It is estimated that about 20% of the workforce is employed in a job that requires shift work. Shift work sleep disorder occurs when you have insomnia or excessive sleepiness due to work hours that take place at least in part during the night. It also can occur due to rotating or extremely long work hours. The symptoms of shift work disorder usually last as long as you keep the shift work schedule. The sleep problems tend to go away once you begin sleeping at a normal time again. Some people may have sleep problems even after the shift work schedule ends. Adults should sleep 7 or more hours per night on a regular basis to promote optimal health.

SHIFT WORK AND SLEEP

KEY POINTS:

  • 1. Shift work sleep disorder makes it hard to stay alert on the job and to sleep at home.

  • 2. Fatigue and sleepiness caused by shift work disorder can be related to unhealthy sleep timing, quality and duration.

  • 3. Shift work sleep disorder makes it difficult to get enough sleep each day.

  • 4. Sleepiness on the job puts you and your co-workers in danger. Inadequate sleep can increase the rate of accidents and injuries in the workplace.
  • 5. Shift work can increase your risk of drowsy driving, which can lead to deadly motor vehicle accidents.
  • 6. Inadequate sleep can impair your work performance and can cause medical problems.

Shift Work Schedules

There are several variations of shift work schedules that can cause sleep and alertness problems. These include:

  • Evening shifts
  • Night shifts
  • Early morning shifts
  • Rotating shifts
  • Split shifts
  • On-call overnight duty
  • Long duration
    work shifts

Some people have a harder time adjusting to certain shift work schedules. “Night owls” who prefer to stay up late and sleep late may adjust more easily to working an evening shift. Likewise, “morning larks” who prefer to go to bed and wake up early may have an easier time with early morning shifts. Many people have difficulty adjusting to night shifts and rotating shifts.

GENERAL OVERVIEW

Shift work disorder is a circadian rhythm sleep-wake disorder. Your circadian rhythms are your body’s internal clock that signals when you are supposed to feel sleepy or alert. Your circadian rhythms operate on a roughly 24-hour schedule. Your body uses sunlight to determine how much of the sleep-promoting hormone

melatonin it produces. In shift work disorder, melatonin production may occur when you need to be awake and alert for your job. Exposure to sunlight after a night shift may prevent you from producing melatonin when you are supposed to sleep during the day.

TIPS:

Sleep is one of the three pillars of a healthy lifestyle. To maintain a healthy energy balance, adults should sleep 7 or more hours per night. You also should get regular exercise. Do aerobic activities like walking, swimming or jogging. You also should do activities to strengthen your muscles. Finally, eat a healthy diet that limits fats, added sugars and sodium. A healthy eating pattern includes:

  • If you work rotating shifts, ask your manager to schedule a natural, “clockwise” rotation. This means that your new shift will have a start time that is later than your last shift.
  • If possible, plan to take a nap during a break in your shift or before reporting for a night shift. Even a nap of just 20 to 30 minutes can improve your alertness on the job.
  • Arrange for someone to pick you up after a night shift, or take a bus or cab home. Drowsy driving can put your life and the lives of other drivers at risk.
  • Try to keep the same schedule on work days and days off. Keeping a routine helps your body know when to be alert and when to sleep.
  • Plan ahead for a major change in a shift-work schedule. Begin to alter your sleep time a few days in advance. This will make it easier for your body to adjust (see the example to the right).
  • Avoid exposure to sunlight if you need to sleep during the day. Use blackout curtains in your bedroom and wear sunglasses if you must go outside.
  • Make sure others in your home are aware of your work schedule. They should keep the home quiet when they know that you need to sleep.
  • If you are having trouble sleeping during the day, ask your doctor if it might help you to take a sleeping pill or the hormone supplement melatonin.
  • Exposure to bright light on the job can improve alertness during night shift work.
SCHEDULE SLEEP TIME
Evening Shift
(5 p.m. — 1 a.m.)		 3 a.m. — 11 a.m
Night 1 of
Transition		 5 a.m. — 1 p.m
Night 2 of
Transition		 7 a.m. — 3 p.m.
Night 3 of
Transition		 8 a.m. — 4 p.m.
Night Shift
(11 p.m. — 7 a.m.)		 9 a.m. — 5 p.m.

ACKNOWLEDGEMENT: CONTENT DEVELOPED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE