Night has fallen and most people are either back home from work or are preparing to leave work for home to have dinner with family and get some much-deserved rest. But for night-shift or graveyard-shift workers, it’s the time they are on their way to work or have just arrived.

In today’s economy, where consumer businesses strive to meet the 24-hour demand for their services and manufacturers, the number of people working night shifts is increasing. People working in factories, information technology, media, transport, healthcare, ambulance drivers and first responders often work round the clock. How do they stay up and work at night? Do they suffer health problems as the body works against the circadian rhythm or the body’s natural clock?

“Health problems arise because you are going against nature,” agrees Shujaat Ameer, who worked the graveyard shift for a market research firm for over a decade. “The body wants rest at night, but we force it to work.”

With most of his firm’s clients based in Europe and America, Ameer was forced to work in their time zone. He went to the office around 5pm and returned at 3am or 4am. “In the day, people usually socialise, move around in office and frequently go out for lunch. At night, when there are fewer people, they stick to their work and become sedentary.”

Working night-shifts disrupts the body’s natural sleep cycle, which can lead to a number of health and social issues

“People working at night are often sleep-deprived and stressed because when they get home, others are awake,” says Dr Imran Afzal, a physician at the Jinnah Medical and Dental Hospital, Karachi. “In the long term, some do adapt, but they become susceptible to sleep disorders.”

Ameer adjusted to the night-shift easily, since his family stayed up till late anyway. “I was used to sleeping late,” he chuckles. However, he says, “Many of my colleagues could not manage the odd hours and they complained about backaches, high blood pressure, etc. One fellow’s health issues only resolved when he switched to a day job.”

Sonam Gulzar Syed, a 25-year-old private nurse does the 9pm to 9am shift. “I get constant headaches and backaches and have gained weight because of the long hours of sitting.” Syed was trained at a large private hospital, where she worked for a while, but later switched to private nursing, as it pays better. “The hospital duty is less strenuous, as you can take little breaks because other nurses provide a back-up,” she says, “but in private nursing, you have to be constantly vigilant.”

Currently, Syed takes care of a lady who has insomnia, diabetes, high blood pressure and recurrent urinary tract infections. As her patient is up most of the night, Syed is unable to nap during the night. On the home front, she takes care of her grandmother who has several health problems of her own, so hardly gets three to four hours of sleep. As she is a nurse, her family expects her to attend to the grandmother.

Night-shifts can cause fatigue, decrease cognitive abilities and reflexes and make people more vulnerable to disease. Other problems include restlessness, sleepiness on the job, decreased attention and disruption of the body’s metabolic process, since working the night-shift interferes with the production and circulation of the vital hormone leptin. This hormone plays a critical role in regulating weight, blood sugar, and insulin levels, which can lead to obesity and diabetes, even with a healthy diet.

Working late at night impacts one’s digestive health also, leading to constipation, indigestion and gastrointestinal problems. Night-shift workers hardly go out during the morning hours and, hence, get very little exposure to the sun, which is a major source of vitamin D production in the body.

“My doctor says the night-shift will kill me unless I exercise, sleep better, and cut down on carbs and stress,” says Zareena Ahmed* a journalist, who has been diagnosed with pre-diabetes. “Since the last few years, I reach home late, I wake up late, and this unhealthy routine has started showing on my face.”

But Syed Aqeel Hussain, who has been working for 25 years at various airports and does 12-16 hour shifts for a company that provides ground handling services at airports, says that the night-shift has not affected his health as his job entails walking. “It often takes three trips to load an aircraft, so I walk quite a bit.”

However, Dr Afzal believes that a person’s age, gender and healthy habits also play their role in managing the graveyard shift. “Women night-shifters often have to manage home as well and suffer more sleep deprivation than men, who are not considered responsible for domestic duties,” he says.

Researchers say there is increasing evidence to suggest that night-work may present a risk of spontaneous abortion, low birth weight, and premature birth for pregnant women.

Health is one thing, but what about family and social life?

“It’s been 10 years now,” says Ahmed who opted for the graveyard shift because it offered her the flexibility to manage her house in the day. “Earlier, there were barely any women working at the copy desk in the evening shift and those who did, left by 10pm. I would be the only woman to stay back till everything was finalised.”

For women who work late shifts, it’s an everyday battle with misogyny and patriarchy. “The men in the newsroom would encourage me to leave early, saying that working till late at night in the office wasn’t good for women,” says Ahmed. “What perturbed them most was how men in my family allowed me to work late at night. I politely but firmly told them to mind their own business. Thankfully, men in my family have not raised any issue.”

“Initially, as a single man, I enjoyed the peace and quiet in the office, but I prefer working in the day time after I got married,” says Ameer, pointing out that families do not accept one’s need to sleep during the day and load you with errands.

Scientists believe that being left out from social activities can also disturb one’s mental health in the long run, and may potentially lead to depression and irritability. “I have missed important family events or arrived late to weddings,” says Ahmed. “But in Ramazan, all Sehri plans fit in my routine. I guess that makes up for a lot of other missed meet-ups.”

Hussain utilises the day for doing more work. “The night-shift allows me to run my watch repair shop in the day to supplement my income,” he points out.

As the global economy moves to a 24-hour day setting, more people will find themselves working into the wee hours. While they should watch their health and regulate their sleep patterns, their employers should also make sure these workers are properly supported and given the help they need to get them through the night.

• • Name changed to protect identity*

The writer is a freelance journalist and tweets @naqviriz

Published in Dawn, EOS, October 17th, 2021