Many professions, particularly in the public health and safety domains, require 24-hour operations. Therefore, the workday is divided into multiple shifts, which are covered by different groups of employees. It is estimated that approximately 20% of working adults work irregular shifts outside the typical 9:00 a.m. to 5 p.m. workday. However, shift work can be difficult to cope with and have several negative consequences, including shift work disorder. This article discusses the symptoms, causes, diagnosis, and impact of shift work sleep disorder, as well as some coping strategies that may be helpful for shift workers.

Causes of Shift Work Sleep Disorder

The human body has a 24-hour cycle of bodily processes known as a circadian rhythm that is attuned to the light of the sun. The circadian rhythm governs many internal functions, including sleep, digestion, body temperature, blood pressure, heart rate, and hormone production, among other things.  We are essentially biologically programmed to sleep during the night and be productive during the day. Working night shifts or a mix of day shifts and night shifts interferes with your body’s circadian rhythm because it requires you to be awake when you’re supposed to be asleep and vice versa. These are some factors that can contribute to the development of shift work sleep disorder, or exacerbate it:

Having a stressful job Working busy night shifts Eating meals at irregular times Having a long work week (over 40 hours of work per week) Not getting a day off to rest after a night shift Not being able to rest or take breaks during night shifts Having considerable home, family, or other responsibilities outside of work that make it difficult to sleep during the day  Not having a strong support system or work-life balance

Symptoms of Shift Work Sleep Disorder

These are some of the symptoms of shift work sleep disorder:

Poor sleep quality Difficulty falling asleep Nightmares and other sleep disturbances Excessive daytime sleepiness Chronic fatigue Irritability  Decreased alertness Trouble concentrating Impaired memory Higher levels of stress and distress Difficulty functioning and performing daily activities

A 2017 study notes that symptoms such as difficulty falling asleep and feeling extremely sleepy during the day can persist for several days after your last night shift, even after your sleep cycle has been returned to more traditional timings.

Impact of Shift Work

Shift work can take a toll on your mental and physical health. 

Impact on Your Physical Health

Working irregular hours and not getting enough sleep can raise your risk of physical health conditions such as:

StrokeHeart diseaseCancerObesityDiabetesInfertility Digestive issuesHormonal imbalancesPregnancy complicationsInfectious diseases

Impact on Your Mental Health

Shift work can also affect your mental health and raise your risk of conditions such as:

DepressionAnxietyAlcohol and substance useStress-related conditions

Other Drawbacks of Shift Work

Apart from health consequences, shift work also has other risks and drawbacks, such as:

Increased risk of workplace errors and accidents Higher risk of car accidents caused by falling asleep at the wheel Less efficient work performance Lower levels of job satisfaction High levels of absenteeism from work Higher healthcare costs Poorer overall quality of life

Diagnosing Shift Work Sleep Disorder 

If you think you might have shift work sleep disorder, it may be helpful to see a sleep specialist. Your primary healthcare provider can provide a referral to one, if you need it. The sleep specialist will interview and ask you about your medical history, sleeping habits, work shifts, and the symptoms you’re experiencing. They may also recommend that you undergo a sleep study that can measure various bodily functions while you sleep.

Coping With Shift Work Sleep Disorder

These are some strategies that can help you cope with shift work sleep disorder:

Prioritize sleep: It’s important to prioritize sleep when you’re off-duty, to ensure you’re getting enough rest. Regulate light exposure: Keep bright lights on while you’re on the night shift, to help you stay awake. When you get home, close the curtains and switch off the lights, so the room is dark enough for you to sleep. Solicit family members’ cooperation: Ask family members not to disturb you while you sleep during the day. Request them to use headphones while listening to music, watching movies, or taking calls.  Don’t drive if you’re too tired: If you’re too tired to drive, make alternate arrangements. Call a cab, take public transportation, get a ride from a coworker, or ask a loved one to pick you up.  Plan naps: Try to plan night shifts such that you can take a nap in between. If your workplace allows it, try to rotate nap breaks with your coworkers over the course of the night shift. Avoid rotating shifts: Consistently working either a day shift or night shift is better than working rotating shifts, as rotating shifts doesn’t give your body a chance to settle into a daily rhythm. Use a sleep aid: If you’re having difficulty falling asleep when you’re supposed to, check with your healthcare provider if a sleep aid such as melatonin is right for you. Maintain a healthy routine: Working shifts can make it hard for you to exercise and eat healthy meals. However, it’s important to follow a healthy routine and diet to maintain your immunity.

Shift work can be difficult to cope with. It can make it hard for you to get enough rest and affect your mental and physical health. It can also jeopardize your safety by increasing your risk of having an accident. It’s important to ensure that you’re getting enough sleep on your time off and following a healthy lifestyle, to help offset the health risks associated with shift work. If you’re feeling low or stressed out, it may be helpful to see a mental healthcare provider, to help you cope.