Oct. 11, 2023 -- Heading to work after the sun sets has become common in the U.S., but what does that mean for the health of night shift workers?
The U.S. Census Bureau estimates that 11.4% to 14% of American workers perform their jobs on a "non-standard schedule," meaning they don’t work in the daytime and may not have predictable work hours.
The National Institutes of Health defines night shift work as employment that takes place as most of the population is sleeping, and that disrupts the body’s natural circadian rhythm -- its natural internal clock.
"Circadian rhythm plays an important role in regulating our sleep patterns," said Shelby Harris, PsyD, clinical associate professor of neurology and psychiatry/behavioral sciences at Albert Einstein College of Medicine in Bronx, NY, and director of sleep health at Sleepopolis. "It follows a 24-hour cycle and is highly influenced by light exposure and darkness. For example, when we are exposed to natural light in the morning, it sends signals to our bodies that it’s time to wake up, be alert, and start our day. When the sun begins to set in the evening, our bodies start to produce melatonin, a hormone that makes us feel tired at night to help us prepare for sleep. Disruptions to our circadian rhythm, such as those experienced during night shift work, can lead to sleep problems, mood irregularities, drowsiness, and slower cognitive processing."
Chinese researchers report that night shift workers are at higher risk for heart attack and diabetes. Some of this has to do with a poor diet. A recent Australian study found that shift workers on rotating schedules are at higher risk for diabetes because they tend to eat more frequent meals and snack more often. What’s more, this kind of disrupted rest can lead to full-blown shift work sleep disorder, according to the Henry Ford Health System.
As a night shift worker, what’s the wisest way to cope? Smart time management is foremost.
"The most important action you can take is to set aside enough hours for sleep," which means 7 to 8 hours of uninterrupted rest, said Emerson M. Wickwire, PhD, professor and section chief of sleep medicine at the University of Maryland School of Medicine in Baltimore.
Using daylight to your advantage is also key. A study review by Korean researchers found that light therapy was the most effective way for shift workers to sleep longer because it can adjust the body’s circadian phase. A light box can be helpful. Also, "if you wake up while it’s still daylight, expose yourself to sunlight as soon as possible to help signal to your body that it's time to be awake," said Harris. "Open your curtains or go for a walk outside. If it’s dark out when you wake up, use a sunrise alarm clock -- they’re designed to mimic the natural rise of the sun. This exposure to light helps to regulate your circadian rhythm." And if you’re getting into bed when it’s light out, blackout curtains and a sleep mask can help.
Even day workers need good sleep planning -- we all face times when we don't get a full night of rest but still need to function well. The good news is most shift workers make it their business to get past their sleep challenges -- and have excellent advice. Read on for these workers’ tips to maximize sleep around the clock.
Let Yourself Feel Tired
Josh Hinton, a U.S. merchant mariner, said he used to work as a night cook on a ship. With an unusual sleep schedule, it's important to give in to fatigue and to be patient with the process, he advised.
"I would wake up at 9 p.m. and work until 10 a.m. It takes about 2 weeks to fully adjust your sleep schedule. It’s impossible to force it -- your body will not immediately switch. Instead, use the fatigue. As days go by, you will start to sleep more during the day and less at night."
Use Reverse Sleep Hygiene
Hinton followed healthy advice for preparing for sleep but simply swapped the time frame around. Instead of stopping caffeine at noon to get a good night’s sleep, "drink coffee in the evening, and stop around midnight," suggested Hinton.
Try the Dark Glasses Trick
"When you’re getting off shift, wear a pair of really dark sunglasses," suggested Valerie Sinady, a night nurse practitioner, certified health coach, and corporate health and wellness consultant. "Darkness acts as a signal to fall asleep. Safety glasses used for welding are very dark, and with options under $10, very cost-effective."
"Integrate naps into your day to prevent sleep deficits if you’re not able to consistently get a full night’s sleep," recommended Carlos da Silva, a physician assistant who has experience working at night and on extended shifts. "I know some night shift workers who split up their sleep, getting a few hours right after they come home, then taking a long nap in the evening, before their next shift. Even a shorter nap just before your shift can keep you alert but still allow you to fall asleep once you get home."
(Bonus tip: Need to stay up later than usual? Take a "coffee nap." A study from the University of South Australia found that drinking 200 milligrams of caffeine, then sleeping for a half hour, increased alertness within 45 minutes of waking up.)
Keep Regular Mealtimes
Debbie Gerken, a certified registered NICU nurse, certified pediatric gentle sleep coach, and infant night nurse, found that meal consistency helped her body adjust better to sleeping after night shifts.
"Eat breakfast when you get home from work," she said. "This will help to keep your digestive patterns the same as days that you have off" -- meaning no hunger pangs to wake you up.
According to the Sleep Foundation, a number of foods can encourage sleep.
These include malted milk (which has been shown to stop sleep interruptions, possibly due to its vitamin B and D content), fatty fish (which contains vitamin D and omega-3 fatty acids, both of which can regulate serotonin and promote sleep), tart cherries (which contain melatonin to regulate circadian rhythm) and kiwi (which contains antioxidants to make sleep easier).
Create the Right Sleep Environment
Amy Karim, an MRI technologist and blogger who often works night shifts, has her setup down to a science: "A dark, quiet, and cool room is crucial. I use earplugs and a white noise machine."
Karim is also very careful about her sleep prep. "I go straight to bed once I arrive home -- no TV, which may stimulate my brain," she said. "I save melatonin for when I’m desperate and can’t fall asleep. I take less than 1 milligram because it has been shown that doses higher 0.3 milligrams may in fact disrupt sleep."
And timing is everything. "Try gradually shifting your sleep schedule by going to bed and waking up 15 to 30 minutes earlier each day until you reach your desired sleep and wake times," suggested Harris. "Also, create a relaxing bedtime routine that includes calming activities like reading, deep breathing, and meditation."
Most importantly: Seek advice to navigate a sleep issue if you need it. If you have trouble with the quality or quantity of your sleep multiple nights a week, talk with your doctor.