Shift work is incredibly disruptive to your sleep-wake cycle
One in five shift workers will develop shift work disorder
Several strategies are available to help you deal with sleep disruptions caused by shift work
Shift work can be incredibly rewarding. Shift workers are typically paid a higher-than-average wage, have an easier commute by avoiding “rush-hour” traffic, and are more likely to work in positions that can directly help people (such as nurses or firefighters). While the rewards may be motivating, especially for people who feel like they are more productive and thrive on a non-traditional schedule, there is a dark side to shift work (and I’m not just talking about the sun going down!). Shift work is disruptive to your sleep-wake cycle and can be very detrimental to your health without intervention.
What qualifies as shift work?
Shift work describes working outside of the normal daytime hours, including evenings, nights, and early mornings (< 7 am). It is very common for shift workers to rotate from sleeping during the night to sleeping during the day, and it is probably unsurprising that this can throw your circadian rhythm completely out of whack.
“I always wake up hungry at 3am because my brain thinks it’s lunchtime”
-You, after working a week of night shifts
How does shift work impact my circadian rhythm?
Shift work or inconsistent hours can influence your circadian rhythm by going against the natural times of light and darkness. This can shift your circadian rhythm, activating your sleep-wake hormones at the wrong times and causing sleep disturbances.
How does shift work impact my health?
Shift work leads to sleep loss and disruptions to your circadian rhythm that reduce your sleep quality and can cause insomnia. Sleep loss impacts nearly every aspect of your physical, mental, and emotional health. The conflict between your body’s circadian rhythms and your work schedule may also lead to a sleep disorder called shift work disorder. Research suggests that at least one in five shift workers will develop shift work disorder.
What is shift work disorder?
Just like the name says, it is a sleep disorder caused by the inconsistency of shift work. It is very common for shift work sleep disorder to go undiagnosed as many people just assume it’s a normal part of shift work. Symptoms make it difficult to enjoy your days off and impair performance during your shifts. Most importantly, shift work disorder puts you at risk for various health problems.
What are the symptoms of shift work disorder?
Excessive sleepiness: This feeling can occur both on and off the job. You may feel a lack of energy, overall fatigue, difficulty concentrating, or mood changes.
Insomnia: The inability to fall asleep or stay sleeping, insomnia prevents you from getting good quality sleep.
Poor sleep quality: You likely won’t feel refreshed after getting sleep. You might feel like you are not getting a complete night of sleep.
Recurring sleep loss: Over time this will lead to sleep deprivation which can be detrimental to your overall health. Severe cases of sleep deprivation can lead to depression, and can even cause hallucinations.
How is shift work disorder diagnosed?
Your doctor will do a physical exam and use the International Classification of Sleep Disorders (3rd edition) to see if you fit the criteria for a shift work disorder diagnosis:
The person must experience insomnia symptoms when trying to sleep and/or excessive sleepiness while they are awake.
They must experience a reduction in total sleep time due to a work schedule that overlaps with a traditional sleep schedule.
They must report symptoms consistent with their shift work schedule for at least three months.
The symptoms cannot be attributed to another sleep disorder, medical condition, side effects from medication, substance abuse, or poor sleep hygiene.
What are the risks?
- Diseases: There is evidence that shift work disorder could lead to serious long-term health problems.
Cancers: Researchers have found that for every 5 years of night shift work, the risk of breast cancer increases by 3.3%. This could be due to nocturnal melatonin suppression and circadian rhythm disruptions acting as carcinogens and increasing tumor incidence.
Cardiovascular diseases: Research has found that shift workers of both genders have up to a 40% higher risk of developing heart diseases compared to day workers. The increased risk is due to metabolic changes that occur with circadian rhythm disruptions.
Gastrointestinal disorders: Shift work has been associated with various gastrointestinal issues, particularly in rotational shift workers. Common problems include abdominal pain, constipation, diarrhea, and irritable bowel syndrome.
Depression: Research has shown that shift work disorder makes people around twice as likely to develop symptoms of depression or anxiety.
Low testosterone: Losing sleep can significantly lower your levels of testosterone. Low testosterone affects men and women alike with symptoms such as fatigue, depression, weight gain, and low libido.
Accident-prone: Sleep disturbances cause alertness and reaction times to decline, putting workers at a higher risk of workplace accidents, injuries, and fatalities. Shift work disorder increases the risk of workplace accidents and injuries by 70% and makes workplace fatalities twice as likely.
Substance abuse: Sleep problems may make it tempting to self-medicate with alcohol or drugs and this can lead to a substance dependency to sleep. Research has found that shift workers with sleep problems are two times more likely to engage in heavy alcohol consumption.
How can I avoid developing shift work disorder?
Using these tips, you can reduce your chances of developing shift work disorder:
1. CREATE A CONSISTENT SLEEP ROUTINE
A consistent sleep routine can help your brain make the connection that it’s bedtime. It also does not need to be dependent on the time of day, which can be very helpful if you’re used to switching back and forth from day to night shifts.
Try developing a 3-step strategy and implement it every day about 2 hours before you want to be sleeping, even on your days off.
It might look something like this:
- Mental decompression: Try meditating or deep breathing exercises.
- Take a warm shower: Research has found that this can help people fall asleep 36% faster.
- Relax: Have some quiet time in a relaxing place, whether that be your bedroom or a hygge space!
2. AMP UP YOUR SLEEP ENVIRONMENT
Creating a cozy sleep environment to go along with your sleep routine will help make sliding into slumber even easier. Make sure if you implement these into your sleep environment that you also keep it a consistent part of your sleep routine. This will be helpful when sleeping during the day.
Create a sleep sanctuary
Make it clutter free
A neat and tidy room induces immediate unconscious relaxation. Make the time to ensure your sleep environment is clutter-free.
Set the temperature to cool
Set the temperature to 65℉ (18.3℃). Sleeping in a room with a cooler temperature can also improve sleep quality.
Sleep masks and blackout curtains
A darker environment helps to signal your melatonin production. Melatonin is a hormone in your body responsible for regulating your sleep cycle.
Earplugs and sound machines
If you sleep better in silence, make sure to have earplugs handy to eliminate environmental sounds during the day (such as traffic, or perhaps you have a noisy toddler). Soothing sounds, such as white noise or pink noise (wind chimes or ocean waves) create a calming environment that can help you relax before falling asleep.
3. PLAN FOR SLEEP
Prioritize sleep and plan it into your daily schedule. Try to make sure that you will be sleeping at the same time each day, relative to when you work.
If you’re working nights, try to stay awake for a few hours after work (typical when working day shifts) and plan to wake up close to the start of your next night shift.
4. HELPFUL SUPPLEMENTS
Melatonin: It is recommended to take a small dose (0.5mg-5mg) of melatonin approximately 30 minutes before you want to fall asleep. Try to only take it on nights your schedule is disrupted.
Magnesium: Magnesium deficiencies can impair sleep, and it is one of the most common deficiencies. You can use a magnesium supplement before bed to help induce relaxation and improve sleep.
STRATEGIES FOR STAYING ALERT DURING SHIFT WORK:
Even if your shift work is causing sleep disruptions, you still need to be alert when your next shift comes. Try these strategies to stay performance-ready:
1. Coffee naps
Ok, I know what you’re thinking. Why in the heck would you mix caffeine with sleep? Interestingly, researchers have found evidence that “coffee naps” can be more effective than drinking coffee or napping alone on shift workers.
Here’s how to take a Coffee Nap: Immediately after drinking your coffee (recommended without sugar) go to a dark, quiet place and set your alarm for 20 minutes. Nap until your alarm goes off and do not sleep longer than 20 minutes.
2. Light therapy
If you want to move your circadian rhythm backwards: Try light therapy between 1-3pm.
Common strategies for staying alert can actually worsen shift work sleep problems
Many of the strategies people lean into to help them deal with sleep disruptions caused by shaft work can actually make the problems worse. Use these strategies to stop the enemy of shift work sleep disruptions in its tracks!
Your electronics give off blue light, which inhibits the production of melatonin. Sunlight is the main source of blue light, but it is also in artificial lightings such as smartphones, TVs, computers, and lightbulbs. Try eliminating your screen time at least an hour before bed. If you absolutely must look at your phone, always wear blue light blocking glasses which can reduce the impact.
Getting the sleep you need can be challenging when you share your life with others. Have an open discussion with the people you live with to set boundaries about your sleep schedule. Try keeping your work schedule on a communal calendar to make sure the people in your household are aware of when they should be quieter.
AVOID SUBSTANCE USE
Alcohol can be a serious sleep disruptor, especially when consumed within three hours of bedtime. Using alcohol to help you sleep significantly disrupts your sleep later in the night as it’s metabolized.
EASY ON THE CAFFEINE
It takes your body about 10 hours to rid itself completely of caffeine. You should avoid drinking it within 6 hours of bedtime. Overuse of caffeine during the day can impair sleep quality, reduce melatonin, and make it harder to fall asleep.