These are disruptive and worrying times to be sure. We are holed up in our homes as many countries, states and provinces have issued shelter-in-place orders. Singers and other performing artists are losing their income. And it’s not just from cancelled performances. Many singers work a second job in the hospitality industry. The closures of restaurants, lay-off from airlines, these have a far reaching effect.

I’m hearing from doctor friends about the severity of it. The life or death choices they are needing to make. And here’s something not mentioned often enough in the media - if you do get it and survive you may get permanent lung damage!

All this is scary stuff!!!

All these worries and isolation can also end up affecting our mental health. So this is a time more than ever that we have to keep looking for the positive.

If you look you can see people showing great amounts of love. 

• The people taking the precaution of self-isolating and physical distancing because they care about the safety of others. 
• The front line workers in essential services who are daily putting their lives at risk so that we still have food on our tables, electricity in our homes, clean water, and of course the health care professionals.
• The volunteers who are shopping and delivering food and medicine to those in quarantine.
• The people checking in on older folks living alone (or any folks living alone for that matter)
• The companies and businesses that are offering free services to keep people connected and to keep businesses running from home offices.
• The teachers who are doing their best to continue to deliver lessons to their students, often adapting to methods they are not familiar with.

The list goes on if you look for it…

In my neighbourhood, some thoughtful soul dotted the pathways with pinwheels full of posititve messages like “Be Kind”, “Laugh”, ”Smile”.


But don’t forget to show some love to yourself, as well.

This is an especially critical time. Parents trying to juggle working from home and looking after their kids. Loss of jobs. Self-isolation. These are all hard on our emotional, mental, physical and social health. So making time to show yourself some love is important.

Here are a few suggestions for your self-care.

This Too Shall Pass

Remind yourself that these are unusual circumstances, that humans are highly adaptable and that this time will pass. The arts community is already adapting with live streaming concerts, balcony concerts, etc. And when this all blows over - you can bet people will want to celebrate! And celebrate BIG! What’s a celebration without music? Start working on your cover of “Happy Days Are Here Again”.

Be Kind to Yourself

Know that you are doing the best you can in the current situation. Forgive yourself for not dealing with the stress and trauma as you think people expect you to. We all have our own ways of coping. Give yourself some grace.

And don’t forget that everyone else is dealing with it too. Sure some people may be acting in an irrational manner to our way of thinking, but they are scared and people react in different ways. Give them and yourself some slack. It will take a burden off your mind.

Stick to a Schedule

Maintain some form of schedule. Keeping busy and practicing some self-discipline can keep your mind occupied. Don’t use this as an excuse to binge watch Netflix and sleep the day away. If you usually have a morning routine, stick to it. Keep meals as regular as possible. Make time to get outside for a walk. Those working from home with kids may need to make creative schedules. For example parents can work in alternating 90 minute blocks; while one parent works the other is looking after the kids.

Eat Well

If you have more time on your hands, this can be a great time to try new recipes or work on improving your nutrition. Plan out some meals and do a day of meal prep. Even though you are at home there will be times that you just don’t feel like preparing anything, but that can lead to stress eating crappy food, which will just make you feel worse in the end. Having healthy food already prepared is the best way to beat the impulse eating. Healthy eating can help boost immunity and help regulate hormones related to stress.

Keep Moving

Whether it’s a stroll through your neighbourhood, dancing to your favourite songs in your living room or doing, yoga or  an at home HIIT body weight workout, keep moving. Exercise has been shown to be as effective as antidepressants to boost mood. It will also protect you from back pain that can occur from being too sedentary. As well, you want to keep your alignment and core singing ready! 

Sleep

Now is a great time to get into better sleeping habits. Reset your circadian rhythms for better health. Go to bed at a regular time. Get your 7 - 9 hours. Allow yourself to wake up naturally without an alarm clock. A good night's sleep can help reduce anxiety, boost your mood and strengthen your immune system.

Stay Connected

Though the term started out as social distancing, what we are really doing is physical distancing. Humans are social creatures. Our well-being is derived, in part by our social interactions. Having meaningful relationships is key to that. For extroverts especially, being in isolation can be hard. So stay connected. Video chats are the best way, because we get more out of the interaction by seeing other people's facial expressions. Have a Zoom Happy Hour with some friends. Skype with your parents or grandparents. Even a good ol’ phone call can do the trick. Going out for a walk can also help even if you aren’t stopping to talk to other people and staying 2 metres away - you will feel less alone. 

Learn Something New

Take the extra time you have to try something new. We all have something we have always wanted to learn, but don’t have the time. This is the perfect opportunity to start. Start learning a new language, learn to knit. You can even have a game with your family - learn one new fact every day and share it.

Be Mindful

Whether you make time for meditation or do household chores in a mindful way this is a great way to show yourself some love. There are some great guided meditations on  self-love, self-esteem, gratitude, tranquility, stress relief - whatever you need it’s out there. That the time to just BREATHE.

Be Creative

As a singer you are already a creative being at heart. Using that creativity during this stressful time is a great way to vent feelings. Write, draw, make music, do an interpretive dance. Whatever feels right to you in this moment. Journaling is a great way to get feelings out and a place to put down some creative thoughts. Your soul needs this.


Do Something Indulgent

Some indulgence is good for your self-care. I’m not talking about eating a bag of chips and washing down with a bottle of wine for dinner. That kind of indulgence is numbing and self-destructive. I’m talking about taking a long hot bath (with ONE glass of wine if you like), giving yourself a mani or pedi, take a day to relax and binge watch a series. If it makes you feel happy, something you can savour without numbing yourself, then it’s probably a legit indulgence. Before reaching for that glass of wine or eating a pan of brownies ask yourself this question. “Am I doing this because I’m bored or stressed or am I doing this because I want to relax and savour the moment?”.



If you are already someone who suffers from anxiety, depression or trauma, this can be an even harder time. Make sure you seek out professional help from a qualified healthcare practitioner if you need to.


We are all here to lift each other up.

If you need someone to talk to or help staying on track with healthy habits please feel free to contact me. I’m here for you. You can contact me here or join my Facebook group Vibrant Body Vibrant Voice where I offer a weekly challenge to keep you on track.

Stay safe my dear singers.

​

​Hydration is one of the most well-known tenets of vocal hygiene. You know you need to keep those folds hydrated well to keep the surface lubricated so that the friction that occurs from the folds constantly beating together won't end up in injury. 

You may also know that hydration also has to hit the deeper layers including the vocalis muscle.  We want hydration at the cellular level of all parts of the vocal folds to keep them flexible for optimal performance. Did you know that studies have shown that a 1-2% drop in body water can impede performance? 

A dip in hydration at this level can also affect your cognitive functioning and you need a clear mind for singing. No time for brain fog when you have to remember all your words, rhythms, choreography, listen to your accompaniment, and the list goes on - all while maintaining good vocal technique.

And let’s face it, the Vocalis Muscle is not a high priority area for the body, so you may feel the effects of dehydration even earlier at your vocal folds. On top of that, your body doesn't register the fact that it's thirsty until you reach the 2% dehydration mark. So staying on top of the hydration game is really important.

You've probably heard the adage "pee pale", however, that might not be telling you everything you need to know about your hydration. You can have clear urine and still be getting dehydrated!!! 

Here are 15 things that may be making you dehydrated:


1. Medications

Many medications can cause dehydration. Some of the most common medications that lead to dehydration are:

• Antihistamines.
• blood pressure medication.
• Chemotherapy.
• Diuretics.
• Laxatives.

Even over-the-counter medications like Midol may have a diuretic effect. Check the contraindications of your medication or check with your pharmacist.


2. Diabetes

One of the symptoms of diabetes is the frequent need to urinate. When blood sugar levels get too high the body tries to bring it back down by flushing out the excess sugar through peeing. If you are frequently thirsty or take too many trips to the washroom see your doctor.


3. Insufficient Fibre

About 97% of the North American population is fibre deficient. They don’t get anywhere near the recommended daily requirement, which is about 30 g of fibre per day. That in itself is far lower than what our bodies are actually designed to handle. Aside from the many other health benefits of fibre, eating fibre and water rich-foods like fruits and vegetables can help hydration. It also will allow it to be absorbed into the body more slowly for deeper hydration. 


4. Processed Foods
    
Ultra processed foods have a number of things going against them. First they are devoid of fibre.(See point 3) They can make your blood sugar levels rise making you feel thirsty.(See point 2). They are often very dry foods since  water has mostly been removed from them. And they are high in sodium. If you do eat processed foods drink more water to make up for lack. Better yet stick to water-rich whole foods..


5. Your period

Estrogen and progesterone influence your body's hydration levels, and when the two are roller-coastering, like when you're in the throes of PMS, you may need to increase your fluid intake to stay hydrated.

Women who experience heavy flows will need to hydrate extra, too, since you are losing fluid. And remember the dehydrating effects of medications - Midol a commonly used medication for menstrual cramps may be making matters worse.


6. Alcohol
    
We all like to have the occasional post show drink with our castmates, but you have to keep in mind that  alcohol has well-known diuretic properties. If you do have a drink or two make sure to drink a glass of water for every serving of alcohol.. 


7. Herbs and Supplements
    
Many herbs and supplements have been shown to increase urine output, which could potentially lead to dehydration.  Among them are  parsley, celery seed, dandelion, and watercress. Small amounts as a seasoning in food should not be a problem as part of a whole food diet, but if you are taking therapeutic amounts of herbal or other supplements, check with your naturopath. Natural does not always mean safer.


​8. Low Carb Diet

Carbohydrates are stored as energy in your body in the form of glycogen in your muscles and liver. Each glycogen molecule is linked to 9 water molecules. That's why when you start a low carb diet you drop a couple pounds of water weight. The number on your scale might look good, but it's not great for your hydration levels. Fruits, which are often shunned because of their perceived sugar levels are richly hydrating (not to mention all the other nutrients they provide). Plus, since whole carbs such as oatmeal, whole grain pasta, and brown rice all soak up water during the cooking process, eating them can actually increase your hydration levels. If you cut them out of your diet you could be reducing your fluid intake, too.

​
9. Indoor Environment 

In the heat of summer or the cold of winter we often head indoors, but air conditioning and heating can both have a drying effect. Probably moreson than the outdoor weather. Who has ever experienced the chapped lips and dry skin of winter,yet you barely spend any time outdoors except for running from your door to your car and back. It’s the heating that’s drying you out! 


10. Exercise
    
If you exercise you will perspire, but the length and intensity of your workout will dictate how much body water you are losing through sweat. It’s important to adjust your water intake to match the intensity of your workout. Endurance athletes especially are prone to dehydration. A good way to make sure you are getting enough is to weigh yourself naked before and after your workout. If you are hydrating enough you should weigh the same. If not, top up with the deficit amount in your post workout drink.


11. Climate 

I mentioned our indoor environment, but of course our outdoor environment matters, too. Extremes of heat, cold, low humidity and high altitudes all can impact your hydration levels. If you’re in a desert-like climate with extremely low humidity and high heat you can feel the water being sucked right out of you (that’s how it felt to me in Las Vegas with temperatures of 110F.  The dry cold of a Winnipeg winter, where I live, can be dehydrating as well. High Altitude is also somewhere where you may need to adjust your water intake.


12. Irritable Bowl Syndrome and Irritable Bowl Disease

Digestive issues like irritable bowl syndrome, irritable bowl disease, diverticulitis and other problems of the gut can be debilitating enough on  their own (believe me I know I have colitis, which still flares up if I eat wheat or broccoli, my two trigger foods), but their symptoms which can include nausea and chronic diarrhea can cause dehydration, In the search of relief, many people who suffer from these conditions try elimination diets to discover or avoid trigger foods, If you are eliminating whole food groups of  fluid-rich foods, you could end up further contributing to dehydration.


13. Flying

High altitude, dry recycled air - air travel can definitely contribute to dehydration if not managed well. If you are flying to a concert gig, you will likely not have sufficient time on the other end to re-hydrate properly, so it’s imperative to stay on top of it before, during and after the flight. Avoid the in-flight alcoholic drinks, which will further complicate matters, drink extra water, and eat plenty of water-rich foods. This is also a great time to use a Humidiflyer or other surface hydration method such as a personal steamer or nebulizer.


14. Drinking Too Much Water at One Time
    
Your body can only absorb so much water at a time. It is better to drink in smaller quantities throughout the day than to guzzle a litre at a time only to have it go straight through you. The danger with this is that it could also be flushing out vital electrolytes that can lead to a potentially life- threatening condition called hyponatremia.


15. Misinterpreting Your Thirst Cue

Often when people feel hungry, it’s actually thirst they are feeling. This can lead to overeating and not getting enough water. If you feel hungry and it’s not close to meal time try this: drink a glass of water and wait 15 minutes. If that satisfies you, then it was thirst you were feeling. If you’re still hungry then go ahead and have a snack. 


To find your optimal level of water to drink start with taking your body weight in pounds and dividing by two. This will give you the amount in ounces of water to drink daily. From there make any adjustments as needed for the above mentioned causes of dehydration. If you keep your hydration levels up you will feel more energized, alert and your vocal folds will be very happy. 


Remember that if you think you are drinking enough and still feel thirsty, you need to seek medical advice.

For more tips of keeping your voice in top shape join the Vibrant Body Vibrant Voice Community.


References:
​
https://www.healthline.com/health/chronic-dehydration#treatment
https://www.bustle.com/p/7-reasons-youre-still-dehydrated-after-drinking-lots-of-water-15727442
https://time.com/109129/14-surprising-causes-of-dehydration/

'Tis the season when many singers are experiencing more bloating than usual. With all the treats everywhere, from green rooms to receptions to holiday gatherings, there always seems to be rich food in sight.

However feeling a bit “overextended” in the belly after a meal can make it uncomfortable to sing. Instead of hitting  high Gs you might be more inclined to hit low “Gas”  And fitting into your costume maybe for difficult if you're carrying a “food baby.”

Well, bloating at the best of times is common. Up to 25-30% of people experience it regularly. It happens when you have trouble digesting. The symptoms come from excess gas, reactions to foods, or food not moving through you as well as it could. 

Though at this time of year, bloating may be associated with the tendency to overeat rich foods, there are many other reasons you might experience these symptoms. Maybe because of a serious condition (disease), or a food allergy or intolerance (what you eat). It can also result from how you eat.

If you have a serious digestive issue like IBS (Irritable Bowel Syndrome), then make sure you eat accordingly. Same goes if you know certain foods give you gas. Simply avoid them. 

If you’re already doing those things, and still experience bloating, here are some great tips for dealing with it naturally.

1 - Don’t overeat

If you overeat at a meal, then you’ll feel bigger around the mid-section. You’ll feel more pressure in your abdomen. It will be more difficult to breath properly for singing. Plus, you’re giving your digestive system a hard time. For many singers this can also end up leading to reflux. It’s better to eat until you feel almost full and not overindulge. Grab an extra snack or small meal throughout the day if you have to. Just don’t over-stuff yourself in one sitting.

2 - Avoid sugar alcohols

Sugar alcohols are low-calorie sweeteners made from sugars. In an ingredients list, they end in "-ol,” and include things like sorbitol, xylitol, and erythritol. They’re found in some chewing gums and sugar-free foods.  Some people experience bloating after eating foods with these. So, try avoiding them and see if that helps you.

3 - Avoid swallowing air

Sometimes the gas that causes pressure in your digestive system is from swallowing air. Things like carbonated drinks are the biggest culprit here. You can also swallow air when you chew gum or drink through a straw, so try ditching these. 

You can also swallow air when eating too quickly or while talking. Which leads me to...

4 - Eat slower, more mindfully, and less stressed

Eating too fast isn’t doing your digestive system any favors. You can help the food move along by chewing it thoroughly and slowing down your eating habits. Be mindful and enjoy the time you are spending eating your meals. Savour them.

The feeling of stress can also cause increased bloating. Stress-reducing techniques can help improve your digestion. Try meditating or deep breathing (but not while you’re eating). :)

5 - Try peppermint

Peppermint oil has been shown to improve bloating. It’s thought to increase transit time by relaxing the stomach muscles and increasing the flow of bile. Try steeping fresh peppermint leaves, or a peppermint tea bag, and drinking it slowly. See if that helps reduce your symptoms.

Conclusion

There are a bunch of natural ways to deal with bloating. 

First, avoid it by not eating things that give you gas or aggravate a digestive issue. Try not to overeat, consume sugar alcohols, or swallow air. Also, eating more mindfully and reducing stress can help too. Finally, if you are experiencing bloating, enjoy a cup of peppermint tea.

If you do all of these, and still experience bloating, then you may have a food intolerance; this could be from an allergy or intolerance. If you have a major concern, then please see your doctor. Your doctor can help to rule out a serious and/or chronic condition. 

Recipe (peppermint): Peppermint Mocha Creamer

1 can coconut milk
½ cup almond milk, unsweetened
2 tbsp cacao powder, unsweetened
½ tsp peppermint extract or essential oil (food-grade and safe for internal use)
3 tbsp honey or maple syrup (optional)

Instructions

Place all ingredients in a blender and blend until well combined.

Store in a sealed container in your fridge.

Serve & enjoy!

Tip: While the non-peppermint ingredients in this creamer may or may not be “de-bloating” for you, try these ideas too:
Grow peppermint yourself;
Chew on the fresh leaves; and/or 
Steep them for tea.

References:

https://authoritynutrition.com/11-proven-ways-to-reduce-bloating/

https://www.dietvsdisease.org/how-to-get-rid-of-bloating/

http://www.precisionnutrition.com/fix-gut-fix-health
​

In today’s world, we are constantly on the go, a steady state “busy-ness” is the norm, and we’re always running from one responsibility to the next - literally! So, it’s no wonder that physical fatigue is such a common complaint among singers. Physical fatigue can put our voice at risk of injury as we are more likely to try to exert more effort singing to compensate.

The good news is that there are some really simple (and natural) ways to increase your energy so you can keep up with your busy life. 

1. Get off the blood sugar roller coaster

One of the simplest ways we can boost our energy is to stabilize blood sugar. When we don’t eat enough food throughout the day or when we eat foods that are higher in sugar, our energy levels bottom out. 

You can balance your blood sugar, and boost your energy naturally by:

• Eating every 3-4 hours gives your body the nutrients and fuel it needs to keep your blood sugar - and energy levels steady
• Consuming foods that are low on the glycemic index (think fruits and veggies, whole grains) instead of the higher sugar white breads and pastas.
• Eating protein with every meal to slow down the release of carbohydrates into your bloodstream. Protein is broken down and released slower so you’re less likely to have a blood sugar spike and subsequent crash.

2. You like to move it, move it!

When you’re tired, the last thing you want to do is exercise. However, as hard as it can be to get your butt off the couch, it’s one of the best things you can do to fight fatigue. 

And, it turns out that you don’t even have to commit to a long workout! 

A California State University study concluded that even a brisk 10-minute walk can increase your energy for up to 2 hours. 

So when you feel that afternoon slump coming on, skip the coffee and lace up your running shoes instead.


3. Up your sleep game

It may seem obvious that lack of sleep causes fatigue. However did you know that the quality of your sleep can have an even bigger impact on your daily energy? Even slight disturbances in our sleep can affect how rested we feel the next day. 

Here are a couple of tips for a more restful sleep:

• Avoid tech in the bedroom, or within 1-2 hours of bedtime. Even the small amount of light, especially the blue light emitted from devices, interrupts your body’s circadian rhythm. Your brain still thinks it’s daytime and won’t wind down.
• Avoid caffeine late in the day - or avoid all together if this is a problem for you
• Try to create a regular sleep/wake schedule to help your body develop a sleep routine = good sleep hygiene.
• Dab a bit of calming lavender essential oil on your temples before bed or put a few drops on your pillow. Breathe in the calm.

​4. Drink up!

Before you reach for that coffee or energy drink to perk you up, consider switching to plain old water. While caffeine is usually the first choice for busting out of an energy slump, remember that it can interfere with sleep.

And then there’s dehydration. Even mild dehydration impairs our concentration, decreases our mood and zaps our energy. Surprisingly, many singers, even though they know the importance of hydration, are not actually getting enough.

How do you know if you may be dehydrated? 

Check the colour of your urine. If it’s the colour of straw, you’re good to go. If it’s a darker yellow colour, it’s time to drink up.

If you’re still craving a caffeine hit, try the Energizing Matcha Smoothie recipe below. 

Matcha gives a longer lasting energy boost than coffee. It doesn’t hit you hard and then cause you to crash. Plus the recipe really is delicious!

Have you ever stopped to think about it? Most singers perform evenings and even into the wee hours of the morning. This can set us up to have a schedule similar to many shift workers. Shift work is defined as anything that is outside regular daytime work hours that could encompass 7 am to 6 pm.
 
In fact, some of us may even be pulling double shifts if you have a day job, as well as your nighttime gigs or rotational shifts if you have a day job during the week and then perform weekends. Even singing teachers can be considered shift workers.
 
This can have serious consequences to our health.  Within the World Health Organization's (WHO) definition of "health", shift work is a risky condition at all three of their reference levels. It is a risk factor for health, it also perturbs the sleep/wake cycle and circadian rhythms, and it hampers family and social life.
 
Some of the health issues that have been linked to shift work include:
 

• Cardiovascular disease (40% higher than daytime workers)
• Diabetes (possibly 50% higher) and metabolic syndrome (3 times higher)
• Obesity
• Depression and Mood Disorders
• Serious Gastrointestinal Problems (greater incidence of reflux or GERD)
• Problems with Fertility and Pregnancy (also increased incidence of endometriosis and painful periods)
• Cancer (WHO classifies shift work as a possible carcinogen, 50% higher rates of breast cancer)

 
Some speculation on the cause of these health risks is that our sleep/wake cycle is disrupted, which affects the circadian rhythm, or body clock. Our bodies naturally are primed for the difference between day and night. In the morning, our body temperature starts to rise to wake us. Sunlight signals receptors into the eye, which sets off production of hormones that will help us thrive through the day. In the evening, our body temperature starts to drop and levels of melatonin, a hormone that helps us sleep, start to rise. When this circadian cycle is disrupted it can cause hormonal imbalances (including melatonin, reproductive hormones, insulin, hunger hormones, cortisol, seratonin and more), a rise in cholesterol levels and high blood pressure, which all can lead to health problems.
 
These disruptions can also lead to insufficient sleep and poor sleep quality. This can lead to fatigue and loss of mental alertness, which could impact our ability to perform at our best. The International Classification of Sleep Disorders has officially defined the Shift Work Sleep Disorder (307.45-1) as one that "consists of symptoms of insomnia or excessive sleepiness that occur as transient phenomena in relation to work schedules".
 
Family and social life can become strained by working hours that don’t fit with the schedules of family and friends. Socializing with friends becomes difficult, since you are working during their leisure time. Singers with children may get insufficient or disrupted sleep by having to take care of young children or get children off to school in the morning. After school time may be taken up with rehearsals or teaching.
 
I personally experienced this with my children. When by kids were preschoolers, it was great – I’d have them all day and then my husband would come home and I would teach from late afternoon through the evening. Once they started school not so great. I’d start teaching as soon as they got home from school until their bedtime. It did cause strain and my kids did start having some behavioural problems until I was able to schedule some family time into my evenings.
 
What can we do?
 
For many singers there is little choice, but to continue to work evenings. If booking daytime gigs, like church work or singing at retirement homes isn’t going to do it for you, then there are some things you can do to try to make your schedule work for you and get your body primed for your work schedule.
 

1. Do not eat for at least two hours before going to bed. This may mean saying no to after show snacks and alcoholic drinks, as well.
2. Wear blue/green light blocking glasses after the show so that your body can start producing melatonin.
3. Take a hot bath or shower. Once your out it can help your body temperature drop faster for better sleep. Add a few drops of lavendar essential oil for even more of a relaxation boost.
4. Wear an eye mask and/or get blackout blinds and keep your room dark with no electronics in it. You’ll have better quality sleep. Even a little blue light from a device or a little sunlight creeping in can signal the brain that it’s “daytime”.
5. Get at least 7 hours of sleep, preferably 8. If you’re not getting to sleep until 2 am then you need to be sleeping until 9 or 10 am.  If you are regularly not getting enough sleep you are setting yourself up for even more health risk.
6. Drink caffeine when you get up. There is some evidence that caffeine helps reset our circadian rhythm. However, you should not have any caffeine for 6 to 8 hours before going to bed, since that will disrupt your sleep.
7. Spend at least 15 minutes in sunlight when you get up. It will signal those receptors in your eyes that will also reset your circadian clock making you feel more alert.

 
Have you ever considered your singing schedule as shift work? I’d love to know how you cope with it and if you use any of these strategies. If you haven’t give them a try and let me know how you do.
 
 Get more tips to optimize your singer’s health with my free Singer’s Wellness Guide. Click here to get your’s now.
 
 
 
 
Resources:
 
https://www.webmd.com/sleep-disorders/features/shift-work
https://www.sleepfoundation.org/shift-work-disorder/what-shift-work-disorder/shift-work-disorder-symptoms
https://oem.bmj.com/content/58/1/68
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430894/