Shift Work Sleep Disorder
What is shift work sleep disorder? What problems can it cause?
Shift work sleep disorder is trouble sleeping because you work nights or rotating shifts. You also may have this problem if you have trouble staying awake or alert when you are supposed to work your shift. You may not be able to sleep during the day, and you may not feel rested with the sleep you do get.
Shift work sleep disorder involves a problem with your body's 24-hour internal clock, or circadian rhythm. Light is a cue to be awake, while dark tells your body to sleep. When you work at night and sleep during the day, your body's internal clock needs to reset to let you sleep during the day. Sometimes that's hard to do.
This sleep disorder usually is a problem for people who work all night. But people who work an early morning shift—for example, starting at 4 a.m.—also may have sleep problems. Rotating shift work also can be hard. In these shifts, people work the day shift on some days and the night shift on others.
Night owls may adjust well
Getting enough good sleep is not a problem for everyone who works nights. Many people who work nights get plenty of restful sleep during the day. Some people are "night owls," and they adjust well to working at night.
Problems from shift work sleep disorder
Shift work can increase stress, and that may make you more likely to get sick. Lack of sleep from shift work can increase the chance of car accidents and on-the-job accidents. It also can lead to trouble concentrating at work and poor job performance.
Many people have trouble sleeping once in a while, especially if they are getting used to a new work shift. But be sure to talk to your doctor if you have trouble sleeping or you have trouble staying alert when you are supposed to be awake.
How is it diagnosed?
Your doctor will use a sleep journal and possibly sleep studies to see if you have sleep problems from shift work. He or she will ask questions about your work hours, when you sleep, how much you sleep, and how you feel when you wake up. Your doctor also will ask if you feel very tired or fall asleep while you're at work.
With a sleep journal, you keep track of when you sleep, how much you sleep, and how you feel when you wake up. You write down this information for a week or two. Your doctor will look at it when you're done.
There are also several sleep studies you might have so your doctor can find out why you're not sleeping well. The studies usually are done in a sleep lab.
If your doctor thinks that you have shift work sleep disorder, you might have a test called actigraphy. For this test, you wear an activity tracker on your wrist that measures your movement during the day and at night. It helps your doctor learn when you are awake and when you are asleep.
How can you help yourself sleep better when you work nights?
Sometimes sleep problems can be fixed only by switching to a regular work schedule—working in the day and sleeping at night. But many people are able to work the night shift by making a few changes. You can help yourself get good sleep by keeping your sleeping environment dark and quiet and by taking good care of yourself overall. In some cases, short-term use of prescription medicine or over-the-counter supplements may help.
- Control light, sound, and temperature.
- Make sure that the room where you sleep is dark. Use blackout drapes or wear a sleep eye mask.
- Put a towel over bright digital devices, such as a clock.
- Wear earplugs to block sounds.
- Use a "white noise" machine. This is useful if there is distracting sound in the house or neighborhood that you can't avoid.
- Keep the room at about 65°F (18°C). It's hard to sleep in a room that is too hot or too cold.
Wear dark wraparound glasses when you drive home in the daylight hours after working nights. This can counter some of the effect of light so your body will be more ready to sleep when you get home.
- Take care of yourself, and get support.
- Eat a healthy diet. Some people who work night shifts gain weight because they eat high-calorie or high-fat meals.
- Don't have alcohol or caffeine in the hours leading up to bedtime.
- Get plenty of exercise.
- Take a nap during a work break if you can.
- Ask family members not to wake you during your sleep time, except for an emergency.
- Ask your doctor if you should try a dietary supplement or medicine.
Doctors usually advise people to use a supplement or medicine only for a short time. The dietary supplement melatonin may help improve your sleep. A man-made form of melatonin is available without a prescription. Your doctor can tell you how much to take and when to take it.
Your doctor may prescribe sleeping pills for a limited time to help you fall asleep. These types of medicines include eszopiclone (Lunesta), ramelteon (Rozerem), zaleplon (Sonata), and zolpidem (Ambien or Ambien CR).
- Ask your doctor about other medicines you might try to help you stay more alert at work.
Use caffeine only early in your shift. You may find that the caffeine in coffee or soda drinks helps you stay alert. But it could keep you awake when you get home in the morning.
- Ask your doctor about trying treatment with light (phototherapy) before a work shift to help you stay alert.
Current as of: March 1, 2022
Author: Healthwise Staff
Kathleen Romito MD - Family Medicine
Mark A. Rasmus MD - Pulmonology, Critical Care Medicine, Sleep Medicine