It’s 1.30am, Friday morning.  I’m struggling to keep awake on the first night shift of the year.  One down (well half of it anyway), six more to go.  I’m a light sleeper at the best of times, however, after a busy med reg night shift, it’s a different story.  I’ve slept through our smoke alarm going off (husband cooking dinner).  I’ve slept through fire engines running outside our house (husband cooking dinner).  Once heavy duty trucks came and dug up the road in front of our house to replace a cracked water pipe (unrelated to husband cooking dinner) – slept through that too.

Some people handle night shifts a bit better.  But on the whole, it’s not a favourite time for doctors, and not a favourite time for patients either.

How do night shifts impact on our neurological function?

How does this in turn impact our patients?

Ogbu et al commented that there was a higher mortality for ischemic stroke patients who were admitted over night, and on weekends, compared within business hours.  This may be to do with resources and staffing as much as the inherent tiredness that accompanies night shift.

In med school we learnt that being over-tired impairs you as much as having a few too many alcoholic drinks.  You’re able to recall information such as doses of antibiotics, but struggle to recognise patterns and diagnose / treat appropriately.

How do we fix sleepiness due to night shift?

According to Dr Douglas, shift work is a major cause of sleepiness.  “Treatment with bright lights has been tried with some success”.  Not so for the slumbering surgical residents right behind me, but an interesting thought that I’d love to hear more about from those of you who have tried this (for patients or yourselves).

From a neurologic point of view, does frequent shift work have a negative impact on our cognitive function?

Do you see certain neurologic illnesses in patients who do shift-work?

What sort of neurologic conditions often are accompanied by sleepiness?

And how do you go about treating this?