Shift Work Sleep Disorder: Symptoms and Treatment

Shift work causes a conflict between the body’s biological clock and its surrounding environment. This is a double-edged sword that leads to drowsiness at work and insufficient sleep or even no sleep at all when it’s time to rest.

The so-called shift work sleep disorder is common among workers like doctors, police officers, firefighters, pharmacists, people in the manufacturing sector, security guards, etc. Although shift work has some adverse effects on sleep, you can’t necessarily get up and leave your job tomorrow. Therefore, it would be beneficial to remember some tips to better deal with shift work disorder symptoms and therefore get healthier sleep—even when you have to work overnight.

It’s no secret that shift work can affect your physical and emotional state. For example, as time goes by, the hobbies you once enjoyed become a distant memory as you wait for “more free time.” Read on to better understand this condition and to learn how to manage it.

What Causes Shift Work Disorder?

Many people work night shifts, with no option but to sleep during the day when everyone else is at work. However, people don’t choose this schedule on their own—they work these positions because they get some benefits for doing so or simply because their profession requires it. 

However, the human body is adapted to a 24-hour rhythm of vital functions, also known as the circadian rhythm. Hardly anyone can outsmart their biological clock, though it may be tricked for a brief period. In the case of a night shift sleep disorder, the biological regime becomes disrupted, which leads to a decrease in body temperature. This also explains why we feel cold when we’re sleep deprived. A common manifestation of lack of sleep is excessive hunger, which is explained by the body trying to recover its wasted energy.

Usually at night, the body has decreased physiological activation and performance. However, shift work and the sleep habits that come with it produce new conditions that are in complete contradiction with the body’s circadian rhythm. Even with prolonged alternating shifts, it’s been found that the body fails to fully adapt and “reverse” its circadian rhythm, meaning the biological clock can’t synchronize with the new sleep-wake pattern.

Similar complaints to the shift work disorder can also be observed when you travel and cross more than two time zones. This condition, jet-lag, only temporarily confuses the biological clock. In this case, however, the body can synchronize its habits of sleeping, eating, etc., to the natural regulator of our biological regime, i.e., natural light. However, this is not the case with shift work. The latter represents a constant challenge to the body’s adaptive capacity.

Is Working the Night Shift Bad for Your Health?

Shift work is generally unfavorable for your sleep and health because it interferes with your natural biological rhythm. In this way, even though you’re awake at night, your body is still pushing you to sleep. Despite what many people say to the contrary, the night shift experience cannot help you learn how to overcome your lack of sleep and develop resilience. The truth is that the more extended night shifts you experience, the greater your risk of health complications.

Because it’s associated with insufficient sleep, work shift disorder increases the risk of developing cardiovascular diseases, gastrointestinal disorders (including acids and ulcers), or a weakening of the immune system.

The cardiovascular risk is thought to also be augmented by smoking, nutrition changes, and stress. Meanwhile, the typical gastrointestinal symptoms are the result of irregular nutrition (often from eating quickly and intermittently); the consumption of cold, dry, spicy, fried, or rich-in-fats food; and the increased use of coffee and tea.

Various studies indicate that shift sleep disorder can also increase the risk of menstrual disorders, pregnancy problems, problems with sperm, low testosterone, and cancer. Too many or too few hours of sleep interfere with circadian rhythms—this changes hormonal levels and the expression of genes that are important in the production of semen.

An inadequate amount of sleep is also related to the appearance of metabolic disorders: changes in appetite, higher levels of triglycerides, obesity, diabetes, etc.

However, the two most severe problems for those with shift workers’ syndrome remain sleep deprivation and chronic insomnia. Prolonged sleep deprivation can cause the appearance of so-called micro sleep. This refers to episodes of involuntarily falling asleep, which last for only a few seconds. However, these episodes can be a major safety danger, especially in the case of driving, operating heavy machinery, or engaging in other high-risk work.

Last but not least, we have to mention the social consequences associated with isolation from family life, insufficient time to interact with a partner, and how this work impedes social activities.

What Are the Symptoms of Shift Work Sleep Disorder?

Some studies on operators and drivers show that prolonged, monotonous work can lead to tiredness in the workplace, which isn’t always recognized by the person experiencing it. The first symptoms are most often associated with extreme drowsiness in the workplace and during off-hours, poor concentration, delays in reactions, and difficulty making decisions. When work shift disorder worsens, more errors, incidents, and reduced performance also become a problem.

Furthermore, additional problematic sleep symptoms have also been observed:

• An insufficient duration of sleep – It becomes challenging to maintain 7–8 hours of complete rest.
• Difficulty falling asleep or possibly not falling asleep at all – Even if it’s time to rest, the external environment keeps the body awake and alert, a condition called night shift insomnia.

The occurrence of irritability and depression is often related to the secretion of certain hormones regulated by the circadian rhythm. As a result, it isn’t rare for problems in interpersonal relationships to happen as well. Night work is a stress factor, and workers often complain of chronic fatigue, nervousness, and anxiety.

Sometimes the workers who suffer from shift work syndrome have no real idea of ​​their condition and actual level of fatigue. Other studies show that the risk of severe work-related accidents is 1.8 times higher during night shifts. Risks during a night shift can be both health and safety related—there’s the direct risk of accidents due to insufficient light, and there’s the indirect risk of accidents related to inadequate, slow reactions and behavior.

The causes of accidents at work are complex, with the essential factors being drowsiness, sleep disturbances, and changes in alertness—all related to shift worker syndrome. In a series of night shifts, the risk of an accident increases with each subsequent shift. Put simply, the morning shift is the most favorable and the healthiest shift, whereas the 3rd shift hours represent the most harmful time to work.

How Do I Get Through Night Shifts?

Prolonged shift work—especially night shift work—significantly disrupts one’s quality of sleep. Deep and continuous sleep is the only effective way to restore the body’s physical and emotional capabilities on a daily basis. It ensures that we fall asleep in the evening and feel awake and rested in the morning, thus avoiding the development of work shift sleep disorder.

Staying awake at work mainly depends on the nature of the job. Here are some of the basic things we can do to mitigate the impact of shift work:

• Walk before work, especially when the sun is still down. Light is a natural signal that keeps the body awake and ready for work.
• Take a brief nap before work—usually 10–15 minutes are enough for the body to recover much of its energy, and it’s an excellent shift work sleep disorder treatment.
• Sleeping at work or napping, if allowed, is also a good idea.
• Be active at work when possible and try to move often, even if it isn’t typically part of your work process.
• If you feel drowsy and tired at the end of the night shift, consider taking public transportation home. Driving in this condition poses a severe risk when you suffer from night shift sleeping disorder.
• Use energizing drinks, including caffeinated liquids. It helps to use them at the beginning of your shift, but definitely not at the end, when your much-desired rest is imminent.
• Eat well. Try to avoid junk food or fast food. Instead, maintain a balanced diet with lots of fruits, vegetables, and cereals.

How Do I Recover from Night Shift Work?

How can you easily fall asleep after a night shift? Try these valuable tips for maintaining good sleep hygiene:

• Don’t eat large amounts of food within two hours before going to bed.
• Don’t drink coffee at the end of your shift.
• Wear tinted glasses on the way home to prepare for sleep.
• Get a comfortable mattress.
• Turn off your phone and any communications that may interrupt your sleep. Limit your time on social media.
• Explain to your loved ones that you have night shift sleep problems and ask them not to bother you when you get back from work.
• Darken your bedroom as much as possible and invest in an eye pillow. The latter is an excellent choice for those of you who have an unstable sleep pattern. The essential oils embedded in the silk tissue can help relieve tension.
• Avoid the sun’s rays—pull your bedroom curtains tight.
• To further prevent shift work insomnia, turn off all noise-generating technology. If it isn’t possible to reduce your environment’s sounds, consider using “white sounds” to relax you.
• Spend an hour with yourself—this can completely change your quality of life. Whether it’s by reading a book, cooking, or cycling, be a little “selfish” and take care of yourself.
• Avoid drinking alcohol before going to bed. Although it may have a sedative effect and alleviate your shift work sleep disorder symptoms, it often causes you to wake up early, and you’ll get a poor quality of sleep.
• Create your own routine—this gives a sense of security and emotional stability. When you know what comes next, the brain functions logically, and you avoid stressors.

Contact your doctor in cases where the sleep deprivation associated with shift work becomes chronic and seriously impairs your work and social life.

Reducing the Effects of Shift Work Sleep Disorder at Your Workplace

Night shift work requires good practices to maintain occupational safety and health. Those who regularly work at least three hours a night between 10 p.m. and 6 a.m. are workers and employees who have night work.

In these cases, there may be specific rules, almost like preliminary medical examinations, because night work can damage the worker’s health—and increase the risk of night shift disorders. Diseases such as ischemic heart attack, insulin-dependent diabetes, severe abnormalities in thyroid function and the adrenal glands, epilepsy, severe depressive disorders, chronic kidney and liver diseases, malignant tumors, and asthma, are considered contraindications for night shift work.

Night work should be organized in such a way that no more than 4–5 consecutive night shifts happen. When this rule is broken, the risk of developing night shift work disorder increases. As a result, the functioning of some areas of the brain become impaired, which may decrease critical thinking, memory, prudence, and motor responses.

During evening and night shifts, additional breaks should be introduced, the number and duration of which are determined by the nature of the work, especially when working overnight. For example, if the shift is 12 hours, a minimum of two regulated breaks at work, at least 30 minutes each, in the first and second half of the work shift must be introduced. This can have a better effect than any shift work disorder medicine.

However, the recommendations for most night workers are for one longer meal break combined with frequent and short breaks to avoid fatigue. For example, short breaks of 5–15 minutes every 1–2 hours to maintain efficiency and reduce incidents, especially when work is highly demanding or monotonous, can make a big difference.

What Is Prescribed for Shift Work Disorder?

To cope with sleep deprivation and insomnia induced by shift work, anyone can start with purely natural remedies, such as melatonin, caffeine, or light therapy. Just keep in mind that a natural treatment for this disorder should aim to improve and regulate sleep safely.

Optimal doses of melatonin (a sleep hormone) and standardized valerian extract can be included in your shift work disorder treatment. Melatonin plays a vital role in regulating the biological clock and maintaining your wake-up cycle. Meanwhile, valerian extract improves mood, eliminates anxiety, and improves concentration.

There are also other options involving these two treatments that help facilitate sleep and improve sleep quality. Taking these remedies doesn’t lead to next-day drowsiness—they help you feel rested and alert (extremely positive effects when working the night shift). Keep in mind, it isn’t recommended to use sleeping pills in the case of sleep deprivation due to shift work, because these can further confuse your circadian rhythm.

Does Shift Work Shorten Your Life?

Shift work can shorten your life indirectly because the resulting sleep deprivation can open the door to severe chronic diseases or increase your chances of being involved in an accident.

Good practices for reducing the risk of accidents include the following:

• Diversify your work activity
• Color-code instructions
• Engage in simple teamwork to help employees with their shift work sleep disorder
• Utilize clear shift transfer procedures
• Allow good communication between employees
• Implement a quick and easy procedure for contacting fire and emergency medical care
• Provide adequate lighting for workplaces and places of movement (some experts recommend brighter illumination, as intense light can activate changes in the biological clock and improve adaptation to night work, increase alertness, and reduce drowsiness)
• Keep things at the appropriate temperature with good ventilation—this can ease the symptoms of shift work disorder
• Limit bass and monotone sounds as they lead to drowsiness
• To increase alertness, some Japanese companies supply fragrances (lemon, mint, etc.) through the ventilation system
• Provide warm food
• Ensure adequate rest and physical activity
• Inform and train workers on how to cope with sleep, diet, stress, family, and social contacts—and help them understand their physical condition, the nature of circadian rhythm disorders, the daily need for sleep, and the effects of age

If you believe you need work shift disorder treatment, it’s critical to communicate with your employer, especially if you think the lack of sleep caused by your work schedule is a danger to your environment at work or your personal health. Let your family or roommates know your schedule and how they can help you get the sleep you need.

Conclusion

While sometimes we have to put up with less-than-perfect sleep for one reason or another, we always try to alleviate the effects of insomnia on our bodies as much as possible. Otherwise, the possibility of developing shift work sleep disorder becomes a real risk and concern. Most people may adjust to these conditions over time and feel that less sleep is enough for them. However, in the long run, lack of sleep due to shift work can have extremely adverse effects.

Changing your lifestyle is a challenging but achievable way to manage shift work sleep disorder. Like most things in the modern world, it’s an act of balance that can greatly affect our quality of life.