Graveyard of dreams
How working the night-shift changes your brain
By Meg Talikoff
Embedded Files
Dustin Pahman sets down his first Celsius can of the morning in the cupholder of his Chevy SUV. In thirty minutes, he and Gina, the brunette in his passenger seat, will reach Glen Falls in upstate NY. They spent May hiking and sharing ice cream in their hometown. Now it’s June, and they’re ready to venture an hour farther.
Pahman’s third wife, Karen, is asleep on a recliner at home—back pain keeps her from resting in their bed. That leaves Pahman sleeping alone, which he hates. But most nights he isn’t home, anyway: he’s been a night-shift mechanic for almost a decade.
Five months after the waterfall date with Gina—on November 11th, 2024—Pahman and Karen are divorcing, and Pahman’s doing standup about it at Boulder Coffee in Rochester.
“Been married three times, going to be divorced three times. I’m not scared to walk down the aisle,” he says. “It’s a big deal to women. They get to walk down the aisle, magical day, I gave that to three different women! I gave them their dream!” He pauses. “Then I ruined it, so, probably I’m a bad guy. It’s alright.”
It's been a rocky fifteen years for Pahman. Recently, he realized that night-shift deserves some of the blame.
Medical researchers have long understood that night-shift work is linked to poor health outcomes. Night-workers are more prone to almost every common disease than day-workers—cancers, metabolic syndrome, heart disease, osteoporosis.
Scientists are now finding that the brain suffers from night work, too. Cohort studies reveal that night-shift workers have more memory problems, worse executive functioning, and poorer mental health than day-workers. One paper found that tired night-workers are 6.5 years cognitively older than their peers.
This year, two studies found for the first time that night work degrades moral reasoning.
Dustin and 13-year-old pug Piper.
Dustin and his 11-year-old daughter.
Night-shifters like Pahman are often proud of their resilience. For much of his adult life, Pahman achieved via determination. At 21, he got sober in few weeks; he hasn’t touched alcohol since. At 26, while working nights and parenting two toddlers, he lost 80 pounds in a year of diet and exercise. These days he runs Toughest Mudders for fun—that’s five-mile laps on repeat from 8 at night until 8 in the morning.
But Pahman could not escape the mental consequences of the night-shift. “Physical is like whoop diddy doo, but mentally, you just kind of lose it,” he says. “You’re thinking that you’re figuring it all out on your own, but on the outside, people are like ‘What is going on? This guy is erratic.’”
When he decided to leave Karen this past summer, Pahman finally isolated the common variable behind his biggest struggles of the decade. “I said, if I’m leaving, I need to get off nights,” he says.
The house where Dustin lived with Karen. Just sold.
The barn Dustin built for Karen in their backyard.
The house that Dustin is now buying. A fresh start.
The new place comes with a pre-painted playroom.
Piper happy on her new couch.
Nanda Kishore Maroju is a professor of surgical medicine, and the director of the emergency department at JIPMER hospital in Puducherry, India. A large part of his job is teaching young doctors—residents—how to navigate the ER.
Last year, Maroju got curious about what night shifts were doing to his residents. He knew night work tired them out, but he wanted to test exactly how well they performed after stretches of consecutive overnights. “It’s one thing to say, ‘we’ve done a night shift, we need to give them a day off, but another to see what night shift really contributes in terms of deficits,” he says.
Maroju knew that past research on how night work impacts cognition was not entirely conclusive. A handful of studies had documented performance decreases on ED procedures; some showed post-night-shift IQ deficits; few had examined specific cognitive domains. For his study, Maroju selected a comprehensive battery of neurocognitive tests and added a moral reasoning measure. His trainees took the tests after five workdays and, separately, five worknights.
After five overnights, the residents showed slightly worse working memory and less power to resist distractors. While the changes were small, “the fact that we could measure a difference in memory is important,” Maroju says. “In high-dependency situations, that could make an impact.”
But the biggest change, Maroju found, was in their moral reasoning. His residents took the Defining Issue Test, which involves responding to morally-fraught scenarios: Should a destitute father steal food from a grocery-hoarder to feed his starving family? Should a reporter release a damaging story about a political candidate?
After night-shifts, residents scored 20% worse on the exam than they did after day-shifts. Working nights, it seemed, had changed these young doctors’ ability to think ethically.
Maroju says he felt sobered by the implications of his small study. He thought about soldiers who, like doctors, work nights. What would happen if a child approached an armed border agent on the soldier’s seventh consecutive night at work? “He may not think twice about pulling the trigger,” Maroju says.
Around the same time that Maroju was testing his residents, a Norwegian researcher named Erlend Sunde was looking at how working overnight affected moral reasoning in university students. For three consecutive evenings, he welcomed undergrads into his lab and had them work on light-blocking computers. They took the Defining Issue Test at 3:30am on the second night.
His team found that the students scored substantially worse on the DIT when working overnight in normal lighting conditions.
Night-work impairs reasoning because trying to be nocturnal flies in the face of our hard-coded sleep-wake system.
Human sleep is controlled by two interacting biological mechanisms, one called Process S and one called Process C. Process S is relatively simple: being awake generates an urge called sleep pressure. The longer you stay awake, the more you want to sleep. With sleep, the pressure goes away.
Process C has to do with cycles of energy and sleepiness called circadian rhythms. They happen the same way every 24 hours, no matter how long you’ve been awake.
Circadian rhythms happen throughout the human body. “You name it, it has a circadian rhythm,” says Brown University professor Mary Carskadon, one of the country’s most prominent sleep scientists. For example, antidiuretic hormone—the chemical that stops you from having to pee—peaks at night. Core body temperature works the opposite way: high in the day, low in the night. That’s why you start shivering when you stay up too late.
The circadian rhythm that many people know about is the melatonin cycle. A surge of melatonin in the evening gets us ready for bed and keeps us asleep all night. We also get a rush of cortisol, the stress hormone, before waking up in the morning. It prepares us “to wake up and get on with our day, whether or not we get a cup of coffee,” Carskadon says.
If Process S and Process C aren’t in sync, our bodies don’t work very well. “Take away the synchrony, and you struggle to stay awake in the daytime and you struggle to sleep at night,” says Carskadon. Night-shift workers get less sleep because when they head to bed at 10 am, they have to fight a rush of cortisol.
Night-workers’ bodies also aren’t prepared to do awake things when they’re up at night. “You’re hungry at the wrong time, and your body isn’t really ready to metabolize the food well,” Carskadon says.
Ultimately, night-shift workers operate under two simultaneous disadvantages: sleep deprivation and circadian misalignment. First, night-workers cannot get as much sleep as day-workers. Second, circadian rhythms dictate that they can’t think as well overnight. Night-workers end up remembering fewer things, struggling to maintain attention, and acting impulsively.
It’s this cocktail of effects that worries Maroju, who knows just how much nuance is required in the emergency room. In a night-shift mental state, people don’t have as much ability to make “judgment-based” decisions, so they default to following clear-cut rules, he says. But there’s a reason we have judgment in the first place.
Most people don’t choose to get married and divorced three times by their mid-thirties—Dustin Pahman knows that. “I’m going to talk in third person—Dustin doesn’t want to make Dustin look bad,” he says, acknowledging his participation in this article. But he says he knows he’s made some wrong choices. “I didn't do some things right.”
Dustin's tattoo of Baku, a nightmare-eating monster from Japanese folklore.
Until recently, Pahman never considered that working nights may have been undermining his decision-making. Nobody had ever told him it was a risk.
When he started working nights in his early twenties, he heard from a friend that “night-shift takes seven years off your life.” But at the time, it was the best job he could get, and he needed the money—he was about to start a family. Night-shift workers were compensated for their availability.
Pahman’s own father had spent a lifetime working second and third shift for General Motors. He and Pahman’s coworkers subscribed to the “tough it out” school of thought, a philosophy for which Pahman could have been the poster boy. “The old-school guys were like, ‘suck it up. Figure it out,’” Pahman says, laughing. And he did.
In many ways, his coworkers were right: night-shift is normal. Nearly twenty percent of Americans work nights some or all of the time. That was never the case until the industrial revolution, because everything was too dark at night. But in the early 1900s, factories and artificial light made overnight work possible, found historian Roger Ekirch. Suddenly, sleep was regulated by the dollar rather than the sun.
Night work wouldn’t happen if it weren’t profitable. In 2019, New York City’s night economy alone generated over $35 billion. Yet nobody has estimated the total social cost of the night-shift.
One study from 2018 found that the “cost of insufficient sleep” in Australia amounted to 1.5% of the GDP and nearly 5% of the total burden of disease. Recently, economists estimated that if every adult in Argentina got 7.5 hours of sleep per night, the country’s GDP would grow by 1.27%. That’s the same amount of money that Argentina spends on education annually.
Not one study focuses on night-shift specifically. None scratch the surface of the quality of life costs, much less any moral ones.
Boulder Coffee, where Dustin does Monday-night stand-up.
Glen Falls, where Dustin took Gina on their June hiking date.
The GM plant in Rochester where Dustin had his first night-shift job.
Dustin's favorite pal with Dustin's favorite food.
Dustin's actual favorite pal with Dustin's favorite pal.
Someone who wishes she could have come along on the trip to Target.
In September, Pahman called his father to tell him that he was leaving nights. “My dad was worried about it. He was like, ‘you know, you’re gonna be losing some money,’” Pahman remembers. Night-shifters make three more dollars an hour. “After tax and everything, maybe it’s 80 bucks a week,” says Pahman. “So it’s not a lot of money for killing yourself, you know?
After Pahman filed for the switch, a day shift job took months to materialize. “Once your mind’s like, we’re done, then it’s just grueling,” he says. His last worknight was September 29th. He started day shift on October 2nd.
One month into day-shift, he is feeling better. He’s been getting a lot more sleep, which is lucky—sometimes ex-night-shifters take years to rest normally again. “I’m not trying to just hold onto reality, now I can do the good daydreaming,” he says.
But it’s not as though his life is perfect now. He begins his morning commute early to leave time for the breakdowns he has in his car. He’s ended a seven-year relationship. He’s living in his brother’s basement. “Everything’s gone,” he says. “I have no comfiness.”
Not that this is all that surprising. The paper in the Journal of Occupational & Environmental Medicine found that night shift workers take nearly five years of good sleep to cognitively recover.
One good thing about day shift is getting to spend weekends with family. The other day, Pahman and his kids went to Target together to buy his daughter a Bluey shirt. She wanted to match her friends at the escape room where Pahman was about to take them for her eleventh birthday.
“After we got in the car on the way back home, my daughter’s like, ‘That was so cool, going to Target,’” Pahman says, smiling.
ENGL1180ZVideo.mp4Reflection:
My favorite part of this process was getting to know Dustin Pahman. I have never had such great access while writing a story, and it was a wonderful lesson in how to set boundaries with your interviewees, how to ask the right kinds of questions, and also, just how much information you need (and don't need!) to write a compelling narrative. The most difficult part was putting it together. I'm not a good writer yet, and I'm not totally happy with the final product, but I'm going to keep working at it until I am! In any case, I hope you enjoyed it and learned something.
References
Sources: John Dela Cruz (09/28); Dustin Pahman (10/01, 11/15, 11/25); Mary Carskadon (10/14); Nanda Kishore Maroju (11/12); Leela McKinnon (11/8); A. Roger Ekirch (11/22)
Papers directly referenced in this story:
Alonzo, R., Anderson, K. K., Rodrigues, R., Klar, N., Chiodini, P., Montero-Odasso, M., & Stranges, S. (2022). Does Shiftwork Impact Cognitive Performance? Findings from the Canadian Longitudinal Study on Aging (CLSA). International Journal of Environmental Research and Public Health, 19(16), 10124. https://doi.org/10.3390/ijerph191610124
Anauati, M. V., Gómez Seeber, M., Campanario, S., Sosa Escudero, W., & Golombek, D. A. (2024). The economic costs and consequences of (insufficient) sleep: A case study from Latin America. The European Journal of Health Economics. https://doi.org/10.1007/s10198-024-01733-8
Khan, D., Edgell, H., Rotondi, M., & Tamim, H. (2023). The association between shift work exposure and cognitive impairment among middle-aged and older adults: Results from the Canadian Longitudinal Study on Aging (CLSA). PLOS ONE, 18(8), e0289718. https://doi.org/10.1371/journal.pone.0289718
Mohammed Muthanikkatt, A., Nathan, B., S, M. A., Murali, S., Krishna, N. S., Raghavan, B., Ganessane, E., & Maroju, N. K. (2024). Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine. Academic Emergency Medicine, acem.14980. https://doi.org/10.1111/acem.14980
Shi, H., Huang, T., Schernhammer, E. S., Sun, Q., & Wang, M. (2022). Rotating Night Shift Work and Healthy Aging After 24 Years of Follow-up in the Nurses’ Health Study. JAMA Network Open, 5(5), e2210450. https://doi.org/10.1001/jamanetworkopen.2022.10450
Sunde, E., Harris, A., Olsen, O. K., & Pallesen, S. (2024). Moral decision-making at night and the impact of night work with blue-enriched white light or warm white light: A counterbalanced crossover study. Annals of Medicine, 56(1), 2331054. https://doi.org/10.1080/07853890.2024.2331054
Zhao, Y., Richardson, A., Poyser, C., Butterworth, P., Strazdins, L., & Leach, L. S. (2019). Shift work and mental health: A systematic review and meta-analysis. International Archives of Occupational and Environmental Health, 92(6), 763–793. https://doi.org/10.1007/s00420-019-01434-3
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