The Shift Worker’s Survival Guide to Sleep with Dr. Bijoy John

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Sleep is mysterious, it's spiritual.

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We heal in our sleep, we grow in our sleep.

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Sleep is the foundation of a lot of other things like fitness and exercise and weight loss and mental health, not to mention diabetes, high blood pressure, stroke, cardiovascular.

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It is the superpower.

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Welcome to Pivoting Pharmacy with Nutrigenomics, part of the Pharmacy Podcast Network, a must-have resource for pharmacist entrepreneurs seeking to enhance patient care while enjoying career and life.

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Join us as we pivot into nutrigenomics, using pharmacy and nutrition for true patient-focused care.

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Explore how to improve chronic conditions rather than just manage them.

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Celebrate entrepreneurial triumphs and receive priceless advice.

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Align your values with a career that profoundly impacts patients.

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Together, we'll raise the script on health and pivot into a brighter future.

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Hello and welcome to Pivoting Pharmacy with Nutrigenomics.

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I'm Dr Tamar L awful Doctor of Pharmacy and Certified Nutritional Genomics Specialist.

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You may not know this about me, but I've spent 17 years working the overnight shift as a pharmacist.

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Yeah, you heard that right 17 years of moonlit commutes, midnight lunches and trying to convince my body that, yes, it's really bedtime when the sun is shining.

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So today we're diving deep into a topic that's close to my heart sleep or, more often, for folks like us, the lack thereof.

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And we're not just talking about any sleep.

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We're talking about the kind of rest that seems almost mythical when you're working shifts that flip the day-night cycle on his head.

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Now, you've probably heard it all before the dire warnings about how skimping on sleep can have serious health consequences like weight gain, diabetes, high blood pressure and even an increased risk of cancer, and, honestly, it's enough to keep anyone up at night just thinking about it.

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But the good news is it's not all doom and gloom.

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There are real, actionable strategies that can help us, the night owls, the swing shifters, to not just get by, but to thrive.

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Now here's where it gets really interesting for us science buffs.

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Have you ever wondered why some of us can power through a night shift with just a cup of coffee and a quick nap, while others feel like they've been hit by a freight train?

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Or why certain diets seem to work wonders for your colleague but leave you feeling sluggish and foggy?

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That, my friend, is where sleep and nutrigenomics come into play.

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Nutrigenomics is this fascinating field that studies how our genes interact with our diet, lifestyle and, yes, our sleep.

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It turns out the quality of our sleep and how our body responds to the stress of irregular sleep patterns can actually be influenced by our genetics, including how we break down nutrients and how resilient we are to stress.

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I'll elaborate more on sleep and genetics in a future episode, but today we're diving into some hard-hitting advice with Dr Bajoy John, who's not only an expert in sleep science, but has been a guiding light for those of us roaming the halls at odd hours.

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He's sharing insights straight from his book Nobody Sleeping and by the time we're done, you'll have a personalized toolkit to help you power down your mind before hitting the hay, optimize your sleep schedule and maybe even inspire you to ditch those not so helpful sleep aids like melatonin or, dare I say, that nightcap we sometimes lean on.

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So whether you're clocking in as the world clocks out or just struggling to catch some Z's, this episode is for you.

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Listen in, dr John.

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Thank you so much for joining us today on Pivoting Pharmacy with Nutrigenomics.

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I'm excited to talk to you, get some tips from you that we can share with our listeners today, but let's dive in with where you started, to how you got to where you are now.

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My background is pulmonary critical care and also sleep medicine.

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I've been doing this for 25 years.

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My passion was always sleep, because sleep is mysterious and it always fascinated me.

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So after a 25 year full-fledged, all these specialties I said I'm gonna just focus and pursue my passion.

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So left the big practice, started my own sleep clinic, then wrote a book.

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Sleep is mysterious, it's a spiritual.

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We heal in our sleep, we grow in our sleep.

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Sleep is the foundation of a lot of other things like fitness and exercise and weight loss and mental health.

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Sleep is the foundation, so I call it the superpower.

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I've discovered that.

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You know I've failed many times.

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I suffered from insomnia and sleep apnea.

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I want to overcome all that and I want to pave the way to everybody else.

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So I believe when people sleep better they are better human beings.

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So we'll have a better world, peaceful world, by sleeping better and that's my mission and I'm on it 24 seven.

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Oh, thank you for having that as a mission, cause we know that sleep puts us in a better mood and it's definitely good for our health, and we don't want cranky people walking around this earth, so thank you for making this your mission.

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Now I wanted to dive in with you today, specifically centered around sleep.

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When it comes to professionals who work night shift or swing shift, you know their schedules vary and in your experience, have you been able to work with individuals with those type of schedules of course you know, in the working in the ICU, when I work 80 or under 100 hours a week.

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I know I was a shift worker.

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I worked all day, all night and then all day, so I'm well aware what it has done to my body.

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So, but I was found a way to manage.

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So it is very complicated.

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Shift workers are in survival mode, so what they do is they are awake than most other people.

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So when you are awake what happens is you have more time to eat.

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So there's many studies showing shift workers have more overweight than regular nine to five workers.

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And then the circadian rhythm shifts, the change in cortisol.

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They're at higher risk for diabetes, the higher risk for blood pressure, higher risk for cancer, not to mention when you drive home, when you're tired, you're at risk for accidents.

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So it changes the entire body's natural circadian rhythm and then most of the shift work is either three days or four days, and then you have to revert back and then revert back.

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So your circadian rhythm is in constant turmoil.

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Your core body temperature when it drops is different.

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So that's the timing of the cortisol.

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The same thing with thyroid hormones, androgens, testosterone.

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Everything is out of whack.

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I mean, I was a victim of that.

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So the best advice I get people is the moment you get a chance to leave the shift work, leave it.

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It's for your own good.

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Wow, you heard that everyone it's.

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The best advice is to just leave it.

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And for those who are in it and maybe now is not the time to leave it, what can they do?

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Are there any interventions that could be done for them to try to get that circadian rhythm on track?

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So you have to be so disciplined.

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I survived by taking naps.

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So let's say you're working, the difficult shift is the graveyard shift and everybody knows why they call it the graveyard shift.

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So let's say your work starts at 7 pm to7 am.

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Right, that's it.

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But remember you have to get there by 7 pm.

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So you're actually preparing by 5 pm and it's going to take.

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You know the hospital work doesn't end at 7.

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You know you have to hand over notes, you know this and that.

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So eight and then nine, so you're actually from 5 pm to 9 am.

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You have a pretty much a long commitment than the 12 hours you're working.

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So you have to be very regimented.

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So if you are in the stage of your life like what I was in for many, many years, for 25 years, I couldn't quit so if you're in the middle of it, so the things that we can do at the end of the shift try not to get much sunlight, have the shades on, be as careful as you can then go home and just prioritize sleep.

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Let's say you reach at nine to have a little bit time.

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So let's dedicate from 9 30 am to 430 pm.

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So again about seven.

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You know seven and a half eight hours dedicated to sleep.

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So that's the only way you have to be so regimented.

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So what happens when you go home?

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Most people, in fact me there's a lot of noises at home, you know.

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You'll only know how many disturbances, how many people come and knock at your door if you stay at home.

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There's a bell ringing, so you have to way find a quiet place in.

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In my mind, I believe, shift workers are just working all the time because they want, you know, especially moms.

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They have children to take care of or the other needs, and they hardly sleep.

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They probably sleep two, three hours and then they get ready for the next shift.

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So the key point I'm making is, if you're a shift worker and you can't get out of it, make sure you have the perfect regimen for the days you're working the shift.

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I hear that, as I taught you before I've been, I worked night shifts 17 years of my 20 years as a pharmacist and when I was single, doing it very easy, very easy to stay structured.

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Then, with marriage and kids, you have less time towards committing to that sleep.

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So it's very important that you stick to a very strict schedule.

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You have noise reduction is definitely needed.

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You have doorbells ringing, lawns being cut outside, people playing music, so you have to definitely work on that.

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And how important is the role of lighting when it comes to sleep?

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Dr John, dr John.

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So the word melatonin, the mella in melatonin is, mella means darkness, so melatonin is only secreted in darkness.

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So the room has to be extraordinarily, especially if you're going to be sleeping during the daytime.

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It has to be really dark.

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Dark out, you know, glasses, dark out shades.

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And of course melatonin is only secreted in lower temperature.

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So make sure you don't go work out before and keep your temperature in your bedroom as low as possible.

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Melatonin is not a condition that is susceptible, it's temperature.

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So keep your room dark and also the temperature low.

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And of course, our favorite things to do in our life is have your phone next to us the light.

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So keep your phone.

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I keep it away from my bed.

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I have it about six feet away.

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I set an alarm for whatever time I have to wake up so I don't get dings notifications.

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So three things have your phone away, keep your bedroom dark and then lower the temperature between 65 to 68.

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I'm glad you mentioned exercise because, as I told you my co-workers at the hospital, they had some questions for me to ask you, and one them was when's the best time to exercise?

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And you just answer that question because we don't want to have that higher body temperature right when we're sleeping.

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We want a cooler, cooler temperature, environmental and as well as body.

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So we answered that question, trying to perhaps work out after you wake up, before you get ready for work exactly.

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That's probably the time because, uh, the only the melatonin speak is just, you know, after the drop of the core body temperature.

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So when you are worked out, you have a lot of cortisol, you increase your metabolism.

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And same thing with a large meal.

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You know, the end product of a large meal is the thermogenic.

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You make heat because the body takes as much to digest that food like.

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That's why, if you have a large meal is a thermogenic, you make heat because the body takes as much to digest that food.

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Like.

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That's why, if you have a big meal before bedtime, your sleep is affected because you know the core body temperature takes longer to come down.

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So don't have a big breakfast before you, you sleep.

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So I mean, I'm talking about a shift worker yeah, that's a good point.

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I want to go back to.

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You mentioned circadian rhythm yes is it possible to have a different circadian rhythm?

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For example, is circadian rhythm set, is it usually at night time, where it's, however, that cycle works, or when people are day sleepers?

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Is it possible to change it so that their circadian rhythm is now different?

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you can change it.

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The circadian rhythm takes the internal cues and the external cues.

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The internal cues is, you know, the build-up of the adenosine.

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You know that the chemical that puts us to sleep and the other chemicals like melatonin and gaba is counteracted by dopamine or epinephrine, and also the sunlight and the noise.

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So when you shift things around, your body will eventually change to the new circadian rhythm.

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But unfortunately for shift workers, you know you only work four shifts and then you, you know another three shifts, or another time you with me, or the three days they are off.

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So it is so complicated.

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This is just that that is the most difficult shift.

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So one of the practical advices I give people is you know you might have to just keep doing the same shift, accommodating your life, just like what you used to do, but then it cuts to family life, children's life.

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So shift workers are having the most difficult time to manage the circadian rhythm because it goes this way and then the body gets confused and goes the other way for the other half of the week.

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Yes, yes, it's not an easy, easy task.

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Now let's go into pharmacological solutions.

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Where do you see the role of medications in managing sleep disorders?

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I know shift workers turn to melatonin, benadryl, alcohol.

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What are your thoughts on that?

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Can you tell us how that actually impacts our sleep quality?

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Is it good, is it bad?

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So I'm not a fan of any medications.

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My strategies, the seven proven strategies that I wrote a book on called Nobody's Sleeping I believe in the holistic we have it.

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So the thing about taking something from the external the body will fight it.

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So, just like alcohol, if you get a bus after one drink today, in a week you want more.

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You know the body gets tolerant to it.

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So I only use melatonin if you have a clock problem, like a shift worker is changing times, and then if you have jet lag, you know some you know people sleep later and wake up later.

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Or you know the older adults tend to sleep earlier.

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That's the only time I use melatonin, but I don't use melatonin to go to sleep.

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Same thing with Benadryl.

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Benadryl has got the anticholinergic properties.

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You're more dizzy now, you know.

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My daughter one day said hey, dad, I have this exam, I want to take Benadryl.

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I said, girl, you might as well as be tired and take the test.

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Then tired and dizzy and take the test.

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You know the risk of being dizzy the next day is the risk of falling, you know.

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So I see a lot of older adults who are Benadryl fall.

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It changes the urinary frequency, and all that with the effects of Benadryl, so that's not good, but with the effects of Benadryl, so that's not good.

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But the FDA has approved Modafinil, you know, or Provigil to keep you awake.

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So I'm into more of that, you know, to get you through the shift work than taking these medications.

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And we don't know the time release of these medications too.

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So no to melatonin, no to Benadryl, no to alcohol, of course alcohol.

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I can talk about 30 minutes on it.

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You know alcohol is a diuretic and also alcohol metabolizes into, like you know to, acetaldehyde, which wakes you up.

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So you, you're dehydrated.

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And this acetaldehyde is a chemical that wakes you up, so now you're groggy, now you're dizzy and you're dehydrated.

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That's the perfect hangover.

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So yeah, so it might put you to sleep, but you're not going to stay asleep and you're going to feel horrible afterwards, so not a great choice at all.

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Now you mentioned your book.

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Nobody's sleeping.

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Uh, congratulations.

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Uh, it's been out for a couple months now and looks like it's getting great reviews.

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Could you give us a little sneak peek into those topics or strategies, maybe one of those seven that you mentioned?

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The title is Nobody Sleeping.

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That actually came out after a good night's sleep.

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So that's what I see in my clinic and I've had my own perils with insomnia in med school and my mom died and starting my business.

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But I've overcome that.

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So the seven.

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I have an acronym for that.

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It's called Sleep.

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Now it's on my website If you all want to visit.

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It's called sleepfixacademycom.

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So the most difficult thing is I can't turn my mind off right.

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So this is where I have my own technique in SLEEP.

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It's called power of your mind.

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So this is a technique I teach people In the power of my mind.

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I have two techniques.

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One is called vivid imagination and the other one is called yoga nidra.

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Vivid imagination, uh, is a thing when you're in bed.

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I don't want reality.

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See, we take our reality into our bed.

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So when I watch a show, I become that producer of the show and then when I lay down, that's what I'm thinking.

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I'm not thinking about the bills or, you know, my employees or any of those things.

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I want to be in the abstract, because sleep is the abstract.

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I've been practicing it for 30 years.

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Nobody has spoken about it.

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I'm the first guy promoting vivid imagination as a technique for sleeping.

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So do that.

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The next one is yoga nidra.

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Yoga nidra means nothingness, that's from the sanskrit word.

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You just lay down, open your palms and think about nothing.

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But if you want to think of something, you just, you know, start focusing on your head, the facial muscles, the neck muscles, chest muscle, all the way down.

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So that's the cognitive behavioral therapy.

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So I'm combining the old technique, the new techniques.

00:17:31.180 --> 00:17:35.076
Yeah, that's the p in the acronym, and then also I'll just go into the.

00:17:35.076 --> 00:17:38.851
The next, and the acronym is that no and no to worries.

00:17:38.851 --> 00:17:44.122
So when I said you know, don't know to worry is you dedicate a time?

00:17:44.122 --> 00:17:48.339
You know I was preparing for your show, I what time it is, I you know where is the link.

00:17:48.339 --> 00:17:50.465
So I stopped by 8 pm.

00:17:50.465 --> 00:17:58.790
So I tell people to have a dedicated time between 6 pm and 8 pm every night, and then from 8 pm you get ready for bed.

00:17:58.790 --> 00:18:00.032
So that's one.

00:18:00.032 --> 00:18:01.557
So you don't bring your worries.

00:18:01.557 --> 00:18:15.180
So I always tell when you enter your bedroom, like the doorway, it's like a tsa screener you're going, you have cell phone beep, you have your worries beep, you have like tight-fitting clothes and all the jewelry beep.

00:18:15.180 --> 00:18:19.634
So this is part, you know it works everywhere, so you know the other acronym.

00:18:19.634 --> 00:18:20.978
I talk about all the other things.

00:18:20.978 --> 00:18:29.280
So vivid imagination, yoga, nidra and no to worries are some of the new things that I am bringing into this world.

00:18:29.280 --> 00:18:32.415
Teaching people how to sleep I love that.

00:18:32.476 --> 00:18:37.049
Thank you so much and that analogy of that tsa going through that scanner.

00:18:37.049 --> 00:18:45.123
It makes so much sense leave all that stuff at the door so that your bedroom can be a true environment for quality sleep.

00:18:45.123 --> 00:18:46.305
I love that.

00:18:46.305 --> 00:18:55.056
I want to close out, dr John, with perhaps a case study or experience, if you're willing and able to share with us, about how you practice.

00:18:55.056 --> 00:18:59.865
Helping people sleep had a unique impact on your patients.

00:19:00.269 --> 00:19:08.500
So when I see people who cannot sleep, I go through, you know, as my years as a physician, I go through whether do they have a medical problem?

00:19:08.500 --> 00:19:11.596
Right, if you have heart problem, lung problem, thyroid problem?

00:19:11.596 --> 00:19:13.082
So you have to rule that out.

00:19:13.082 --> 00:19:17.717
One of the common things people are not sleeping is something called restless leg syndrome.

00:19:17.717 --> 00:19:20.971
Your legs are like creepy crawly, you're moving around.

00:19:20.971 --> 00:19:22.074
You know, you can't, lay't, lay down.

00:19:22.074 --> 00:19:27.222
Still you know it's a simple mechanism or a deficiency is iron deficiency is one of those causes.

00:19:27.222 --> 00:19:28.670
So you can easily correct that.

00:19:28.670 --> 00:19:30.013
So make sure there's no medical.

00:19:30.013 --> 00:19:31.477
The next one is a big one.

00:19:31.477 --> 00:19:31.999
Is that I?

00:19:32.298 --> 00:19:41.655
I look into, uh, you know, mental health problems which is affecting sleep, because, uh, you know, I think it's page 94 I mentioned, uh, you know sleep and anxiety worsen.

00:19:41.655 --> 00:19:42.778
You know the know sleep and anxiety worsen.

00:19:42.778 --> 00:19:44.651
You know the relationship between sleep and anxiety.

00:19:44.651 --> 00:19:48.298
Poor sleep worsens anxiety and anxiety worsens sleep.

00:19:48.298 --> 00:19:49.321
So I look into that.

00:19:49.321 --> 00:19:51.534
And then, finally, I look into sleep disorders.

00:19:51.953 --> 00:20:03.463
Whether you have sleep disorders like insomnia, restless legs, limb movements during sleep or REM behavior disorder, or you just have insomnia where you just can't sleep.

00:20:03.463 --> 00:20:06.349
So that's how I evaluate somebody.

00:20:06.349 --> 00:20:10.279
You know there is also the other spectrum of people who sleep too much.

00:20:10.279 --> 00:20:12.192
That's actually a separate entity.

00:20:12.192 --> 00:20:21.065
Uh, you know, we can get into it, but when I see somebody I divide are you sleeping too much or are you not sleeping too much or not sleeping enough?

00:20:21.065 --> 00:20:25.840
So when you don't sleep enough I go in through the medical, psychological or sleep disorders.

00:20:25.840 --> 00:20:29.416
So once I figure all that out, then I put them into my program.

00:20:29.416 --> 00:20:30.915
It's a six weeks course.

00:20:30.915 --> 00:20:34.400
You know, people don't like me for the first two weeks because I'm changing.

00:20:34.400 --> 00:20:36.576
After two weeks they start loving me.

00:20:36.576 --> 00:20:43.536
You know the doctor John is working and so that's how I approach a patient who walks into my clinic.

00:20:43.596 --> 00:20:44.619
Thank you for sharing that.

00:20:44.619 --> 00:20:45.933
Yeah, after two weeks.

00:20:45.933 --> 00:20:48.401
That's something I noticed as well when I work with clients.

00:20:48.401 --> 00:20:55.243
Once they start making whatever the change is, it really doesn't take that much time to start seeing improvement when they understand what they need to do.

00:20:55.243 --> 00:21:00.021
So in just two weeks I'm glad to hear that your clients or patients can start seeing improvement.

00:21:00.021 --> 00:21:15.796
Please visit Dr Bajoy John at the sleepfixacademycom and there you can see his sleep course and also access to his a copy of his book Nobody's Sleeping with the seven proven sleep strategies for better health and happiness.

00:21:15.796 --> 00:21:19.296
So that you can sleep soundly, we all need that.

00:21:19.296 --> 00:21:23.337
Dr John, thank you for joining us today on Pivoting Pharmacy with Neutrogenomics.

00:21:23.337 --> 00:21:34.993
This was a wealth of knowledge and I know that healthcare workers out there that are working swing shift, that are working seven on seven off night shifts, will truly benefit from this episode and your resources.

00:21:35.336 --> 00:21:38.185
Yes, my heart goes out to all of them because I was there.

00:21:38.185 --> 00:21:39.651
I did that for 25 years.

00:21:39.651 --> 00:21:42.557
And also, you know, a good thing is to take a nap.

00:21:42.557 --> 00:21:44.541
That also is rejuvenating.

00:21:44.541 --> 00:21:46.675
So sleep is the superpower, you know.

00:21:46.675 --> 00:21:55.124
It helps to lose weight, it helps with your fitness, mental health, physical health I mean, not to mention diabetes, high blood pressure, stroke, cardiovascular.

00:21:55.124 --> 00:21:57.832
It is the superpower, it covers all.

00:21:57.832 --> 00:22:03.423
And, of course, not to mention low libido that can be associated just by the fact that you're so tired.

00:22:03.423 --> 00:22:10.550
So I want everybody to discover it sleep well be well and let's go sleeping.

00:22:10.570 --> 00:22:12.112
That's all I have for you today, friend.

00:22:12.112 --> 00:22:18.276
A huge thank you to Dr Bajoyan for sharing such invaluable advice and insights with us.

00:22:18.276 --> 00:22:27.080
I hope you feel a bit more equipped to tackle the challenges of shift work with new strategies to improve your sleep and, ultimately, your health.

00:22:27.080 --> 00:22:31.723
Remember, every shift may end, but your health journey is ongoing.

00:22:31.723 --> 00:22:42.759
Now I'd love to hear from you have you tried any sleep strategies that have worked for you, or maybe you have a question about how nutrigenomics could influence your sleep patterns?

00:22:42.759 --> 00:22:51.394
Share your thoughts, stories and questions with me on social media at Dr Tamar Lawful, or comment right here on the podcast platform you're listening in on.

00:22:51.955 --> 00:23:07.700
We're here to build a community where we can learn from each other, so don't hesitate to get involved and if you found today's episode helpful, subscribe to our podcast and share it with a friend or colleague who might also benefit from learning more about optimizing their sleep while working the night shift.

00:23:07.700 --> 00:23:14.573
Your support means the world to me and it helps us keep bringing new content that makes a difference in your daily and nightly lives.

00:23:14.573 --> 00:23:28.238
Coming up next week on the show we're talking about the must have wardrobe essentials for every health conscious professional woman, so you can look and feel your best without sacrificing comfort on your wellness budget.

00:23:28.238 --> 00:23:29.840
Talk to you next Friday.

00:23:29.840 --> 00:23:36.962
Until then, always remember to raise the script on health, because together we can bring healthcare to higher levels.