24-Hour Shifts Take A Toll On The Heart

People who work in emergency medicine and provide fire-prevention services, medical internships and residencies as well as other high-stress jobs, are usually needed to work 24-hour shifts with very little opportunity available for sleep. It is known that extreme fatigue can affect many emotional, cognitive and physical processes and can cause stress hormone secretion, increased inflammatory processes and increased blood pressure. What isn't known is how these 24-hour shifts, that lead to sleep deprivation, affect the functioning of the heart.

It was important to investigate whether any negative health-related effects were associated with too much work and not enough sleep, since people seem to work longer hours or at more than just one job in order to make ends meet. Researchers then decided to conduct a first-of-its-kind study to investigate what the immediate effects of a 24-hour shift, associated with sleep deprivation, had on the health of people. 

The study

For the purposes of this study, researchers enlisted 20 radiologists who were healthy and not known with any acute or chronic conditions. These radiologists included 19 males and one female, with an average age of around 32 years. The participants weren't allowed to consume caffeine-containing products, as well as not being allowed to take in food and drinks containing theobromine (which is found in tea, nuts and chocolate). 

Each of these test subjects had cardiovascular magnetic resonance (CMR) imaging performed on them (in order to determine cardiac contractility), with strain analysis done before and after a 24-hour shift that included an average of 3 hours of sleep. The test subjects also have blood and urine samples taken from them, as well as having their heart rates and blood pressures measured and monitored.

A limitation of the study was that researchers didn't take into account factors such as environmental stimuli and the individual's own stress levels.

The findings

When all the relevant investigations were performed and the data was collected and analyzed, the following findings were made.

• There was an increase in systolic and dialstolic blood pressures of around 6% and 11%, respectively.
• The heart rate in these individuals had increased by 8%.
• Peak systolic circumferential strain, which represents heart contractility, had increased slightly.
• The test subjects' thyroid functions had shown increased levels of thyroid stimulating hormone (TSH) as well as the thyroid hormones T3 and T4. There were also increased levels or cortisol, which is a hormone released by the body as a response to stress. 

READ Best Tips for Stress Management

The clinical significance

The findings made in this study seemed to be short lived, therefore the researchers stated that further studies needed to be performed in a larger population group in order to determine whether there were any long-term affects of sleep deprivation. The findings in these studies would then help health care professional better understand how shift duration and workload would affect public health.

Chronic Fatigue Syndrome: Causes, Risk Factors & Management 

Chronic fatigue syndrome (CFS) is a complex condition that's characterized by severe fatigue that can't be explained by an underlying medical condition. This fatigue doesn't improve with rest and can be made worse with mental or physical activity. The symptom of chronic fatigue can also be due to more than one underlying condition.

Causes

The exact cause of CFS is unknown, but it may be due to a combination of factors that affect individuals who were born predisposed to this condition.

Some possible causes are thought to be:

• Viral infections - such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV), although no conclusive link to this has been discovered as of yet.
• Hormonal imbalances - abnormal levels of hormones produced in areas such as the adrenal and pituitary glands, as well as the hypothalamus are thought to lead to CFS.
• Immune system problems - such as an impaired immune system.

Risk factors

The following are regarded as possible risk factors for the development of CFS.

• Being female is a higher risk factor than being male.
• Individuals in their 40s and 50s.
• Having increased stress levels.

Symptoms

There are 8 official signs and symptoms, with the inclusion of fatigue, that gives CFS its name. These are also the signs and symptoms used as the diagnostic criteria for CFS, because there is no single test that can confirm its diagnosis, although investigations need to be done to exclude other conditions that cause similar issues.

The signs and symptoms are: 

• A new type of headache or one with a different severity or pattern.
• Sore throat.
• Unexplained muscle pain.
• Loss of concentration or decreased memory.
• Enlarged lymph nodes in your armpits or neck.
• Sleep that doesn't result in a refreshed feeling in the morning.
• Pain that moves around the joints with no redness or swelling.
• Severe exhaustion that carries on for more than 24 hours after mental or physical exercise.

Complications

CFS can cause certain complications, and they include the following:

• Restrictions in the affected individual's lifestyle.
• Depression.
• Increased absences from work.
• Social isolation

READ Fibromyalgia & Chronic Fatigue Syndrome

Management

CFS affects different people in different ways. Therefore, the treatment strategy for each affected individual may be different. 

Certain medications can offer symptomatic relief, and they include:

• Sleeping tablets - sleep hygiene is usually advocated such as avoiding alcohol and caffeine before bed, taking a warm bath and choosing a regular time to go to sleep. If these suggestions don't work, then sleeping tablets may be prescribed.
• Anti-depressants - many people diagnosed with CFS can suffer from depression. Ant-depressants may then be prescribed to help these patients with their mood as well as improve sleep and relieve pain.

Certain therapies can also help patients diagnosed with CFS.

• Graded exercise - a physical therapist can help determine what types of exercise can help depending on one's activity level. If the patient is inactive, they are started on stretching and range-of-motion for just a few minutes a day. These exercises are increased slowly over weeks to months. The patient's endurance will then improve as they gradually increase the intensity of the exercise over time.
• Psychological counseling - a psychologist can be consulted to help figure out options to work around some of the limitations that CFS is causing. This helps the patient feel more in control of their lives and the CFS instead of the other way around. Self-management strategies and cognitive behavioural therapy are among the most helpful.