KiwiRail has made the move to ban workers from using sleep aids such as melatonin and Zopiclone, citing safety concerns.
Experts have voiced concerns with these changes, as many of the impacted staffers were shift workers who relied on medication to get through the odd hours.
Dr Alex Bartle from the Sleep Well Clinic joined the Afternoons team to discuss the dangers of working shift work - and whether a reliance on sleep meds is helpful or harmful.
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Speaker 1 (00:09):
You're listening to a podcast from news Talk zed Be
follow this and our wide range of podcasts now on iHeartRadio.
Speaker 2 (00:16):
Doctor Alex Barta is one of the foremost experts in
sleep in this country. He runs the sleep Well Clinic
and he joins us on the line now, doctor Bartle,
Good afternoon, Good afternoon.
Speaker 3 (00:26):
Good to talk to you. In simple terms, what does
working night or rotating shifts do to the body's circadian rhythms?
The Cicadian clock? And see what is the Cicadian clock.
Let's go to base well.
Speaker 4 (00:39):
Circadian clock is based on the light and the dark,
which for thousands of years has been sort of twelve
years to twelve hours day, twelve hours night. And we've
mucked around with that in that we're now living in
an environment where we change our day and night so
much so light suppresses melatonin and starts producing cortisol, and
that wakes us up, gets us going during the day
(01:01):
and at nighttime when he gets dark, we produce melatonin
that reduces ability to stay awake. Can we fall asleep,
And so when you start doing shift work, you're trying
to sleep when you should be awake, and you're trying
to be awake when you should be asleep. So it does.
It's very difficult. Nobody really puts up with Cicadian rhythm
(01:21):
dysfunction for too long. It's always difficult to sleep and
difficult to stay awake during the night.
Speaker 3 (01:28):
And so can that just be solved as simply as
blackout curtains or eye masks and you know.
Speaker 4 (01:36):
Ear plugs, no question, if you come home in the
morning and it's daylight, keeping the place dark and wearing
sunglasses on the way home, for example, to block the
light keep it dark during the night during the day
will help. But the problem is that, you know, if
you were doing three or four weeks of night shift
and just spending night tivit, you would soon train your
Cicadian rhythm to a night shift phase. But we don't
(01:58):
do that. We tend to spend you know, three or
four nights maybe on night shift, and then we go
on to day shift or we have the weekends off,
which means we go back to a normal rhythm. And
so it's this swapping backwards and forwards that's actually the
difficult part of it.
Speaker 3 (02:11):
And how quickly does this sort of I guess you'd
call it sleep debt build up in terms of shift work.
So if you're losing your sleep, how quickly does that
start to affect your performance?
Speaker 4 (02:22):
Well, I mean even after one night, it's not going
to be quite as good as it would have been otherwise.
And in fact, the best sort of shifts are those
these days that are in and out of night shift
very quickly. For example, the police often run a twelve
hour shift, so they'll do twelve hours day and a
twelve hours night, but they do two nights, two days
(02:42):
and four off. That's not bad. They get their hours
in okay, enough for a week's work, but they are
only doing two nights and then they're on to four
days off, which is probably a way to go.
Speaker 2 (02:53):
So, doctor, what's your thoughts about malatonin? And it will
soon be sold over the counter without requiring a prescription.
Were you in favor of that when it's an announce
when it was announced? And is it a good way
for night shift workers to get some shut eye if
they haven't been sleeping well for a good week.
Speaker 4 (03:09):
It's probably nothing like as effective as keeping the room
dark and quiet and making sure that they're not working
during the day. It's not. It works very they're going
to have very low dose of meloton in any way,
even the Cicadian, the two milligram slow release products, even
the manufacturers of that initially said it didn't make any
(03:29):
difference under fifty five year olds. So it's a very
weak it's not really a sleeping pill. It's not a
sleeping pill. And you know, jet lag maybe for people
who are pilots or aircrew occasionally use it, but it's
not that effective. The most important part is light and dark.
As I've said right at the beginning, that's the most
(03:50):
powerful in train abound cicadian rhythm. Zopiclone, on the other hand,
which is the other pill that's been mentioned, is a
proper sleeping pill, and if you take that too close
to actually going to do some safety critical work, that's
probably not a good idea. But again, it has an
active life what's called a half life of about six hours,
and so if you take it when you want to
(04:11):
go to sleep at sort of seven in the morning,
eight in the morning, when you get home, by the
time you go to work at ten o'clock at night,
it's going to be well out of the system by then.
So again it's quite a short acting but a good
sleeping till pill.
Speaker 3 (04:24):
So if it's if malatonin pills are quite weak. Were
you surprised that Kiwi Rols put this ban on the
use of melatonin?
Speaker 4 (04:36):
Yes, I am, indeed. In fact, that's probably why the
government we're quite happy to put it onto open open
buying through pharmacies because really it's more a placebo response
rather than that fantastically chemical response.
Speaker 3 (04:51):
Because I think this is the case because I've taken
the malatonin a lot when I've been in the States,
and I found it very effective. But I just wonder
if that's because you just let yourself off the hock.
You know, you need to get some sleep because the
work you need the day, and you take the pearl
and you've pulled the curtains in your hotel room and
then you're just calm, you know, as you say your course, And.
Speaker 4 (05:12):
I think there's a lot to do with it. And also,
of course when we're traveling a lot of the time
we spend more time outside during the day, and outside
light is the most powerful and trainer. If you like
about circadian rooms. You know, if you go to the UK,
for example, the best thing you can do is spend
the first few days outside as much as you can,
and that will most quickly and train you so you
can start sleeping at night and being away during the day.
(05:34):
It's the light dark cycle that makes a huge difference.
Speaker 2 (05:37):
Would there be a worry doctor? And I note in
this story that it mentioned some of the workers had
been using the likes of zoppo clone for years. For you,
as a sleep expert and a doctor, would that give
you cause for concern if someone is using it on
a regular basis for that long.
Speaker 4 (05:51):
Well, yes I would. And the most concerning part is
if you're starting to need more and more of it,
which is so commonly happens when you start with half
does the job, and then you need one, and then
you need one and a half. That's the problem. People
who perhaps in their seventies or eighties, have been taking
it for decades, take half a pill every night. I've
got no problem with that. It's not ideal, but I'm
(06:13):
not going to suddenly jump up and down about that.
But if you're a twenty year old and needing to zopoclane,
there are many other ways in which we need to
get their sleep sorted out rather than taking zopoclone.
Speaker 3 (06:23):
What do we know about the type of sleep you
get on the likes of zopoclone or what's the other one,
dimezapan is that I might have said that wrong, because
when I take it, I feel like, you know, I've
been knocked out, But generally wake up with a horrible
metallic taste in my mouth, crudibly dry mouth, and feel
sort of odd, kind of like my brain's been raised,
(06:47):
as opposed to have been refreshed, if you know what
I mean.
Speaker 4 (06:50):
Yes, I mean it does have different effects on different people,
but the majority, not all, but the majority of people
do get this metallic taste in the mouth. That's pretty common.
But you know, many people wake up in the morning
after zoppoclona feel fired in the morning. But there's certain
number of people yourself included. Obviously does have a hangover
sort of effect. In terms of quality of sleep, the
(07:12):
zopoclone probably doesn't. Is a non benzodiazepine, so it doesn't
have some of the effects of diazepin, which is a benzodiazepine.
So in terms of impacting on sleep, it doesn't impact greatly.
It does reduce the amount of ram and non rams
sleep you have to some degree, so your sleep isn't
going to be quite as good with any medication. But
(07:32):
zoppotone is probably the safest of all the sleeping Taler
two pills, but only I've taken just occasionally for emergency.
Speaker 3 (07:41):
You might say, if we flip this around and get
from trying to go to sleep to waking up, you
say that natural light is the best way. I was
telling my partner because she was saying she's feeling very sleepy.
I said, try looking up at lights. So do electric
lights work as well as as the sun for waking
you up.
Speaker 4 (08:01):
Don't look at the light, don't look at the sun.
Speaker 1 (08:04):
No.
Speaker 4 (08:04):
Just generally ambient light in rooms are less than a
thousand lux you know lux missle of light, So something
like in my office here, it's something something like six
or seven hundred lucks, which I think is pretty average.
Outside is completely different in the Auckland moment, and it's
sort of variously sunny and a bit cloudy. It's probably
something like sixty to seventy thousand lucks. It's completely different outside,
(08:29):
and that's what our brain is for thousands of years.
In the middle of summer, it might go up to
even to eighty to one hundred thousand lucks. That's what
our brains, what our brains haven't been used in the
past is glare. So when we need to wear some protection,
possibly is where it's clary, so tilts, our buildings, concrete slabs,
tarmacadam roads. What we need where you go outside, which
(08:49):
is much better for us is shaded blue, green life.
She's going to walk through the local park or gardens.
You know, shaded, don't look at the sun, but just
being outside the light is completely different, and it's a
particularly game for the walk to you know, green blue environment,
which is our natural environment to colors anyway, that's what
(09:11):
suppresses melatonin, wakes us up and starts producing serotonin, which
makes us feel good. And the more serotonin we produced
during the day by spending more time outside, that converts
to melotonin. So the more serotonin produced during the day,
the more melotonin it converts to at night and helps
us sleep. So when your mum said to you, you
know you've been out camping or tramping for a day,
(09:32):
or your sleep well might deal because you've had lots
of fresh air. It's nothing to do with the air.
Speaker 3 (09:38):
Interesting and so in the modern world, if say you
work in an office, you're working inside, then you should,
you know. And some of us get up when it's
still dark, and we drive to work when it's pretty
much dark, and we go straight inside, and then we
wonder why we're so sleepy.
Speaker 4 (09:50):
What we need to.
Speaker 3 (09:51):
Try and do is find would five ten minutes walk
outside and the natural light be enough to sort of
get you serotoning and melotonin and down.
Speaker 4 (10:02):
Yes, five or ten minutes is better than nothing. We
usually suggest half an hour would be a great time
to do that, and of course the more the better,
but half an hour is probably what we would usually recommend.
But as I say, if you can manage five or
ten minutes outside in a shaded, blue green environment that
sidea of just going for a walk through the local
park or whatever. If you can walk to work or
(10:24):
spend a bit of time outside, then you're quite right.
But many people, particularly in winter, go from their house
into their car, which is in effecting doors into their
office as I do. I mean, I'm in an office
at the moment, and it's in this relatively dim light.
We don't think it's dim, but it feel but it
is actually much dimmer, and I tried to get out
I've just been out of lunch time. So I've just
(10:45):
went for a walk. This at lunchtime, which is the
main time I can get outside, so summer's better for that,
but nonetheless spending bit of time outside really helpful in
shaded light.
Speaker 3 (10:57):
Wow, thank you so much for that. There was a
great chat, no trouble, Thank you very much.
Speaker 2 (11:02):
That is doctor Alex Bart, one of the foremost experts
in sleep in New Zealand. He runs Asleep Well Clinic
and I imagine he's been incredibly unt over the past
couple of years. Sleep such a major thing.
Speaker 1 (11:11):
For more from News Talk set B listen live on
air or online, and keep our shows with you wherever
you go with our podcasts on iHeartRadio
You're listening to a podcast from news Talk zed Be
follow this and our wide range of podcasts now on iHeartRadio.
Speaker 2 (00:16):
Doctor Alex Barta is one of the foremost experts in
sleep in this country. He runs the sleep Well Clinic
and he joins us on the line now, doctor Bartle,
Good afternoon, Good afternoon.
Speaker 3 (00:26):
Good to talk to you. In simple terms, what does
working night or rotating shifts do to the body's circadian rhythms?
The Cicadian clock? And see what is the Cicadian clock.
Let's go to base well.
Speaker 4 (00:39):
Circadian clock is based on the light and the dark,
which for thousands of years has been sort of twelve
years to twelve hours day, twelve hours night. And we've
mucked around with that in that we're now living in
an environment where we change our day and night so
much so light suppresses melatonin and starts producing cortisol, and
that wakes us up, gets us going during the day
(01:01):
and at nighttime when he gets dark, we produce melatonin
that reduces ability to stay awake. Can we fall asleep,
And so when you start doing shift work, you're trying
to sleep when you should be awake, and you're trying
to be awake when you should be asleep. So it does.
It's very difficult. Nobody really puts up with Cicadian rhythm
(01:21):
dysfunction for too long. It's always difficult to sleep and
difficult to stay awake during the night.
Speaker 3 (01:28):
And so can that just be solved as simply as
blackout curtains or eye masks and you know.
Speaker 4 (01:36):
Ear plugs, no question, if you come home in the
morning and it's daylight, keeping the place dark and wearing
sunglasses on the way home, for example, to block the
light keep it dark during the night during the day
will help. But the problem is that, you know, if
you were doing three or four weeks of night shift
and just spending night tivit, you would soon train your
Cicadian rhythm to a night shift phase. But we don't
(01:58):
do that. We tend to spend you know, three or
four nights maybe on night shift, and then we go
on to day shift or we have the weekends off,
which means we go back to a normal rhythm. And
so it's this swapping backwards and forwards that's actually the
difficult part of it.
Speaker 3 (02:11):
And how quickly does this sort of I guess you'd
call it sleep debt build up in terms of shift work.
So if you're losing your sleep, how quickly does that
start to affect your performance?
Speaker 4 (02:22):
Well, I mean even after one night, it's not going
to be quite as good as it would have been otherwise.
And in fact, the best sort of shifts are those
these days that are in and out of night shift
very quickly. For example, the police often run a twelve
hour shift, so they'll do twelve hours day and a
twelve hours night, but they do two nights, two days
(02:42):
and four off. That's not bad. They get their hours
in okay, enough for a week's work, but they are
only doing two nights and then they're on to four
days off, which is probably a way to go.
Speaker 2 (02:53):
So, doctor, what's your thoughts about malatonin? And it will
soon be sold over the counter without requiring a prescription.
Were you in favor of that when it's an announce
when it was announced? And is it a good way
for night shift workers to get some shut eye if
they haven't been sleeping well for a good week.
Speaker 4 (03:09):
It's probably nothing like as effective as keeping the room
dark and quiet and making sure that they're not working
during the day. It's not. It works very they're going
to have very low dose of meloton in any way,
even the Cicadian, the two milligram slow release products, even
the manufacturers of that initially said it didn't make any
(03:29):
difference under fifty five year olds. So it's a very
weak it's not really a sleeping pill. It's not a
sleeping pill. And you know, jet lag maybe for people
who are pilots or aircrew occasionally use it, but it's
not that effective. The most important part is light and dark.
As I've said right at the beginning, that's the most
(03:50):
powerful in train abound cicadian rhythm. Zopiclone, on the other hand,
which is the other pill that's been mentioned, is a
proper sleeping pill, and if you take that too close
to actually going to do some safety critical work, that's
probably not a good idea. But again, it has an
active life what's called a half life of about six hours,
and so if you take it when you want to
(04:11):
go to sleep at sort of seven in the morning,
eight in the morning, when you get home, by the
time you go to work at ten o'clock at night,
it's going to be well out of the system by then.
So again it's quite a short acting but a good
sleeping till pill.
Speaker 3 (04:24):
So if it's if malatonin pills are quite weak. Were
you surprised that Kiwi Rols put this ban on the
use of melatonin?
Speaker 4 (04:36):
Yes, I am, indeed. In fact, that's probably why the
government we're quite happy to put it onto open open
buying through pharmacies because really it's more a placebo response
rather than that fantastically chemical response.
Speaker 3 (04:51):
Because I think this is the case because I've taken
the malatonin a lot when I've been in the States,
and I found it very effective. But I just wonder
if that's because you just let yourself off the hock.
You know, you need to get some sleep because the
work you need the day, and you take the pearl
and you've pulled the curtains in your hotel room and
then you're just calm, you know, as you say your course, And.
Speaker 4 (05:12):
I think there's a lot to do with it. And also,
of course when we're traveling a lot of the time
we spend more time outside during the day, and outside
light is the most powerful and trainer. If you like
about circadian rooms. You know, if you go to the UK,
for example, the best thing you can do is spend
the first few days outside as much as you can,
and that will most quickly and train you so you
can start sleeping at night and being away during the day.
(05:34):
It's the light dark cycle that makes a huge difference.
Speaker 2 (05:37):
Would there be a worry doctor? And I note in
this story that it mentioned some of the workers had
been using the likes of zoppo clone for years. For you,
as a sleep expert and a doctor, would that give
you cause for concern if someone is using it on
a regular basis for that long.
Speaker 4 (05:51):
Well, yes I would. And the most concerning part is
if you're starting to need more and more of it,
which is so commonly happens when you start with half
does the job, and then you need one, and then
you need one and a half. That's the problem. People
who perhaps in their seventies or eighties, have been taking
it for decades, take half a pill every night. I've
got no problem with that. It's not ideal, but I'm
(06:13):
not going to suddenly jump up and down about that.
But if you're a twenty year old and needing to zopoclane,
there are many other ways in which we need to
get their sleep sorted out rather than taking zopoclone.
Speaker 3 (06:23):
What do we know about the type of sleep you
get on the likes of zopoclone or what's the other one,
dimezapan is that I might have said that wrong, because
when I take it, I feel like, you know, I've
been knocked out, But generally wake up with a horrible
metallic taste in my mouth, crudibly dry mouth, and feel
sort of odd, kind of like my brain's been raised,
(06:47):
as opposed to have been refreshed, if you know what
I mean.
Speaker 4 (06:50):
Yes, I mean it does have different effects on different people,
but the majority, not all, but the majority of people
do get this metallic taste in the mouth. That's pretty common.
But you know, many people wake up in the morning
after zoppoclona feel fired in the morning. But there's certain
number of people yourself included. Obviously does have a hangover
sort of effect. In terms of quality of sleep, the
(07:12):
zopoclone probably doesn't. Is a non benzodiazepine, so it doesn't
have some of the effects of diazepin, which is a benzodiazepine.
So in terms of impacting on sleep, it doesn't impact greatly.
It does reduce the amount of ram and non rams
sleep you have to some degree, so your sleep isn't
going to be quite as good with any medication. But
(07:32):
zoppotone is probably the safest of all the sleeping Taler
two pills, but only I've taken just occasionally for emergency.
Speaker 3 (07:41):
You might say, if we flip this around and get
from trying to go to sleep to waking up, you
say that natural light is the best way. I was
telling my partner because she was saying she's feeling very sleepy.
I said, try looking up at lights. So do electric
lights work as well as as the sun for waking
you up.
Speaker 4 (08:01):
Don't look at the light, don't look at the sun.
Speaker 1 (08:04):
No.
Speaker 4 (08:04):
Just generally ambient light in rooms are less than a
thousand lux you know lux missle of light, So something
like in my office here, it's something something like six
or seven hundred lucks, which I think is pretty average.
Outside is completely different in the Auckland moment, and it's
sort of variously sunny and a bit cloudy. It's probably
something like sixty to seventy thousand lucks. It's completely different outside,
(08:29):
and that's what our brain is for thousands of years.
In the middle of summer, it might go up to
even to eighty to one hundred thousand lucks. That's what
our brains, what our brains haven't been used in the
past is glare. So when we need to wear some protection,
possibly is where it's clary, so tilts, our buildings, concrete slabs,
tarmacadam roads. What we need where you go outside, which
(08:49):
is much better for us is shaded blue, green life.
She's going to walk through the local park or gardens.
You know, shaded, don't look at the sun, but just
being outside the light is completely different, and it's a
particularly game for the walk to you know, green blue environment,
which is our natural environment to colors anyway, that's what
(09:11):
suppresses melatonin, wakes us up and starts producing serotonin, which
makes us feel good. And the more serotonin we produced
during the day by spending more time outside, that converts
to melotonin. So the more serotonin produced during the day,
the more melotonin it converts to at night and helps
us sleep. So when your mum said to you, you
know you've been out camping or tramping for a day,
(09:32):
or your sleep well might deal because you've had lots
of fresh air. It's nothing to do with the air.
Speaker 3 (09:38):
Interesting and so in the modern world, if say you
work in an office, you're working inside, then you should,
you know. And some of us get up when it's
still dark, and we drive to work when it's pretty
much dark, and we go straight inside, and then we
wonder why we're so sleepy.
Speaker 4 (09:50):
What we need to.
Speaker 3 (09:51):
Try and do is find would five ten minutes walk
outside and the natural light be enough to sort of
get you serotoning and melotonin and down.
Speaker 4 (10:02):
Yes, five or ten minutes is better than nothing. We
usually suggest half an hour would be a great time
to do that, and of course the more the better,
but half an hour is probably what we would usually recommend.
But as I say, if you can manage five or
ten minutes outside in a shaded, blue green environment that
sidea of just going for a walk through the local
park or whatever. If you can walk to work or
(10:24):
spend a bit of time outside, then you're quite right.
But many people, particularly in winter, go from their house
into their car, which is in effecting doors into their
office as I do. I mean, I'm in an office
at the moment, and it's in this relatively dim light.
We don't think it's dim, but it feel but it
is actually much dimmer, and I tried to get out
I've just been out of lunch time. So I've just
(10:45):
went for a walk. This at lunchtime, which is the
main time I can get outside, so summer's better for that,
but nonetheless spending bit of time outside really helpful in
shaded light.
Speaker 3 (10:57):
Wow, thank you so much for that. There was a
great chat, no trouble, Thank you very much.
Speaker 2 (11:02):
That is doctor Alex Bart, one of the foremost experts
in sleep in New Zealand. He runs Asleep Well Clinic
and I imagine he's been incredibly unt over the past
couple of years. Sleep such a major thing.
Speaker 1 (11:11):
For more from News Talk set B listen live on
air or online, and keep our shows with you wherever
you go with our podcasts on iHeartRadio
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