Shift Workers and Sleep
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Allah created us to be night sleepers, not workers. We can if necessary stay up and work during times when we should be sleeping, but in general, our hormones and our rhythms are geared for daytime wakefulness. However, modern civilization has grown into an all-day-all-night operation, unnaturally forcing many people to work at night. Two particular sleep-related problems are associated with shift work: difficulty sleeping during the day and difficulty staying alert at night. Before we go into the details of shift work problems, we should define the body’s circadian rhythm. The body’s circadian rhythm is its alternating cycle of sleeping and waking. In healthy adults, sleep tends to occur during a particular phase of the circadian rhythm. This circadian rhythm is set and maintained mainly by two external stimuli; light and noise. Circadian rhythms are finely tuned phenomena in which hundreds of body functions mesh with each other. Those who work the night shift ought to sleep when their bodies want to be awake, resulting in a contradictory relationship between sleep time and circadian rhythm. When we change work shifts, it takes time to reestablish that fine balance. It usually takes at least two to three weeks before we are fully adjusted to a total day-night reversal.


Shift work affects our lives in many ways. The average sleep cycle for a night shift worker sleeping during the day is two to four hours shorter than that of the day worker sleeping at night. Day sleep is light, fragmented, and more likely to be disrupted. Sleep deprivation and insomnia can be severe in shift workers. In turn, this affects job performance, since people are generally sleepiest between 2:00 AM and 6:00 AM, even after years of working nights. Under these circumstances, mood deteriorates and health suffers. For example, digestive secretions follow a circadian pattern. If you eat while on the night shift, you fill your stomach with food at the time when it is not ready for digestion, and you leave it empty when all the acid secretions occur. This is probably why night shift workers have more peptic ulcers than daytime workers do. Shift workers must also cope with a lot of family and social problems. They have to work while the rest of the world is in bed, and sleep while the rest of the world is at work and engaged in leisure activities. These people complain that they do not have enough time to spend with their family and friends, make appointments and get engaged in leisure activities.

There has been much concern about the dangers to the public caused by workers being sleepy on the job. The three nuclear disasters, Three Mile Island, Peachtree, and Chernobyl all happened in the early morning. Human factor was cited as a factor in all three. Was sleepiness a factor also?!

How to Sleep Better If You Are Doing Shift Work:

It would be best if we do not have to shift work at all. However, as it is unavoidable, here are few things you can do. Initially, we have to differentiate between professions like physicians who have to be on call at night where their sleep is frequently interrupted and other shift workers. Also, some people are better suited to shift work than others. As a general rule, the older we get the more difficult it becomes to work nights and rotating shifts. Several strategies may help the shift worker sleep better.

Shift Workers

Workplace Conditions:

Shift work should be organized in way to help the shift worker sleep better. That can be done by rotating clockwise from day to evening to night. This approach is more natural and helps the worker to adjust his/her circadian rhythm gradually. Short breaks during working hours may help in increasing alertness. It is better to have longer shift periods to allow the body to adjust to the new shift (i.e., three weeks rotation is better than one-week rotation). The workplace environment should stimulate the worker’s alertness. Lighting level should be bright enough. The temperature should be cool rather than warm. Caffeine containing beverages should be available to the workers. Both the employer and the employee should educate themselves about shift work and its effects.

Sleep and Home Conditions:

Rotating shift workers should start adjusting their sleep schedule at the end of their current shift to cope better with the new shift. On the last few days of the current shift, sleeping time should be gradually adjusted to be ready for the new shift. For example, if your next shift will be the evening shift, try to delay your sleeping time and hence your wake up time 1-2 hours every day to ease into the new night shift. If your shift is at night and you have to sleep in the daytime, simulate the night environment in your bedroom by making it dark and quiet. White noise (constant low background noise like a fan or air conditioner) may help block out external noise. The worker should follow the sleep schedule of each shift as strictly as possible even in the off days. Try to work out a fixed time to spend with your family and friends without significantly compromising your sleep schedule.

Workers who permanently work night shifts, should strictly follow and defend their sleep schedule even during weekends. Changing the sleep schedule during the weekend to cope with the social commitments may upset the sleep schedule for the whole week. Employees in jobs that require frequent awakening at night like physicians may benefit from short naps in the daytime.

Sleeping Pills:

There is no good evidence that improving daytime sleep by sleeping pills has a significant effect on alertness and performance in the subsequent night shift. These pills have side effects and overtime may result in dependency. Moreover, this type of treatment does not address the actual cause of the problem. I do not recommend the use of these medications in shift workers.

Eating Habits:

Food may play a role in good sleep. Shift workers should eat meals that are high in protein and carbohydrates, and avoid fried and fatty food. It is not advised to go to bed when hungry or after a heavy meal.

Finally I wish you all a restful restoring sleep.


Ahmed BaHammam, FACP, FCCP
Professor of Medicine
Director, University Sleep Disorders Center
College of Medicine, King Saud University