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If you’re a shift worker struggling with sleep, you’re not alone. Studies have found that more than a quarter of people who work nontraditional hours suffer from shift worker sleep disorder. This means having chronic issues staying awake during your working hours and/or sleeping during times you want to be getting shuteye.
Finding ways to get enough sleep is important not just for your health and job performance, but also for the safety of those around you: People who work night shifts are at higher risk for drowsy driving-related car crashes. Fortunately, strategies exist to help you get some good rest, whatever time of day you get off work.
Shift work and circadian rhythms
Shift work means having a schedule that deviates from the traditional 9-to-5 day shift. That could mean overnight shifts, very early morning shifts or shifts that start in the late afternoon or evening. Between 15% and 30% of the workforce falls into this category.
“We live in a 24-hour society, so we have industries in so many sectors that require people to work non-traditional hours,” says Catherine McCall, MD, a sleep physician and assistant professor of Psychiatry and Behavioral Sciences at the UW School of Medicine. “Our society simply would not function without a sizable proportion of our society doing shift work and working at night.”
It can be very challenging, though, when your shift interrupts your circadian rhythm, aka your internal 24-hour cycle, for when your body is ready to sleep and when it feels awake. This cycle is made up of countless biological clocks in every cell in your body that are coordinated by a master clock in the brain called the suprachiasmatic nucleus. The suprachiasmatic nucleus synchronizes with the outside world’s day-night cycle through specialized cells in the retina that are sensitive to light growing brighter or dimmer. Other cues like food intake, exercise and temperature also affect your circadian rhythm.
Things can get wonky when your job requires you to be awake and active during times of the day when your biological clock wants to wind down and sleep, and vice versa. Your circadian rhythms can adjust to some extent under the right conditions, but it’s very difficult to completely overcome the disruption.
“The timing of our internal clock doesn’t change very quickly; it really can’t change by more than an hour in either direction per day,” says McCall. “It’s a pretty slow process.”
The health effects of shift work
So, what problems result from being out-of-sync with your circadian rhythms? The most obvious is feeling sleepy when you’re at work. In addition to the circadian mismatch, the feeling in your body telling you to sleep — called homeostatic or “sleep” pressure — also gets stronger the longer you’re awake. Normally, a good night’s sleep eliminates the homeostatic pressure, which will begin to build again the next day.
But if you need to stay awake for a night shift, the sleep pressure will continue to build. At the same time, the circadian alerting signal fades, and the brain increases melatonin production, leaving you increasingly tired and drowsy. This can be dangerous, especially if you need to operate heavy machinery or drive a car or truck. Then, when you get home after your night shift, your circadian rhythm will have already started promoting wakefulness, making it difficult to go to sleep.
If this becomes a chronic problem — a sleep disorder — the effects can be more than just drowsiness and short-term cognitive fuzziness. Research has found associations between sleep disorders and everything from hypertension to cancer to dementia. It also can worsen or lead to mental health issues like depression and anxiety.
How to avoid shift work sleep disorder
While the best way to avoid a sleep disorder from shift work — and the negative health effects that come with it — is to, well, not do shift work, you’re not doomed if you want or need to continue to work nontraditional hours. Here are some ways to be alert at your job and fall asleep when you get home.
Take naps
When you’re working a night shift, especially when you’re new to the schedule, your homeostatic pressure will be extremely high. One thing you can do? Take a nap.
“If you’re able to nap before that first shift, you can reduce some of that homeostatic sleep pressure, and that can help you remain alert at night,” says McCall.
If you can take naps during your shift, that can be helpful, too, though that might not be an option for you. Just try to cap your naps at around 15 minutes to avoid slipping deep into sleep and then feeling groggy when you wake up, which could affect your cognitive sharpness on the job.
Drink caffeine
Something else that can lessen homeostatic pressure? Caffeine. That’s right, don’t be afraid to hit the coffee pot every hour or two, especially during the first part of your shift. Count back eight hours from when you plan to go to sleep after your shift — that’s when you should stop consuming caffeine so it doesn’t prevent you from falling asleep.
“If you take larger amounts of caffeine or start having it later, it could cause jitteriness or lead to difficulty getting to sleep when you get home,” says McCall.
Control your light intake
Another strategy is to try to adjust your circadian rhythm through light cues. That means getting light at the beginning of your shift and blocking it at the end. If it’s still light before work and you can spend some time in the sunlight, that’s ideal. Otherwise, consider bringing a light therapy lamp to work — make sure it’s between 2,000 and 10,000 lux — and have it on during the first half of your shift.
Then, at the end of your shift, wear sunglasses and avoid getting direct sunlight on your way home. Keep the lights dim in your house and your curtains drawn as you wind down for bed.
Finally, before bed, do your best to avoid looking at your phone screen or turning on the television. If you need to use your devices, turn the brightness down as much as possible.
Take melatonin
In addition to avoiding light after your shift, you can boost your melatonin with a supplement before bed. Typically, all that’s needed is a low dose of between 1 and 3 milligrams, which is still much higher than the 1/3 milligram that our brain naturally produces each night. Keep in mind that melatonin pills are not regulated, so do some research on which brands are trustworthy. Make sure it won’t interfere with other medications you’re taking and that you don’t take too much — it is possible to overdo it, which could lead to symptoms like headaches, excessive sleepiness, trouble breathing and vomiting.
Have a bedtime routine
Finally, having a bedtime routine is helpful no matter what time you go to bed.
“Something that’s not talked about enough is having a wind-down routine where you’re getting ready for bed,” says McCall. “That’s just as important to do during the day as it is at night because if we don’t have that wind-down routine, we’re still sending signals to our brain to be active.”
This might mean taking a hot bath or shower, which is a good cue for your body.
“After a hot bath or shower, you have this cool down, and that tricks your brain into thinking that it’s time for your temperature to go down with sleep,” says McCall.
Your routine could also include stretching, reading, journaling or listening to relaxing music. Use a white noise machine or ear plugs to block out any noise or commotion outside, and blackout curtains or a sleep mask to eliminate any daylight coming in. Communicate with your household to make sure you’re not interrupted for the seven to nine hours you need to rest. Finally, turn the thermostat down so your room is cool.
Can you adjust your sleep schedule to align with your shift?
If you consistently use these strategies and cues, especially being disciplined about when you get and avoid light, it’s possible to shift your circadian rhythm earlier or later. How much you can move it, and how sustainable it is, depends on when your shifts are, how often and sporadically they change, and in what direction (earlier or later). There are also other variables like medications you’re taking and other underlying sleep disorders.
“Usually, it’s only a partial adaptation to your work schedule, but it could be beneficial for people doing longer-term shift work, so they kind of shift into that mode and then stay there,” says McCall. “For short periods of time, it may not be feasible.”
Solving the sleep puzzle is not easy while doing shift work, but it is possible to get better rest. And the more sleep you can get, the better you’ll perform at work and the more you’ll be taking care of your health.
