift workers is that when it comes time for them to sleep, they can’t. Long-term Adderall addicts are also at risk for developing symptoms that mimic schizophrenia or a psychotic episode. This is the result of the brain essentially “overdosing” on dopamine and norepinephrine.
Getting Help for a Stimulant Addiction
If you or someone you know is addicted to Adderall, methamphetamine, cocaine or another stimulant, tbere is help. With the help of treatment, many people who have struggled with the same problem have gone on to achieve a life free of stimulants.
Help starts with a phone call. At FHE Health, our experienced counselors are available 24/7 to listen to you, answer your questions and offer advice about the best treatment program for your needs.