Colin Snow
Shift sleeping can refer to a few different concepts. In the context of employment, it can refer to sleep-in shifts, where employees are required to sleep at their workplace to be able to quickly respond if they're needed during the night, often in care homes or healthcare settings. Shift sleeping can also refer to shift work sleep disorder (SWSD), a circadian rhythm sleep disorder characterised by insomnia, excessive sleepiness, or both, affecting people whose work hours overlap with the typical sleep period. This can lead to various health issues and a diminished quality of life. Finally, shift sleeping can also refer to reality shifting, a concept that gained popularity during the 2020 pandemic, where people attempt to shift their consciousness to another reality, either through lucid dreaming or in their waking life.
| Characteristics | Values |
|---|---|
| Definition | Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia, excessive sleepiness, or both affecting people whose work hours overlap with the typical sleep period. |
| Prevalence | About 20% of the full-time workforce in the United States participates in some form of shift work. Not everyone who does shift work experiences SWSD. SWSD is estimated to affect 10-40% of shift workers. |
| Symptoms | Insomnia, hypersomnia, difficulty concentrating, lack of energy, impaired decision-making, slowed reaction times, and poor work performance. |
| Health Risks | Increased risk of accidents, depression, anxiety, alcohol use disorder, low fertility, pregnancy issues, obesity, diabetes, insulin resistance, elevated body fat, and dyslipidemias. |
| Treatment | Melatonin supplements, sleeping pills, wake-promoting agents (e.g., Modafinil, Armodafinil), bright light therapy, dark therapy, caffeine, and napping. |
| Sleep-in Shift | A sleep-in shift is when an employee sleeps at their workplace, typically in healthcare or care homes, to respond quickly during the night. |
| Compensation | The Supreme Court ruled in 2021 that staff working sleep-in shifts are not entitled to the National Minimum Wage while asleep but must be paid at this rate or higher when awake and working. |
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Sleep-in shifts
Shift working is a work schedule that falls outside the hours of 7 am to 6 pm. It includes fixed, rotating, or irregular work timings. Nearly one in five employees works some form of non-traditional shift, which is associated with negative health consequences, including cognitive complaints, cancer, and a diminished quality of life. Shift workers also sleep one to four hours less than non-shift workers, and a substantial percentage of them develop shift work disorder, a circadian rhythm sleep disorder. This disorder is characterised by excessive sleepiness, insomnia, or both, and can lead to impaired work performance and increased accidents.
There has been debate in the UK about whether staff on sleep-in shifts should be paid the National Minimum Wage during the hours they are sleeping on-site, as they are neither at home nor able to use their time freely. However, the Supreme Court ruled in 2021 that staff working sleep-in shifts in a social care setting are not entitled to the National Minimum Wage while asleep, but must be paid at this rate or higher for the hours they are awake and working.
To manage the challenges of shift work and sleep-in shifts, employees can take several steps. These include creating a bedroom environment conducive to rest, using eye masks, earplugs, or white noise machines, and avoiding caffeine close to bedtime. Additionally, melatonin supplements, wake-promoting agents, and bright light therapy can help improve alertness and sleep quality. However, it is important to consult a healthcare provider before taking any supplements or medications.
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Shift Work Sleep Disorder (SWSD)
The symptoms of SWSD include excessive sleepiness, lack of refreshing sleep, and drowsiness. These symptoms can affect both work and leisure time. The non-traditional work schedule can disrupt a person's circadian rhythm, or "biological clock," which regulates wakefulness and sleepiness at relatively set times throughout the 24-hour day. The Cleveland Clinic estimates that those who have regularly shifting schedules are most likely to be affected by SWSD. However, not everyone who works a non-traditional shift experiences SWSD, as many people who work these shifts have circadian rhythms that make them natural "night owls."
The specific symptoms of insomnia often vary depending on the shift worked. For example, people with SWSD who work between 4 a.m. and 7 a.m. often have trouble falling asleep, while those who work evening or night shifts might have issues staying asleep. Hypersomnia, or excessive sleepiness at unwanted times, can also occur when a person with SWSD is at work during the night or early morning hours. This can be dangerous and impair work performance.
There are several treatments and lifestyle changes that can help relieve the symptoms of SWSD. Doctors may prescribe sleeping pills or wake-promoting agents to help with sleep issues, but these can lead to dependency and have unpleasant side effects. Melatonin supplements may also help people adapt better to shift work schedules, but they should be used under the guidance of a healthcare provider. In addition to these treatments, there are many lifestyle changes that can help improve sleep quality, such as maintaining a regular sleep schedule, taking naps when possible, limiting caffeine intake before bedtime, and using heavy shades to create a dark environment for sleeping.
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Health risks
Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder that affects people who work outside the typical 9 a.m. to 5 p.m. workday. It is characterised by insomnia, excessive sleepiness, or both, and can have several negative health consequences.
Shift work sleep disorder can have a range of adverse health effects, including:
- Increased risk of accidents and errors: Sleep deprivation and decreased alertness associated with SWSD can lead to accidents and errors, especially in professions such as driving, flying, or operating heavy machinery.
- Metabolic issues: Shift work has been linked to metabolic syndrome, which includes conditions such as high cholesterol, insulin resistance, elevated body fat levels, and dyslipidemias. These factors increase the risk of heart disease, diabetes, and stroke.
- Cancer: Disrupting the circadian rhythm through shift work has been associated with an increased risk of certain types of cancer, including colorectal cancer. The World Health Organization recognizes shift work as a probable carcinogen.
- Cognitive impairment: Sleep deprivation can lead to decreased cognitive performance, including difficulty concentrating, slowed reaction times, and impaired decision-making abilities.
- Mental health issues: SWSD has been linked to an increased risk of mental disorders, including depression, anxiety, and alcohol use disorder.
- Reproductive issues: Shift work has been associated with low fertility, issues during pregnancy, and reproductive problems in both men and women.
- Gastrointestinal issues: SWSD can contribute to gastrointestinal problems, such as decreased immune function and inflammatory markers.
- Cardiovascular risks: In addition to the increased risk of heart disease, shift work has been linked to a higher risk of heart attacks and wrist and hip fractures, especially in long-term night shift workers.
- Immune system: Partial and total sleep deprivation, common in shift workers, has been linked to a decrease in anti-inflammatory markers, such as IL-10, which play a role in tumour suppression.
While these health risks are concerning, it's important to note that not everyone who works shifts will experience SWSD. Additionally, there are strategies to mitigate the impact of shift work on sleep, such as napping before or during night shifts, caffeine consumption, and melatonin supplements. However, it is recommended to consult a healthcare provider before taking any supplements or making significant changes to your sleep routine.
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Treatments
Lifestyle changes are another important component of treating SWSD. This includes maintaining a healthy diet rich in fruits and vegetables, limiting caffeine intake, and keeping a regular sleep schedule, including on days off. If possible, take 48 hours off after a series of shifts and limit your naps to 20 minutes to avoid grogginess. It is also recommended to use blackout blinds or heavy curtains to block sunlight when sleeping during the day and wear sunglasses when leaving work to minimize sun exposure.
Medication can also be used to treat SWSD. Melatonin supplements are considered safe and can improve sleep quality. Additionally, wake-promoting agents such as Modafinil (Provigil) are approved by the FDA for excessive sleepiness associated with SWSD. Hypnotics and sedatives, such as zolpidem (Ambien) and eszopiclone (Lunesta), can be prescribed by a doctor but should be used sparingly and for short periods.
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Sleep loss
Insomnia is typically associated with SWSD, with those working between 4 a.m. and 7 a.m. struggling to fall asleep, and those working in the evening struggling to stay asleep. Hypersomnia, or excessive sleepiness at unwanted times, can also occur during night or early morning shifts. Sleep issues associated with SWSD usually last as long as the person works non-traditional hours, and tend to go away once they return to a conventional sleep schedule. However, sleep issues can persist even after the shift work schedule ends.
Shift work sleep disorder is a common issue, affecting 10-40% of people working non-traditional shifts. Overall, about 20% of the full-time US workforce works some form of non-traditional shift. Sleep loss is also common, with an estimated 50-70 million US adults meeting the medical criteria for sleep deprivation at any given time.
There are some strategies that can help mitigate sleep loss. For shift workers, it is recommended to get at least 7-9 hours of sleep per day. Napping before or during night shifts can improve alertness, as can consuming moderate amounts of caffeine. However, it is important to stop consuming caffeine later in the shift to avoid disrupting sleep. Bright light therapy and melatonin supplements may also help with circadian adaptation.
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Frequently asked questions
Shift sleeping is a term that refers to a sleep pattern that involves working and sleeping at unconventional times. This is usually due to working night shifts or early morning shifts.
SWSD is a circadian rhythm sleep disorder that affects people who work hours that overlap with typical sleep periods. The symptoms of SWSD include insomnia, excessive sleepiness, or both. Insomnia is the difficulty of falling and/or staying asleep. Hypersomnia, or excessive sleepiness, can occur when an individual with SWSD has to be productive, awake, and alert.
There are several treatments for SWSD. Melatonin supplements, which are available as oral supplements in the US and Canada, can help individuals adapt better to shift work schedules. The American Academy of Sleep Medicine recommends 3mg of melatonin before bed for shift workers. Additionally, wake-promoting agents are medications that can improve alertness and the ability to maintain wakefulness.
