Navigating Shift Work and Sleep

Practical Tips for Improving Sleep Hygiene and Workplace Safety

By Edward Gilberti, ATC, CSCS, USAW2
Injury Prevention Specialist, Fit For Work

Humorist W. C. Fields said, “The best cure for insomnia is to get a lot of sleep,” but obtaining proper rest is no laughing matter for workers and supervisors navigating nontraditional schedules. As many as 40% of shift workers report sleep disorders, ranging from insomnia – difficulty falling/staying asleep – to hypersomnia – excessive sleepiness at unwanted times, including on the job.

In Part 1 of our Shift Work series, we discussed the necessities, benefits, and challenges of working outside the traditional nine-to-five day. Next, let’s look specifically at sleep issues, and how your team can get proper rest to boost alertness and ensure safety as well as performance at work.

Effects of Shift Work on Circadian Rhythms

Shift work disorder, characterized by sleeplessness or excessive sleepiness, can affect people who work overnight, early morning, or rotate their shifts. In fact, most workers on permanent night shifts do not fully adapt to the imposed sleep-wake schedule. Why? Because shift work disrupts the body’s circadian rhythm.

Circadian rhythms – from the Latin circa (around) and diem (day) – are physical, mental, and behavioral changes that help our brains regulate sleeping, waking, and functioning.

Stimulation comes from the eyes seeing light vs. dark, plus eating, exercise, and the environment. Disrupting the natural 24-hour circadian rhythm can cause problems with sleep at home, attentiveness at work, and overall physical and mental health.

Risks and Costs

Research reveals an 18-30% increased risk of occupational health and safety incidents during second and third shifts, with some statistics pointing toward a doubling in accidents or incidents. Employers and employees alike may face losses due to workers’ compensation issues associated with shift work.

Imagine warehouse shift workers operating industrial machines with minimal safety features. The pace is fast, and sleepy employees may not be as attentive, resulting in slower responses and an increased chance for injury.

Accidents can occur, often linked to decreased alertness, as seen in notable industrial disasters like the 2005 BP oil refinery explosion, the space shuttle Challenger explosion, and the nuclear incident at Chernobyl. In addition to personal employee impacts, lost productivity due to fatigue and health conditions costs employers an estimated $136.4 billion annually.

Health Consequences

Along with grogginess, employees experiencing shift work sleep disorder (SWSD) may experience difficulty concentrating, depression, irritability, anxiety, forgetfulness, and fuzzy thinking. Sleep issues can even affect judgment, so a person doesn’t notice its effects.

Further, sleep deficiency is linked to many chronic health problems. According to John Hopkins Medicine, sleep deprivation can affect health in far-reaching ways:

• 50% higher risk for obesity
• 33% increase in dementia risk
• 3x more likelihood of catching colds
• Increased risk of high blood pressure
• 36% increased risk for colorectal cancer
• Nearly 3x increased risk for type 2 diabetes
• 48% increased risk of developing heart disease

Once workers are aware of the issues, treatment should focus on lifestyle changes – before individuals experience significant adverse health consequences, diminished quality of life, and issues on the job.

Understanding Sleep Cycles

Employees may find it helpful to understand how sleep cycles work. Sleep is a fairly complex process: An individual typically experiences four to six sleep cycles per “night,” each lasting about 90 minutes, with each cycle containing several stages.

Transitioning through these stages allows the brain to recuperate from the day’s activities and supports proper brain and bodily functions:

• N1 is light sleep – beginning to relax, the brain slowing, periods of brief movement, falling asleep
• N2 is continued light sleep – body temperature, breathing, and heart rate decreasing and muscles relaxing as the brain slows with only brief bursts of activity
• N3 is deep sleep – body temperature and blood pressure dipping to help release metabolic waste from the brain, as slow delta brain waves work to repair tissues and consolidate memory
• Rapid eye movement (REM) sleep includes vivid dreaming – supporting essential cognitive functions such as memory, learning, and creativity – and only occurs after at least 90 minutes of sleep

Seven Steps for Quality Sleep

While proper sleep hygiene practices encourage healthy transitions through sleep stages, two factors determine quality sleep: How many hours did you sleep? Did your sleep feel restorative?

Most people require at least seven hours of sleep to feel rested and energized. Here are seven tips to help ensure quality sleep:

1. Plan and follow a consistent sleep schedule, with few fluctuations, even on weekends. This plan will help train the body and set circadian rhythms.
2. Avoid stimulating light and keep the room dark. Use blackout curtains or an eye mask and turn off electronics at least one hour before bed to reduce blue light exposure. Blue light, emitted by screens and LEDs, is a high-energy light that can disrupt sleep patterns. Many devices have built-in blue light filters, and blue light-blocking glasses can also be effective.
3. Create a quiet sleep environment by informing others of your sleep schedule and setting electronics to “do not disturb.” White noise, earplugs, or cotton balls can block outside sounds, and sleep music or meditation apps can help promote relaxation.
4. Limit eating and drinking close to bedtime. Avoid caffeine for six hours, alcohol for four, and steer clear of sweets, spicy, or fatty foods before lying down.
5. Wear loose clothing and socks for comfort. Invest in quality pillows and bedding, replace pillows/mattresses every five to seven years, and keep the room temperature between 65-68°F for optimal sleep.
6. Track sleep with a wrist-based activity tracker or smartwatch, which estimates sleep stages by tracking movement and heart rate patterns. Keep a log of sleep hours and quality to help make scheduling decisions.
7. Consult a healthcare provider to address sleep challenges and check for underlying issues like sleep apnea, blood sugar, or hormone imbalances. Ask about safe sleep aids, their side effects, and appropriate use.

Transitioning into the Workday

The activities you engage in upon waking help set the tone for the day, no matter what shift you are working. Avoid skipping breakfast or relying on fast food. Start by hydrating with water, then fuel up with a balanced meal, including protein, whole grains, and fruit. Plan regular exercise to support overall health and sleep, aiming for 20 minutes of cardio daily and two light strength sessions weekly.

If possible, get outdoors for sunlight, or consider a light therapy box and vitamin D supplement if daylight exposure is limited. Since everyone is unique, finding the health habits that work best for you is key to success.

Conclusion

Quality sleep is crucial for shift workers and their supervisors, directly impacting alertness, safety, and performance. Employers and employees should engage in discussions about sleep hygiene and the importance of proper rest between shifts. Consider hosting an on-site Lunch-and-Learn or organizing a “sleep challenge” to raise awareness and encourage healthy sleep habits, benefiting both individual well-being and workplace performance.

If you are ready to take the next step—contact us to learn how we can help you support your shift workers and enhance safety and performance across your organization.

Ed Gilberti is a certified athletic trainer with over 20 years of experience in both athletic and industrial settings. His diverse background includes working in high school and collegiate athletics, as well as with grocery distribution, manufacturing, and water and electrical utilities over the past five years. Ed has a strong passion for strength and conditioning, wellness, and injury prevention. Outside of work, he enjoys spending time with his family, including his wife and young son.

References

1. Ricci, J.A., Chee, E., Lorandeau, A.L., & Berger, J. (2007). Fatigue in the U.S. workforce: Prevalence and implications for lost productive work time. Occupational and Environmental Medicine, 49(1), 1-10.
2. Cleveland Clinic. (n.d.). Shift work sleep disorder. Retrieved from https://my.clevelandclinic.org/health/diseases/12146-shift-work-sleep-disorder
3. PubMed. (2019). Shift work and its impact on health. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6859247/#:~:text=A%20subset%20of%20shift%20workers,a%20result%20of%20shift%20work
4. Harvard Health Blog. (2023). Shift work can harm sleep and health: What helps. Retrieved from https://www.health.harvard.edu/blog/shift-work-can-harm-sleep-and-health-what-helps-202302282896
5. OSHA. (n.d.). Worker fatigue and hazards. Retrieved from https://www.osha.gov/worker-fatigue/hazards
6. Sleep Foundation. (n.d.). Stages of sleep. Retrieved from https://www.sleepfoundation.org/stages-of-sleep#:~:text=Progressing%20smoothly%20multiple%20times%20through%20the%20sleep,mind%20and%20body%20to%20wake%20up%20refreshed
7. USA.edu. (n.d.). How to work night shifts and stay healthy. Retrieved from https://www.usa.edu/blog/how-to-work-night-shift-and-stay-healthy/