Shift work and sleep: how to sleep after night shifts

Why is shift work so hard on sleep?

Your body clock is set mainly by light, and it doesn’t shift quickly. On night shifts you’re asked to be alert when your clock is pushing you towards deep sleep, and to sleep in the day when it’s promoting wakefulness. Daytime sleep is also interrupted by light, noise and family life. Most night workers never fully adjust, especially on rotating rotas, and early morning shifts cut sleep short too.

What are the health risks?

A 2016 BMJ review drew on 38 meta-analyses and 24 systematic reviews. It found that the main effect of shift work on sleep is acute sleep loss around night and early shifts, and that shift work is linked to:

• accidents and injuries,
• weight gain and type 2 diabetes,
• coronary heart disease,
• smaller increases in the risk of stroke and some cancers.

The original studies were mixed, and the increased risks are modest. The authors noted that these links look very similar to those for insufficient sleep, which may be part of the reason.

How can you sleep better around shifts?

Before a night shift

• Sleep in as late as you can on the morning before your first night.
• Take a nap in the afternoon or early evening.

During the shift

• Use bright light at work early in the shift if you can.
• Have caffeine early in the shift rather than in the last few hours, so it doesn’t stop you sleeping when you get home.
• Eat light meals rather than a large meal in the middle of the night.

After the shift

• Wear sunglasses on the way home to reduce morning light.
• Go to bed soon after getting home, in a dark, cool, quiet room. Blackout blinds, an eye mask and earplugs or white noise help.
• Avoid using alcohol to get to sleep: it makes daytime sleep lighter and more broken.

Between blocks of shifts

• Keep a regular “anchor” time when you’re always asleep, if your rota allows.
• Get outdoor light in the day on your days off to help your body clock reset.

When to get help

See a GP if you have persistent insomnia or excessive sleepiness that you can’t manage, if you have fallen asleep at the wheel, or if you might have sleep apnoea, which makes shift work much harder. Sleeping pills or alertness medicines are occasionally used under specialist advice, but they are not a long-term fix.