How to Cope with Shift Work

One of the most powerful things you can do to improve sleep quality is to wake up and go to bed at a similar time each day. For most shift workers, this is impossible. In fact, shift workers are often expected to work when their bodies want to rest, and to sleep when their internal rhythms are telling them to stay awake.

Shift work usually refers to work scheduled outside the standard hours of 7am to 7pm.

According to the latest Labour Force Survey, 19% or almost 1 in 5 of the workforce are shift workers. More than half of these, over 3 million people, work night shifts. This is often on a rotating basis, where schedules cycle according to a fixed schedules, such as earlies, to lates, to nights.

Night shifts have traditionally been the domain of transport, healthcare, policing and manufacturing but as society expects access to more services 24/7, night work in distribution, technology, retail and hospitality is increasingly common.

How do our bodies know when to sleep?

The Nobel prize for medicine in 2017 went to scientists who revealed that every cell in our bodies is programmed to operate on a 24 hour or circadian rhythm of action and recovery.

Circadian rhythms are written into our DNA - they influence everything, not just sleep and alertness - but mood, cognition, blood pressure, appetite, immune function... Every organ in our bodies has its own internal clock.

When we wake up at the same time, every day, our body clocks get into sync and everything works efficiently. We use signals called ‘Zeitgebers’ (or time givers), from the environment to keep the clocks co-ordinated, and in time with our environment. The most important Zeitgeber is bright light, which keeps us awake, while darkness signals the brain that it’s time for sleep. Food, movement and increases in temperature are all daytime signals.

Why is it harder to sleep during the day?

When you transition to a new shift pattern, there is a lag while your body clocks catch up. Most people can only adjust their internal clocks by 2 to 3 hours every 24 hours, so it typically takes a few days to adjust to a new schedule. If any of our Zeitgebers are sending ‘wake up’ cues at bedtime - such as if the room is too light, or too hot, or we’ve been running around a lot, or just eaten - it will be slower to adapt, and much harder to get into a deep sleep.

From a practical perspective, sleep during the day also means contending with a lot more noise from traffic, family or co-habitants, deliveries, etc., as well as managing family responsibilities and trying to find time with loved ones. There is simply less time to sleep during the day.

Some of the behaviours which naturally improve sleep quality, such as regular physical activity, and making healthy food choices, are also often more challenging for shift workers, since they may want to shop and exercise outside conventional opening hours.

Advice to help with shift work

1. How can you prepare for night shift work?

• We usually cope with sleep disruption better if we’re well rested. So try and protect at least 7 hours sleep in the build up to your night shifts.
• Get organised with healthy snacks and food in the fridge/freezer, so that you have less to do during your recovery time between shifts.
• Keep a visible record of your sleep and work schedule somewhere so your partner, family or housemates can easily see it - such as on your door, or the kitchen fridge - so that they don’t inadvertently wake you up.
• Take a nap a few hours before your shift to reduce sleepiness when you’re at work.

2. How can you stay alert while you’re on a night shift?

• Seek out bright light before and during the early part of a night shift. Ensure that both work and rest areas are well lit.
• Taking regular breaks will help you to concentrate during the shift. Moving your body will also help you feel more alert.
• When you have the same shift for at least a few days, eat a meal or snack at the same time each night to help keep your body clocks co-ordinated. Try and consume your main meals during daylight hours if you can, and avoid high sugar foods in the early hours of the morning, when you are more likely to store excess energy as fat.
• Drink plenty of water. Dehydration can make you feel fatigued, and can also interfere with sleep later.
• Caffeinated drinks like tea and coffee can be helpful stimulants to promote attention in the first half of a shift, but taken within 6 hours of bedtime could result in a longer time to fall asleep, reduced deep sleep and fewer sleep hours. Aim to stop drinking caffeine at least 3 hours before bedtime.
• A mid shift power nap is more effective than coffee for improving alertness. Even if you only have 10 minutes to rest your eyes, it could still help boost concentration and mood. Getting physically active will also make you feel more alert.
• Towards the end of the shift, try and make time for a debrief - either written or verbal, to download what you’ve learned during the shift and what needs to be done on the following shift. This will hopefully help you to leave work at work.. and prevent the same thoughts whizzing round in your head when you want to sleep.

3. How can you get home safely after your night shift?

• Do you need to drive? You are at higher risk of falling asleep at the wheel if you drive after a night shift. If public transport, carpooling or cabs aren’t practical, vary your route home so that you’re less likely to be driving on ‘autopilot’. If you’re very tired, take a short nap before setting off.
• Daylight is a signal to the body to stay awake. If you’re not driving, wearing sunglasses or blue light blocking glasses on the way home can encourage the production of melatonin, prepare the body for sleep and avoid shifting the body clock the wrong way.

4. How can you recover after a night shift?

• Most people find it easiest to sleep in the morning after the night shift, before the strongest circadian drive for wake kicks in at around 10-12. They might then wake in the early afternoon, and have another nap before the second night shift. Another option is to stay awake in the morning and have a longer afternoon sleep. The important thing is to try and reserve 7 hours for sleep - even if you’re not able to sleep for all of it, you will still benefit from the opportunity to rest.
• Follow the same routine to prepare for bed on day or night shifts. This will encourage pattern recognition and get the body ready for sleep – a light snack, a warm bath or shower, brushing your teeth, soothing music, relaxation exercises or meditation could be part of a wind down routine. The more often you practice a relaxation technique, the easier it will be to quickly and deeply relax.
• Avoid having a clock or alarm clock where you can see it during your rest time. Looking at the time may make you feel anxious.
• Use blackout curtains or drapes to make your bedroom as dark as possible. A comfortable eye mask can also help.
• If you sleep in a noisy environment, you can soundproof the bedroom with double-glazing, carpets, heavy curtains and wall insulation. Ear plugs can also help to preserve your peace and quiet. Some people find white noise from a fan or white noise machine can help to drown out disturbing sounds.

5. How can you recover between night shifts?

• Try and find time for exercise before your next shift starts. If you can stay physically fit, your body will be better able to cope with changes to the body clock, and you’ll feel less fatigued overall.
• When you’re trying to return to a natural day shift pattern, remember that bright light in the mornings is a powerful signal for re-setting your body clock.

To learn more about managing the health risks associated with shift work, please click  here.