Dealing with Shift Work

Tips on coping with shift work.

Posted Jan 04, 2010

I have always thought it ironic that the sleep medicine field recognizes the challenge of getting good sleep and functioning well, because a grueling schedule involving working over-night is inherent in the work of sleep medicine. Much of the important work in the sleep field is done on third shift! Sleep technicians conduct sleep studies and titrate patients for continuous positive airway pressure therapy (CPAP) during the night. They are a part of that estimated 20% of workers in industrialized countries that have jobs requiring shift work. Thus, some of the most important workers in the field face the risk of clinically significant sleep disturbance and daytime drowsiness due to their work. As anyone who has spent a night in the sleep laboratory (or any other place where you are awake all night) knows, it can get very dicey trying to stay alert and function effectively around 3:00 am.

Many shift workers find that they never fully adapt to their schedules and deal with disturbed sleep on an ongoing basis. Little wonder then that sleep technicians have had to find ways of coping. Below I will note some suggestions on dealing with shift work. These tips come from the National Sleep Foundation and can be helpful for anyone working third shift. Willian Spriggs' book "Essentials of Polysomnography" covers many of these techniques from the perspective of a sleep technician.

The sleep environment is especially important. All of the rules of good sleep hygiene apply. Be sure the bedroom is dark and quiet. Light blocking shades and ear plugs can be helpful. Eye shades can also help if it is not possible to keep a very dark room. Put the cell phone on vibrate. Unplug any land line. Heavy carpeting and drapes can help dampen sound. If there is some unavoidable sound, a white noise generator or even a fan can help mask it.

Bedtime rituals are especially important. Keep the bedroom cool and take a warm bath about an hour before retiring. Avoid stimulating activities like videogames prior to bed time. Don't eat a heavy meal before going to bed and avoid caffeine for at least 5 hours before you try to sleep. Avoid alcohol for several hours before bed time. Exercise should not be sooner than three hours before bed time.

When planning a sleep schedule, try as much as possible to keep the same schedule throughout the week, including days when working and days when not working. Long naps are not helpful but short naps of about 20 minutes can help restore alertness.

Be especially careful when driving home. Drowsiness at this time can result in traffic tickets or accidents. A short nap before leaving work can help maintain alertness until you get home, without making it more difficult to fall asleep later. When driving home in the morning wear dark sunglasses to prevent exposure to bright light. Bright light affects the circadian rhythm and will make it more difficult to fall asleep when you get home. If available use a car pool or public transportation to reduce the amount of driving you have to do. This is also good for the environment.

Staying awake and alert on the job can be very challenging. Short breaks can help maintain alertness. Conversation and activity help prevent sleepiness. Exercise such as walking can also help. Eat regular meals and avoid fatty foods that often result in sluggish feelings. Caffeine should be used sparingly and only in the early part of the shift. Avoid keeping the most boring work for last when you are the most exhausted. The low point of the night is around 4 am so this is a good time to plan for a break. Keeping bright lights on (as they do in hospitals) also helps prevent sleepiness and increases alertness.

It is especially important to be alert to the signs of sleepiness. When you experience the familiar signs of yawning, eyes closing and head bobbing, plus the subjective experience of drowsiness, it indicates that you need to take a break, move around, and increase your level of stimulation.

Dealing effectively with the challenges of shift work is vital to the shift workers themselves and to the rest of us as their work is critical to the functioning of a modern society. With regular use of the techniques noted above it should be possible for shift workers to function more effectively and lead happier lives both on and off the job.