Shift work is common across the globe, and not just for police, nurses and bakers. Public transport, supermarkets, factories and online shopping services operate 24 hours a day, requiring staff to do shift work or night shift.
Any shift between 7pm and 6am is considered to be night shift work and research shows shift workers get between 1 and 4 hours less sleep than daytime workers.
If you work at night or on shift rotation, you may be missing much more than the odd party. If you’re also missing out on good quality sleep, you may be suffering from shift work sleep disorder. In this article, we take a look at what shift work sleep disorder is and how shift workers can help get the best sleep possible.
Shift work sleep disorder (SWSD) is characterised as not having a regular sleep pattern or having trouble getting enough sleep specifically because you work a night shift or on rotating shifts that overlap or are out of sync with a traditional sleep-wake cycle. SWSD is a circadian rhythm disorder.
The most common symptoms of SWSD are difficulty sleeping and excessive sleepiness. Other symptoms associated with SWSD can include difficulty concentrating, headaches, or lack of energy. If you are a shift worker and you are experiencing any of these symptoms, please see a health professional.
If you have trouble sleeping for other reasons, read more at the Sleep8 blog, and please see your health therapist about any ongoing sleep issues.
Doctors don’t know for sure how shift work affects sleep. It may be a combination of many things, from hormone levels, food and drink, where and when you sleep, hobbies, and family life. If you’re trying to sleep during the day in preparation for night shift, even the daytime noises in your neighbourhood will disturb your rest!
However, working all or even part of the night also means your opportunities to experience daylight at the right times are reduced. What light you do get is artificial and may also be low level because of where you work (care facilities, hospitals). Your body’s exposure to natural light and dark is compromised.
You have a 24-hour internal clock, or circadian rhythm, that responds to light and dark to help your body know when to be active and when to rest. When you work at night and sleep during the day, your body's internal clock must reset so you can sleep during the day. For some people this happens easily, but for others it doesn’t and may result in difficulty falling asleep, staying asleep, or not being sufficiently rested after daytime sleep.
Melatonin is a hormone that helps control sleeping and waking cycles, and supports your health by making your immune system strong. Most melatonin is made by your body at night. Daylight signals your body to make less melatonin. If you work at night in artificial light, your body may be making less melatonin than it needs to maintain good sleep and good health.
Not everyone who works shifts or works odd hours will develop SWSD, but almost all shift workers get fewer sleep hours than the average daytime worker.
People who work through the night are at greatest risk, but people who work late evening or early morning shifts may also experience SWSD. Rotating shift work can also put you at risk. If you work the day shift on some days and the night shift on others, you put pressure on your body to continually adjust your internal body clock, or never give it a chance to fully adjust.
If you have SWSD, you are not getting enough good quality sleep. People with SWSD have higher rates of absenteeism and workplace accidents related to sleepiness than night workers without the disorder.
Lack of sleep can contribute to car accidents, relationship troubles, poor job performance, job-related injuries, memory problems, and mood disorders. Studies also suggest that sleep disorders may contribute to heart disease, obesity, and diabetes.
If you are a shift worker and suspect you may have SWSD, you should see a health professional. Your health professional will ask questions about your working and sleeping hours, how much sleep you get, and how you feel when you wake up. They will ask if you feel sleepy or fall asleep while you're at work. You may be asked to wear a device on your wrist to measure your movement during the day and at night (actigraphy). It helps your doctor learn when you are awake and when you are asleep. You may be asked to keep a sleep diary (at home) or perhaps even participate in a sleep study (usually in a sleep lab).
These can all help reach a diagnosis of SWSD, or another sleep disorder, or an underlying problem that may be causing your sleep issues.
If you are diagnosed with SWSD, your health professional will advise you on the next steps.
They may recommend ways to avoid SHSD, such as those listed below. Supplements such as melatonin and magnesium may be recommended, or you could be prescribed medication for short term use to assist with sleep or prevent drowsiness during your work shifts. Other treatments include bright light therapy and chronotherapy.
If you’re a shift worker, there are many things you can do to support yourself in getting good sleep.
Practice good sleep hygiene
Get plenty of exercise
Try to eat most meals during daylight hours i.e. before and after your shift. During your shift, it’s betteer to eat filling, easily digestible snacks
Stay hydrated, drink water. The caffeine in coffee and tea may help you stay awake during your shift, but it can also raise blood pressure and cause problems after your shift when you need to sleep
Turn on the lights over your direct workspace or work area and leave them on throughout the entire night
Take a nap during a work break if you can, but be aware that napping may affect your sleep quality after work
Reduce daylight exposure after work. Wear dark wraparound glasses and close the blinds before you go to work to so your body will be more ready to sleep when you get home
Prioritise sleep. Go to bed straight after work. Put electronic devices away 30 minutes before bedtime. Wearing blue light blocking glasses in the 90 minutes before you go to bed may help
Stay away from alcohol and caffeine before you go to bed
Eat a small meal or snack that contains melatonin when you get home. Foods that contain high levels of melatonin include milk, pistachios, fatty fish, rice, goji berries, oats, mushrooms, bananas, corn, sour cherries.
Put a do not disturb sign on your front door and silence your phone
Encourage your house mates or family to keep the house as quiet as possible
Set the thermostat at 18˚-22˚C
Use earplugs or a white noise machine to reduce background noise
Use block-out blinds, or a sleep mask, and remove or cover anything that emits light
Ask family members, housemates, friends and neighbours not to wake you during your sleep time, except for an emergency.
Whether you have SWSD, or just occasional sleep issues, if you are a shift worker you can combine good sleep hygiene with these tips to help ensure you get enough good sleep to support your health and wellbeing. If your sleep problems are ongoing, you should see a health professional.