Shift Work: How to Handle Sleep, Life

Got odd hours at work? Learn how to make your schedule work for you.

From the WebMD Archives

Patricia Rose Brewster works the night shift. A fiber optics engineer in El Paso, Texas, Brewster, 50, has been clocking out and going to bed past dawn for the last 30 years. She wouldn’t have it any other way.

"I love working nights," she says. "People are friendlier, more laid back. You can get more work done at night than you can during the day...NO management at night. I would never work any other shift."

Brewster is one of the lucky ones. She says that despite her schedule she has never had any difficulty sleeping. Most people don’t have it so easy.

"We don’t see a lot of people who do fine on shift work," says Sally Ibrahim, MD, of the Cleveland Clinic’s Sleep Disorder Center. "They have trouble sleeping, trouble waking. And they’re drowsy when they’re awake."

Schedule Out of Whack

Working the graveyard shift forces the body to operate counter to its circadian rhythm, the internal clock that tells us when we should be sleeping and when we should wake. Few people adapt easily or completely to such schedules. It’s not uncommon for such people to suffer from shift work sleep disorder (SWSD).

SWSD is characterized by insomnia and excessive sleepiness. People with the disorder are more accident prone, irritable, and less able to concentrate – none of which will help win Employee of the Month status. Ibrahim says that lack of sleep is also linked to depression, anxiety, substance abuse, and other mood disorders.

Despite the toll that such shifts can take, somebody has to work them, from the waitress at the all-night diner to the on-call plumber, as well as police, firefighters, fiber optics engineers, and, of course, physicians and other hospital staff.

Karen O’Connell, MD, has worked from 11 p.m. to 7 a.m. in the emergency room at Children’s National Medical Center in Washington, D.C. for 2 1/2 years. She says she will never give it up, but she believes she’ll never fully adjust.

"It’s a very different lifestyle," says O’Connell, a 37-year-old mother of two young children. "A physician’s schedule doesn’t lock me in with what’s natural."