As a volunteer emergency medical technician (EMT), Danielle Bujnak often took the 12-hour dinner-to-breakfast shift from roughly 6 p.m. to 6 a.m.
She expected shift work to get easier as she got used to it, but that wasn’t the case.
“[When I hit 30], I was like, ‘I can’t do this anymore. This is hard,’” Bujnak says.
She recalls struggling to stay awake and, frustratingly, having problems falling asleep after shifts. She left work as an EMT, but she didn’t take a job with a regular sleep schedule.
Instead, Bujnak transitioned to becoming an infant care and sleep specialist. As most caregivers know, it’s not a 9 to 5 gig.
As a result, she began searching for strategies to optimize her sleep.
Bujnak isn’t alone in her sleep hardships or work schedule.
A 2018 review suggested about 18 percent of the U.S. workforce works alternate shift schedules, and a 2017 survey indicated that about 21 percent of European workers work shifts.
With such a significant portion of the population on an irregular schedule, there’s a need for sleep habits that are optimized for shift work.
Does shift work affect sleep quality? What the data says
Experts say shifting schedules, especially overnight work, can wreak havoc on the circadian rhythm, an internal clock that controls sleep-wake cycles.
The circadian rhythm “allows our bodies to rest and recover during sleeping hours and digest, absorb, and perform activity during awake hours,” says Nicole Avena, PhD, an assistant professor of neuroscience at Mount Sinai School of Medicine and a visiting professor of health psychology at Princeton University.
“Shift workers have an altered circadian rhythm,” she adds, “making it hard for their bodies to recover from injury, sickness, and fatigue.”
Several recent studies suggest that shift work lowers sleep quality.
In a 2020 Australian of 136 paramedics, respondents self-reported poorer sleep quality and higher levels of insomnia than norms for the general population.
A 2020 Argentinian of 122 drivers suggested that, though participants got the total recommended hours of sleep, the rest was dispersed throughout the day. A high risk for fatigue was linked with disrupted circadian temperature rhythms and indicated the need for strategies to prevent disturbed sleep.
A 2020 of 86 nurses with 8-hour, rapidly rotating shifts indicated that participants were more prone to poor sleep quality, which affected their work performance. Another 2020 study of 424 workers suggested a link between shift work and poor sleep quality.
A night shift worker’s sleep schedule may increase the risk for developing cardiovascular disease and type 2 diabetes, according to a 2018 review. A 2021 systemic review and meta-analysis suggested shift workers had a significantly higher body fat percentage than the non-shift group.
Shift work may have cognitive impacts as well.
A 2020 suggested shift workers had a significant reduction in cognitive functions in both day and night shifts, but cognitive performance was more impaired during night shifts
Sleep tips for shift workers
Researchers have noted the occupational hazards associated with shift work, but millions of workers are asked to adapt their sleep schedules to a job that isn’t 9 to 5. Can it be done?
Experts say it’s possible with the tips below.
Mentally prepare for sleep
Humans have evolved to sleep during the night and remain active during the day, says Colin Espie, PhD, the co-founder and chief scientist at Big Health and professor of sleep medicine at the University of Oxford.
That can put a mental barrier between shift workers and sleep.
“When you’re a shift worker, and you’re not ready to sleep, it can get more frustrating,” Espie says.
The problem?
“Trying to fall asleep can be a surefire way to stay awake,” he says.
Espie says clearing your head by journaling or writing out a to-do list before bedtime can help. “Then, when things come into your mind, you can say, ‘I’ve already thought about it,’” Espie says.
Though not about shift workers specifically, a 2018 indicated that writing a to-do list for 5 minutes before bed was more beneficial for sleep than journaling about activities completed while awake.
Keep it dark
An older 2011 indicated that exposure to room light before bed suppressed the production of the sleep-inducing hormone known as melatonin.
Night shift workers don’t just have room light to contend with, though. They need to learn to sleep while the sun is up.
“The main thing that controls the body clock is exposure to dark and light cycles,” Espie says. “Light wakes you up, particularly bright light outside.”
Darkness is key, because the brain interprets exposure to light as time to be awake. Espie suggests investing in blackout curtains to block sunlight from your sleep space.
If you’re heading home from a night shift when the sun is out, consider wearing sunglasses to decrease light exposure.
Beware of melatonin
Since light suppresses melatonin, can taking it in supplement form reverse the issue for night shift workers? Buyers should beware, according to Carleara Weiss, a sleep science advisor with Aeroflow Sleep.
“There are a lot of misconceptions around melatonin,” Weiss says. “It tells [your] body it’s time to fall asleep. It doesn’t make you sleep, per se. It gives your brain the indication it is time to sleep.”
A 2022 meta-analyses and systematic review indicated melatonin could positively affect sleep quality in adults with respiratory diseases, metabolic disorders, and primary sleep disorders — but not with mental health disorders or neurodegenerative diseases.
Additionally, a 2022 research letter indicated that the use of high doses of melatonin may be rising, and that the actual quantity of melatonin in marketed supplements may be up to 478 percent higher than the labeled content.
This has experts concerned, especially because it’s unknown whether long-term melatonin use is safe. Weiss suggests speaking with a healthcare professional to weigh the pros and cons before trying melatonin.
Have a routine
When you travel to a new time zone, you may experience jet lag. Suddenly, your body thinks it’s time to sleep while the sun is shining brightly outside.
“Your time for exercise, eating, and sleeping are all determined by body clocks,” Espie says. “We have to try to bring them into a new normal.”
Espie says a person can establish a new normal through routine. “The schedules we have and cues we give ourselves get us into new habits,” Espie says.
Establishing a routine was how Bujnak got her sleep and overall well-being on track.
By running through the same routine in the same order over time, she essentially flicked an “on” switch and told her body it was bedtime — even in broad daylight.
“If you do it in the same order every night, your brain sees it as one big activity… that ends with going to sleep,” Bujnak says.
She says it’s the order and not the amount of time you spend doing something that matters most. In other words, it’s fine to shower for 90 seconds one morning when you’re especially tired and then stretch it out to 15 minutes the next.
Keep bedtime consistent on off-days
It may be tempting to adjust your schedule to something that feels more “normal” by societal standards on a day off. Your off days may also be a chance to see friends and family members who have 9-to-5 jobs.
Espie says it’s best to stick to your routine whenever possible, particularly if you’re tired or you worked overtime. Altering your bedtime on days off can exacerbate “social jet lag,” a phenomenon caused by irregular sleep patterns.
Shift workers are already more prone to experiencing social jet lag. Staying up later on days off, so they can socialize, can make them more tired, Espie says.
Give yourself grace
Shift work requires you to defy human nature and sleep when it’s light. This interferes with sleep-inducing hormones.
Getting used to sleeping during the day can take time, and each person will adjust differently. Espie suggests not beating yourself up if you’re having trouble.
“Recognize that there’s nothing wrong with if lacking energy or feeling like it’s a struggle,” he says. “That’s a reality. It’s best for people to psychologically adapt to it, accept some of the difficulties, and not berate themselves.”
Espie says that being hard on yourself for not sleeping can trigger stress, making bedtime even more of a challenge.
However, if symptoms of insomnia or excessive sleepiness during shift work persist over 3 months, this can indicate shift work disorder. This can adversely affect work productivity and safety, as well as increase the risk for depression or adverse social consequences.
If you suspect you may have shift work disorder, it’s important to see a sleep specialist to receive a diagnosis and treatment plan.
Find support from peers
Shift workers might work different times than their friends and family, but Espie says they’re often not alone.
Colleagues may be having the same issues, and discussing it during breaks can help ease frustrations keeping you up at night.
“We get a positive response from people when we say we are struggling with sleep, because most people know what that feels like,” Espie notes. “Even ‘good’ sleepers sometimes have bad spells.”
This knowledge can help shift workers give themselves a break.
A 2020 study of shift nurses suggested that social support may help lessen job stress and shift work sleep disruptions.
Try aromatherapy
A 2020 systemic review and meta-analysis of shift work nurses indicated that aromatherapy could significantly improve sleep quality.
Weiss says more research is needed to confirm if aromatherapy can help shift workers sleep, but she believes it’s worth trying.
“It may have a relaxation component, either the scent or when used as a massage oil… and that can help with sleep quality,” Weiss says.
Limit caffeine intake
Caffeine can provide you with a jolt of energy — something shift workers may particularly need. Still, Avena says shift workers should be mindful of when and how much of it they consume.
She suggests eliminating caffeine consumption at least 4 to 6 hours before bedtime. The amount a person should consume per day also varies.
Generally, Avena recommends sticking to a maximum of 400 mg of caffeine per day. In other words, four cups of coffee or two energy drinks.
Additionally, she advises people to reduce that intake by at least half if they notice they’re having trouble sleeping.
Make it personal
The internet — and your workplace break room — may be full of sleep tips. Still, not all of them will work for you.
For example, Espie says the Centers for Disease Control and Prevention (CDC) recommends people 18 to 60 years old get at least 7 hours of sleep. You may find you only need 7 hours, while your colleague needs at least 9.
Your sleep schedule is customizable, even when you work shifts, Bujnak says.
For some, it’s best to sleep “as soon as they come home in the morning,” she says. Others “get better sleep if they go to sleep and wake up right before work.”
