How Shift Work Affects Sleep

Shift work is a vital and growing part of the modern economy. It’s been estimated that 20% of the work force is engaged in some form of shift work. While extending work outside traditional daytime hours offers obvious productivity advantages it also comes with a price. Shift work has been linked to a broad range of problems including: fatigue, sleepiness, insomnia, decreased concentration, depressed mood, gastrointestinal disturbances, cardiovascular disease, infertility, absenteeism, errors, etc.

Shift work causes these problems by misaligning what the body wants with what it gets. The body and its internal workings (e.g. hormone production, neurotransmitter function, etc.) run on an approximately 24 hour cycle that is tuned to generate alertness during conventional daytime hours and rest during traditional sleep time. In shift work this gets flipped, and the body is exerted when it is priming for sleep and induced to sleep when it is bracing for activity.

There are a number of strategies that can help mitigate the effects of shift work. Most of these are centered either on trying to control one’s sleeping environment or helping reset the body’s clock to facilitate better and more refreshing sleep. They are:

• Try to avoid frequent shifting between day and night schedules.
• Planned sleep schedule: a disciplined sleep schedule helps promote an increased amount of sleep. Napping before work and after the main sleeping period is a common helpful strategy.
• Protect your sleep environment: A dark, quiet environment can go a long way to promoting sleep during the day. Other helpful tips include avoidance of TV/computer or other stimulating activities before sleep, avoidance of caffeine 6 hours before sleep, etc.
• Timed light exposure: Light is the most powerful way to set your body’s clock and exposure or avoidance at certain times can have a powerful effect in improving alertness, mood, work time tasks and sleep quality. In general, restriction of light in the early morning after a night shift will help facilitate sleep, mood and alertness.
• Timed melatonin: Melatonin before daytime sleep may help promote sleep in some but will cause drowsiness or have no effect in others.
• Caffeine: consumption of caffeine during night shift improves alertness but be careful not to take it too close to your planned bedtime (usually you shouldn’t take caffeine 6 hours before your planned bedtime)
• Prescription sleeping tablets and stimulants: These can be helpful in some but should only be used in the setting of careful attention to the above strategies and under a physician’s supervision.
• Be aware of sleep apnea: this is a very common disorder that will make it harder (or impossible) for the above strategies to work. 

For more information on Saint Alphonsus Sleep Services please visit www.saintalphonsus.org/sleepwell.

Written by: Rory Ramsey, MD

Dr. Rory Ramsey is a Sleep Medicine doctor with the Saint Alphonsus Medical Group, a primary care and specialty physician network of more than 260 medical providers across 40 locations in Idaho and Oregon.   

To schedule an appointment with Dr. Ramsey or to find a medical provider near you, call 877-401-DOCS (3627) or visit www.saintalphonsus.org/docs today.