We can feel groggy when our sleep schedule is thrown off even just a little. So what happens when shift work requires people to regularly stay awake through the night and sleep during the day — and how can they protect their health and well-being?
What is shift work disorder?
Mounting evidence, including several new studies, paints a worrisome picture of the potential health fallout of nontraditional shift work schedules that affect 15% to 30% of workers in the US and Europe, including factory and warehouse workers, police officers, nurses, and other first responders.
So-called shift work disorder mainly strikes people who work the overnight or early morning shift, or who rotate their shifts, says Eric Zhou, an assistant professor in the Division of Sleep Medicine at Harvard Medical School. It is characterized by significant problems falling and staying asleep, or sleeping when desired. That's because shift work disrupts the body's normal alignment with the 24-hour sleep-wake cycle called the circadian rhythm.
"People who work 9-to-5 shifts are typically awake when the sun is up, which is aligned with their body's internal circadian clock. But for shift workers, their work hours and sleep hours are misaligned with the natural cues to be awake or asleep," Zhou says. "They're working against the universe's natural inclinations — not just their body's."
What's the connection between shift work and health?
A 2022 research review in the Journal of Clinical Sleep Medicine links shift work to higher risks for serious health problems, such as heart attack and diabetes. This research suggests adverse effects can include metabolic syndrome (a cluster of conditions that raises the risks for heart disease, diabetes, and stroke), accidents, and certain types of cancer.
"The research is consistent and powerful," Zhou says. "Working and sleeping during hours misaligned with natural light for extended periods of time is not likely to be healthy for you."
How do new studies on shift work boost our understanding?
New research continues to add to and strengthen earlier findings, teasing out specific health effects that could stem from shift work.
- Shift workers on rotating schedules eat more erratically and frequently than day workers, snack more at night, and consume fewer healthier foods with potentially more calories, a study published online in Advances in Nutrition suggests. This analysis reviewed 31 prior studies involving more than 18,000 participants, comparing workers' average food intake over 24 hours.
- Disrupting the circadian rhythm through shift work appears to increase the odds of colorectal cancer, a malignancy with strong ties to lifestyle factors, according to a 2023 review of multiple studies published online in the Journal of Investigative Medicine. Contributors to this higher risk may include exposure to artificial light at night, along with complex genetic and hormonal interactions, study authors said.
"Cancer understandably scares people, and the World Health Organization recognizes that shift work is a probable carcinogen," Zhou says. "The combination of chronically insufficient and poor-quality sleep is likely to get under the skin. That said, we don't fully understand how this happens."
How can you protect your sleep — and your health?
If you work overnight or early morning shifts, how can you ensure you sleep more soundly and restfully? Zhou offers these evidence-based tips.
Time your exposure to bright and dim light. Graveyard shift workers whose work schedule runs from midnight through 8 a.m., for example, should reduce their light exposure as much as possible after leaving work if they intend to go right to sleep once they return home. "These measures could take the form of wearing blue light–blocking glasses or using blackout shades in your bedroom," he says.
Make enough time for sleep on days off. "This is often harder than it sounds, because you'll want to see your family and friends during nonwork hours," Zhou says. "You need to truly protect your opportunity for sleep."
Maintain a consistent shift work schedule. "Also, try to minimize the consecutive number of days you spend working challenging shifts," he says.
Talk to your employer. Perhaps your boss can schedule you for fewer overnight shifts. "You can also ask your doctor to make a case for you to be moved off these shifts or have more flexibility," Zhou says.
Look for practical solutions that allow you to get more restful sleep. "People engaged in shift work usually have responsibilities to their job as well as their family members, who often operate under a more typical 9-to-5 schedule," he notes. "The goal is to preserve as strong a circadian rhythm as possible under the abnormal schedule shift work requires."
FAQs
"You need to truly protect your opportunity for sleep." Maintain a consistent shift work schedule. "Also, try to minimize the consecutive number of days you spend working challenging shifts," he says.
Can shift work harm sleep and health? ›
Such work schedules disrupt the biological circadian rhythm and natural sleep-wake cycles. This disruption may cause significant consequences. A growing body of evidence shows a connection between shift work and numerous hazardous health outcomes, including both physical and mental health conditions.
What are the pills for shift work? ›
Wake-promoting agents are medications that improve your alertness and your ability to maintain wakefulness. The U.S. Food and Drug Administration (FDA) currently approves two of these medications for SWSD: Modafinil (Provagil®). Armodafinil (Nuvigil®).
What is the healthiest shift work schedule? ›
In general, clockwise shift rotations should be used (day–evening–night). Ideally, a rotational schedule should include no more than 3 night shifts in a block, with 3 days of recuperation after the night shift work. In general, 8-hour shifts are preferable to 12-hour shifts.
What is the best sleep aid for night shift workers? ›
Taking melatonin will do two things: First, it will help shift the timing of the circadian clock to help you manage shift work better. Second, it will help you sleep when you are transitioning between work shifts by telling the brain to sleep at a different time than normal.
Is working day shift bad for your health? ›
A shiftworker is at increased risk of health problems, such as digestive upsets, obesity and heart disease, and accidents due to excessive daytime sleepiness.
Does working night shift age you? ›
Preliminary findings have underlined a possible relationship between shift work and aging by showing an association between duration of NS work and reduced telomere length [5,6], although its use as a potential index of biological aging is still controversial [7].
What is best vitamins for working on night shift? ›
Some of the most highly recommended supplements for shift workers include vitamin D, magnesium, and melatonin. Vitamin D supplements can help counteract the reduced exposure to sunlight during night shifts while magnesium can help with relaxation and better sleep quality.
How to fix shift work sleep disorder? ›
Lifestyle changes that help manage shift work sleep disorder
- Try to keep a regular sleep schedule, including on days off.
- If possible, take 48 hours off after a series of shifts.
- Wear sunglasses when leaving work to minimize sun exposure. ...
- Take naps when possible.
- Limit caffeine intake four hours before bedtime.
What are the best medications for sleep?
- Doxepin.
- Temazepam.
- Triazolam.
- Ramelteon.
- Suvorexant.
- Trazodone.
- Estazolam.
- Eszopiclone.
“It's definitely harder to train your body to work the night shift, because your body is not used to staying up all night,” said Sparr. “I noticed at the times that I work night shifts, you're more edgy, you have more of an attitude, you're angry, you're tired, you're exhausted, and you feel drained.”
Are 12 hour shifts better than 8 hour shifts? ›
There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety.
What is 4 3 3 4 shift schedule? ›
A 4 on 3 off 3 on 4 off shift pattern is a scheduling system where employees work for four days, rest for three days, work again for three days, and then take four days off. This cycle offers a balance between workdays and consecutive days off, allowing extended rest periods.
Can magnesium help you sleep better? ›
Magnesium supplementation may promote better sleep by calming the nervous system, relaxing muscles, reducing anxiety, alleviating restless leg syndrome, and helping regulate your circadian rhythm.
What medication is used for shift work disorder? ›
Wakefulness-Promoting Medications
The Food and Drugs Administration (FDA) has approved two wakefulness-promoting agents for treating shift work disorder, modafinil. View Source and armodafinil. View Source . Taken one hour before work, these drugs may help boost alertness during your shift.
How unhealthy is working night shift? ›
Night shift work increases the risk of developing diabetes, heart disease, and obesity. It disrupts the body's circadian rhythms—the 24-hour internal “clock” that controls when you sleep and wake. Studies have shown that eating at night alters the body's metabolism.
Is it unhealthy to sleep in shifts? ›
Drerup says segmented sleep schedules tend to reduce your overall number of hours of sleep, which can lead to sleep deprivation. The NHLBI warns that this can put you at risk of high blood pressure, depression and anxiety, heart disease, diabetes and obesity.
Is shift work bad for your mental health? ›
Shift work is associated with poorer mental health outcomes. This includes higher rates of depressive symptoms and anxiety. In fact, one study found that the risk of depressive symptoms was 33% higher in shift workers than in non–shift workers.
Does shift work reduce life expectancy? ›
According to a 2022 study, between 15% and 20% of the workforce in industrialized nations works shifts. Holmes said those who work during the biological night are making a “huge sacrifice,” explaining: “We know those folks on average are going to die 15 years sooner.”
