Sleep Help for Shift Workers
What is Shift Work?
Shift workers follow a schedule that’s outside of the traditional Monday through Friday 9-5 work day. Typically, full days are divided into shifts, with workers covering the entire 24 hours, some of them in the evening, overnight, or early in the morning. Shift workers are becoming increasingly common in our 24 hour society.
While shift work can keep hospitals, factories, retail stores, and other places of employment operational and productive around the clock, it can also take its toll on workers. Often, shift workers struggle to get adequate sleep as their circadian rhythm or internal clock pushes them to stay drowsy at night and alert during the day.
Occupations in Shift Work
Almost 15 percent of workers in the United States are on shift work schedules. Shift work is most common in service occupations including police, firefighting, security, and food preparation. More than half, 50.6 percent of shift workers, are in protective service, while 40.4 percent of shift workers are in food preparation and serving. Production, transportation, and material moving occupations make up an additional 26.2 percent.
Men are more likely to take shift work than women, with 16.7 percent of men and 12.4 percent of women on shift work schedules. In race, 20.8 percent of African American or Black workers are on shift work, while shift workers make up 16.0 percent of the Hispanic or Latino workforce. Asians have a 15.7 percent shift workforce, and 13.7 percent of white workers are on shift work.
These professional occupations typically involve shift work:
- Security guards
- Food preparation and serving workers
- Emergency medical services workers
- Hospital staff
- Air traffic controllers
- Casino workers
- Manufacturing and production workers
- Retail service and stocking workers
- Meteorology professionals
- Internet service workers
- Media and telecommunications workers (TV and radio broadcasting)
- IT support staff
- Customer service representatives
- Hospitality workers
- Truck drivers
- Bus drivers, railroad workers, ship transport, and other transportation workers
- Public utility workers
- Funeral and death care professionals
- Oilfield workers
Why People Work Shift Schedules
For many shift workers (54.6 percent) taking shift work schedules is just in the nature of the job. Others participate in shift work for personal preference, better family or child care arrangements, job availability, or better pay.
Types of Shift Work Schedules
- Multiple shift patterns: Workers on multiple shift patterns do not work the same hours every day. They may work afternoons or evenings one day, then switch to overnight the next, sometimes even within the same week.
- Same shift pattern: Workers on a same shift pattern work fixed, predictable hours, but they are overnight or otherwise not in line with the typical Monday through Friday 9-5 schedule.
Shift Work and Sleep
Shift work may be essential for many occupations, but it is not without its disadvantages. The National Sleep Foundation reports shift work causes sleep disturbances, excessive sleepiness, fatigue, poor concentration, absenteeism, accidents, errors, injuries, and even fatalities.
Consider these facts on shift work and sleep:
- Only 63 percent of shift workers believe their work schedule allows them to get enough sleep versus 89 percent of non-shift workers. (National Sleep Foundation)
- Among night and rotating shift workers, about 10 percent have shift work disorder. (National Sleep Foundation)
- Shift workers experience excessive sleepiness or insomnia at a rate of 25 to 30 percent. (National Sleep Foundation)
- Night shift workers typically sleep around five to six hours, which is less than the recommended seven to nine hours of sleep per day or night. (Journal of Clinical Sleep Medicine)
- Rapid shift rotations are associated with reduced total sleep more than slower rotations with at least three weeks per shift schedule. Rapid counter clockwise rotations are especially disruptive. (Journal of Clinical Sleep Medicine)
- Sleep loss associated with shift work is primarily taken out of stage 2 sleep (the dominant sleep stage) and REM stage sleep. (Journal of Clinical Sleep Medicine)
- The night shift has a 30 to 50 percent increase in accidents in car manufacturing. (Journal of Clinical Sleep Medicine)
- Between 10 to 20 percent of workers report falling asleep during night work. (Journal of Clinical Sleep Medicine)
- Performance decrease during simulated and actual shift work is approximately equivalent to the effects of blood alcohol levels of .05 percent or greater. (Journal of Clinical Sleep Medicine)
- Alertness related accidents and loss of performance is estimated to cost society more than $40 billion annually in the United States. (Journal of Clinical Sleep Medicine)
- Improving rest conditions for on call medical interns to a maximum of 16 consecutive hours of work and 60 hours per week has been found to reduce many types of medical mistakes. (Journal of Clinical Sleep Medicine)
- Medical interns with shifts longer than 24 hours are more than twice as likely to have a car crash and five times as likely to have a near miss driving after leaving work. (New England Journal of Medicine)
- Car crashes cause 22 percent of work related deaths. In seven percent of these car crashes, drowsiness or falling asleep are primary crash factors. (National Institute for Occupational Safety and Health)
How Shift Work Affects Your Circadian Rhythm
Your circadian rhythm is your body’s internal timekeeper. When you do shift work, you’re creating a misalignment between this internal clock and the outside world. Your circadian rhythm tries to keep you in line with the outside world, reinforced by light and other external signals. This may make you drowsy while you’re working at night — and wide awake when you should be sleeping during the day.
This effect is exacerbated if you’re on a rotating or multiple pattern schedule. While on a permanent shift, your circadian rhythm can adjust somewhat over time, it’s difficult to do so when the schedule keeps changing. Your circadian rhythm just can’t catch up, keeping you in a state that’s like constant jet lag.
Shift Work Tendencies
Certain tendencies are common when sleep is affected by shift work. Shift workers often become night owls and sleep fewer than six hours on workdays. They typically work more hours per week on average and dangerously, experience drowsy driving at least once a month. Shift workers may also experience more accidents, decreased performance, and excessive sleepiness.
Shift Work Disorder
Shift work can lead to a condition known as shift work disorder, a circadian rhythm sleep disorder that can misalign or desynchronize your sleep, making it difficult to sleep when you want or need to.
Symptoms of shift work disorder include:
- Excessive sleepiness when you should be awake
- Insufficient or unrefreshing sleep
- Lack of energy
- Difficulty concentrating
- Difficulty in personal relationships
Shift work disorder health risks include:
- Heart disease
- Metabolic problems
- Gastrointestinal problems
- Increased risk of certain treatments
Medical treatments for shift work disorder include:
- Good sleep hygiene
- Schedule adjustments
- Sleep environment adjustments
- Relaxation techniques
- Medications including Provigil and Nuvigil
Tips for Managing Shift Work Sleep Disruptions
There’s no denying that shift work can cause sleep problems, affecting your performance and overall wellbeing. But there are some steps you can take to improve your sleep and decrease the negative effects of shift work.
- Maintain a regular sleeping schedule: Keep your sleep schedule consistent to give your circadian rhythm the ability to adjust and stick with your sleeping schedule.
- Get enough sleep: Be careful not to skimp out on sleep hours, giving yourself enough time to rest and refresh.
- Be careful with caffeine: It’s a good idea to drink coffee at the start of your shift to improve alertness, but avoid caffeine later in your shift, as this can interfere with sleeping when you’re ready to head home.
- Avoid working multiple nights in a row: Sleep deprivation may increase over several nights, so it’s best to schedule days off in between night shifts to give yourself time to recover.
- Avoid rotating shifts: Shifts that change often make it more difficult for your body’s internal clock to adjust to the schedule.
- Avoid extended work hours: Make sure you have time to sleep and participate in activities outside of work so that you’ll feel refreshed before it’s time to get back to the job.
- Avoid long commutes: Give yourself as much rest time as possible by avoiding long commutes. If possible, avoid bright light or stopping for errands on your way home from work, which will only make you more alert and hinder falling asleep.
- Expose yourself to bright light at the start of your “day”: Bright light tells your brain that it’s daytime and time to be alert. Using bright light can help you train your body to recognize the start of your nighttime shift as day.
- Take measures to stay alert at work: Use bright lights to keep yourself more alert when you’re on the job. Bright light can tell your brain that it is daytime and time to be awake.
- Take a nap before the night shift: A quick nap before you go in for your night shift can improve alertness and help you catch up on any missed sleep.
- Limit disturbances during sleep hours: Use blackout curtains or blinds to block out light during the day, turn off your phone, and ask family to limit noise and visitors while you’re sleeping.
- Share your schedule with family members: Be sure that family members are aware of your schedule and understand that it may mean not being involved in daytime activities. Encourage them to plan around your schedule.
Sleep Tips for Shift Workers
- National Sleep Foundation: Tips from Shift Workers: Read these tips from seasoned shift workers to find out how they manage sleep while working shifts.
- WebMD: Sleep and the Night Shift: Find out if you have shift work sleep disorder and get tips for better sleep if you work unusual hours.
- Cleveland Clinic: How You Can Sleep Better if You Work the Night Shift: Minimize shift work sleep disorder with these suggestions from the Cleveland Clinic.
- Mayo Clinic: Night Shift Sleep Tips: Promote better sleep with these tips from the Mayo Clinic.
- University of Pittsburgh Medical Center: The University of Pittsburgh Medical Center offers sleep solutions for shift workers, including strategies for getting sleep, short snoozes, and changes you can make.
Sleep Tips for Shift Work by Profession
Nurses and Doctors
- Medscape: Nurses Are Talking About: Working the Night Shift: Learn about how much sleep is enough and how to get dedicated to giving yourself enough sleep as a nurse on the night shift.
- Time: Should Your Doctor Be Napping on the Job?: Time explains why doctors and nurses should nap at work.
- Medical Protection: Surviving a Night Shift: Protect yourself and your patient with these night shift survival tips.
- Psychology Today: The Night Shift, Nurses and Sleep Deprivation: Psychology Today recommends using naps to adjust to the night shift.
- Villanova University: Keep Healthy Sleep Habits When You Are on the Night Shift: Find out about the serious issues that can occur if you don’t get enough sleep, factors contributing to insufficient sleep, and tips for night shift nurses to get better sleep.
- Scrubs Magazine: 19 Ideas for Shift Nurses to Get More Sleep: Scrubs Magazine offers 19 tips for getting more sleep as a night shift nurse.
- Medscape: A Wake Up Call for Nurses: Sleep Loss, Safety and Health: Learn just how important it is for nurses to get sufficient sleep in this resource.
- Vanderbilt University: Sleep Strategy Used by Night Nurses Throws Off Their Circadian Clocks: Vanderbilt University explains the strategies night nurses use to manage shift work sleep disruptions.
- U.S. Department of Transportation Federal Railroad Administration: Fatigue Status of the U.S. Railroad Industry: This resource illustrates the prevalence of employee fatigue in the railroad industry.
- National Transportation Safety Bureau: Rail Workers: Deadly Tired…But Still Working: Learn about the dangers of working while tired from the perspective of a former railroader now working with the NTSB.
- Railroaders’ Guide to Healthy Sleep: Anonymous Sleep Disorders Screening Tool: Are you at risk for sleep disorders? This tool assesses railroaders for sleep problems.
- Railroaders’ Guide to Healthy Sleep: Your Sleep Toolkit: Use this sleep toolkit to track your sleep, test your reaction time, and more.
- Railroaders’ Guide to Healthy Sleep: Smart Sleep Tips, A to Zzzzz: Learn about night work coping tips, napping, caffeine, adopting a healthy lifestyle, and more.
- Railroaders’ Guide to Healthy Sleep” Seek Help for Poor Sleep: Railroaders can get help for poor sleep from these resources.
- Railroaders’ Guide to Healthy Sleep: Work Life Balance Tips for Railroaders: Explore this resource to find smart sleep strategies and learn how to get support, stay close to family and friends, and make time for yourself.
- National Sleep Foundation: Sleep Disorders Linked to Poor Health and Reduced Occupational Performance in Police Officers: The National Sleep Foundation highlights an important piece of research revealing the effects of sleep disorders in police officers.
- PoliceOne: Police and Sleep Problems: Are You a 40 Percenter?: Nearly 40 percent of active duty officers suffer from sleep abnormalities. Find out why these issues go undiagnosed and untreated, and what you can do about it.
- International Journal of Police Science & Management: State Police Officer Sleep Patterns and Fast Food Consumption: This study assesses the sleep patterns and fast food consumption of a sample of police officers and highlights the predictors of sleep including sports, stimulant drinks, and shifts worked.
- National Institute of Justice: Sleep Disorders and Law Enforcement Officers: The National Institute of Justice offers research on sleep disorders and their impact on officer safety.
- PoliceOne: 10 Ways Police Officers Can Get Better Sleep: PoliceOne offers several suggestions for improving police officer sleep.
- Firefighter Nation: Study Shows Firefighters Don’t Get Enough Sleep: Find out why firefighters often don’t get enough sleep and what you can do about it.
- Firefighter Deaths Could Be Linked to Poor Sleep: Learn why sleep problems could be a major factor in firefighter deaths caused by heart attacks and traffic accidents.
- Fire Engineering: Sleep to Survive: How to Manage Sleep Deprivation: This resource offers an overview of sleep deprivation, performing shift work, and how firefighters can take countermeasures and cope with unusual sleep schedules.
- U.S. Fire Administration: Firefighter Health, Wellness, and Fitness: This resource explores firefighter wellness, including sleep deprivation and how firefighters can adopt healthier habits.
- FireRescue1: Firefighter Sleep: 7 Ways to Improve Your Crews’ Sleep and Safety: Discover methods for improving safety and sleep in the firehouse.
- Air Line Pilots Association International: The Air Line Pilots’ Guide to Fighting Fatigue: Pilots can learn about the hazards of fatigue, fatigue mitigation dos and don’ts, and much more in this resource from the Air Line Pilots’ Guide to Fighting Fatigue.
- National Academies Press: The Effects of Commuting on Pilot Fatigue: The Effects of Commuting on Pilot Fatigue combines information on sleep, commuting, fatigue, and circadian rhythms with an examination of airline and regulatory oversight policies and practices. This resource also includes recommendations for action.
- Psychology Today: Pilot Trouble in the Skies: Psychology Today explains why a lack of sleep impacts pilots on the job.
- Association for Psychological Science: Crew Schedules, Sleep Deprivation, and Aviation Performance: The Association for Psychological Science assesses the problem of sleep deprived pilots and what can be done to mitigate this problem.
- New York Times: Do Pilots Get Enough Sleep?: The New York Times examines whether pilots get enough sleep, highlighting incidents, the danger of long days, and the power of a safety nap.
Active Duty Military
- American Academy of Sleep Medicine: Active Duty Military Personnel Prone to Sleep Disorders and Short Sleep Duration: Learn about a study that found a high prevalence of sleep disorders and a short sleep duration among active duty military personnel. The study highlights the need for policy and culture change.
- Soliders and Sleep: The Military’s Shifting Stance: This article from the National Sleep Foundation shares how the military is taking steps to improve sleep for soldiers.
- Centers for Disease Control: Insufficient Sleep for Active Duty Soldiers a Big Health Problem: The CDC’s assessment highlights the daily insufficient sleep prevalent among U.S. military service members.
- Real Warriors: How to Develop Healthy Sleep Habits: Real Warriors debunks common sleep myths and helps soldiers learn how to develop healthy sleep habits that offer better performance.
- Security Guard Training HQ: What to Do if Your Security Guard Job Becomes Monotonous: Security Guard Training HQ offers helpful tips for staying alert even on the night shift.
- Silvertrac: Security Guard Tips: 10 Ways to Stay Awake During the Graveyard Shift: Here you’ll find helpful tips for staying awake on the graveyard shift and maintaining good health.
- Ergonomics: Self Reported Health and Wellbeing Amongst Night Security Guards: This study analyzes the well being of night security guards, noting more sleep disturbances and fatigue.
Additional Resources for Shift Workers
- National Sleep Foundation: Sleep Hygiene: The National Sleep Foundation explains sleep hygiene with examples of good sleep hygiene and suggestions for finding the best sleep hygiene routine.
- American Sleep Association: Sleep Hygiene Tips: The American Sleep Association offers suggestions for getting better sleep with good sleep hygiene.
- Harvard Healthy Sleep: Twelve Simple Tips to Improve Your Sleep: Follow these tips from Harvard to learn how to improve your sleep and maximize the quality of your sleep hours.
- National Sleep Foundation: What is Sleep Hygiene?: The National Sleep Foundation explains how habits, routines, and more can help you get ready for bed and enjoy better sleep.
- National Sleep Foundation: Sleep Disorders Problems: Read this resource from the National Sleep Foundation to learn about abnormal sleep, circadian rhythm disorders, excessive daytime sleepiness, and more.
- WebMD: Sleep Disorders Health Center: Get an overview of sleep disorders, learn how to identify them, live with them, and find resources for help from WebMD.
- Stanford Medicine: Sleep Disorders: Stanford Medicine highlights some of the most common sleep disorders.
- Cleveland Clinic: Common Sleep Disorders: Explore insomnia, sleep apnea, restless legs syndrome, narcolepsy, and more with the Cleveland Clinic.
- Entrepreneur: 6 Types of Tech That Can Help You Sleep Better: Entrepreneur explores lights, monitors, home automation technology, and more that can help you improve your sleep.
- The Guardian: How to Use Technology to Sleep Better: The Guardian explains how you can use blue light filters, red lights, smart alarms, and more to sleep better.
- T3: Sleep Tech: The Best Gadgets for Improving Your Slumber: Learn about gadgets that can be helpful for improving sleep.
- The Huffington Post: Is Sleep Technology Improving Sleep?: The Huffington Post explores whether sleep technology is helping people improve their sleep.
Shift Work Sleep Studies
- American Psychological Association: The Risks of Night Work: Learn what psychologists know about shift work sleep and the solutions they’re working on.
- Journal of Clinical Sleep Medicine: Sleep Loss and Fatigue in Shift Work and Shift Work Disorder: Learn how shift work can lead to sleep loss and fatigue by requiring workers to sleep at the wrong biological time of day.
- Sleep Journal: Shift Work Sleep Disorder: Prevalence and Consequences Beyond That of Symptomatic Day Workers: Compare the insomnia and sleepiness of day workers and shift workers in this study.
- New England Journal of Medicine: Modafinil for Excessive Sleepiness Associated with Shift Work Sleep Disorder: This study evaluates the use of modafinil in patients with shift work sleep disorder.
Shift Work Disorder
- American Sleep Association: Shift Work Disorder: The American Sleep Association explains shift work disorder, its effects, and tips for managing the disorder.
- National Sleep Foundation: Shift Work Disorder: The National Sleep Foundation shares symptoms, treatment, coping information, and facts about shift work disorder.
- WebMD: Shift Work Sleep Disorder: Find out what shift work sleep disorder is, how it’s diagnosed, treated, and more from WebMD.
- Cleveland Clinic: Shift Work Sleep Disorder: Explore the symptoms, consequences, and dealing with the effects of shift work sleep disorder from the Cleveland Clinic.
- WebMD: An Overview of Insomnia: Visit WebMD’s resource to learn about types and causes of insomnia, how its diagnosed, symptoms, treatments, and good sleep habits that can help beat insomnia.
- Mayo Clinic: Insomnia: The Mayo Clinic offers an in depth exploration of insomnia, from symptoms and causes to risk factors, complications, treatments, and even alternative medicine.
- National Sleep Foundation: What Causes Insomnia: Learn about the causes of insomnia from the National Sleep Foundation.