Sophie Bostock, PhD
How to sleep well as a night shift worker
I had a lot of fun filming with OJ Borg and Police Inspector JW for the programme that went out on BBC Morning Live this week! You can catch up on iplayer 21/6/22.. 23 min in!
We were there for serious reasons.. to discuss the tricky challenges faced by shift workers. I've spent the last two years working with Oscar Kilo, the National Police Wellbeing Service, to help create an online programme and webinars to help with the demands of policing.
Jackie works a 2,2,2 shift pattern - 2 earlies, 2 lates and 2 nights, followed by 4 rest days.
Her challenges included how to get enough sleep before an early (when your body doesn't want to fall asleep, but you're getting up at 4 or 5am), how to avoid the lure of the golden arches on the way home from a night shift, and how to get to sleep during the day.
In the segment we talked about using bring light in the morning before an early to shift the body clock forward.. also dimming the lights before bed... and using breathing techniques to de-stress and calm down to help you fall back to sleep.
Why do we normally sleep at night?
Every cell in our bodies contains a little molecular clock. We’re programmed for eating, movement and concentration when it’s light during the day, and for rest and recovery when it’s dark at night. These 24 hour rhythms are called the circadian rhythms, or body clocks.
All our cells and organs have their own clocks, but we use signals called ‘Zeitgebers’ (or time givers), from the environment to keep the clocks co-ordinated, and in tune with our environment.
The most important Zeitgeber is bright light. Bright light gives a wake up call to a master clock in the brain, which spreads the message to the rest of the body to be alert. Dim light and darkness promotes the release of melatonin, the hormone which signals that it’s time for sleep. Food, physical activity and temperature can also influence the body clocks.
Why is it harder to sleep during the day?
When you first switch into to night shifts, there is a lag while your body clocks adjust. Most people can only adjust their internal clocks by a maximum of 2 to 3 hours every 24 hours, so although it will get easier after a few days/nights in the new routine, night workers still spend a lot of time at odds with their internal clock.. this is called circadian misalignment.
If the room is too light, or too hot, or we’ve been running around a lot, or just eaten dinner - it will be harder to get into a deep sleep. Night shift workers typically have at least an hour less sleep overall than day workers. From a practical perspective, sleep during the day obviously also has to contend with a whole lot more noise from traffic, family or co-habitants, deliveries, etc., as well as managing family responsibilities.
Tips to help with shift work
1. Before your first night shift
We usually cope with sleep disruption better if we’re well rested. So try and protect at least 7 hours sleep in the build up to your night shifts.
Get organised with batch cooking and healthy snacks and food in the fridge/freezer, so that you have less to do during your recovery time between shifts. Night shift workers are at greater risk of weight gain because of a disrupted metabolism, so aim for natural, unprocessed foods that are low in sugar.
Keep a visible record of your sleep and work schedule somewhere so your partner, family or housemates can easily see it - such as on your door, or the kitchen fridge - so that they don’t inadvertently wake you up.
Take a nap a few hours before your shift to reduce sleepiness when you’re at work. If you’re a natural early bird, you may be able to have a long nap for a few hours in the afternoon. If you’re a night owl, you may find it more difficult to sleep in the afternoon, but try a 20 minute nap before you get ready for work. (Napping for between 30 and 60 minutes means you are more likely to be woken from deep sleep. It can take up to an hour to shake off the ‘sleep inertia’ and feel fully alert.)
2. Staying alert while you’re at work
Get as much bright light as you can before and during the early part of a night shift. This might mean having with a light box on your desk, or near you if the overhead lighting is not very strong.
Taking regular breaks will help you to concentrate. Moving your body will also help you feel more alert.
Try and consume your main meals during the day if you can, and avoid high sugar foods in the early hours of the morning, when you are more likely to store excess energy as fat.
Drink plenty of water. Dehydration can make you feel fatigued, and can also interfere with sleep later.
Caffeinated drinks like tea and coffee can be helpful stimulants to promote attention in the first half of a shift, but taken within 6 hours of bedtime could result in a longer time to fall asleep, reduced deep sleep and fewer sleep hours.
A mid shift power nap is more effective than coffee for improving alertness. Even if you only have 10 minutes to rest your eyes, it could still help boost concentration and mood. Getting physically active will also make you feel more alert.
Towards the end of the shift, try and make time for a debrief - either written or verbal, to download what you’ve learned during the shift and what needs to be done on the following shift. This will hopefully help you to leave work at work.. and prevent the same thoughts whizzing round in your head when you want to sleep.
3. Getting home safely after your night shift
Do you need to drive? You are at higher risk of falling asleep at the wheel if you drive after a night shift. If public transport, carpooling or cabs aren’t practical, vary your route home so that you’re less likely to be driving on ‘autopilot’. If you’re very tired, take a short nap before setting off.
Daylight is a signal to the body to stay awake. If you’re not driving, wearing sunglasses or blue light blocking glasses on the way home can encourage the production of melatonin, prepare the body for sleep and avoid shifting the body clock the wrong way.
4. Protecting your recovery after a night shift
Most people find it easiest to sleep in the morning after the night shift, before the strongest circadian drive for wake kicks in at around 10-12. They might then wake in the early afternoon, and have another nap before the second night shift. Another option is to stay awake in the morning and have a longer afternoon sleep. The important thing is to try and reserve 7 hours for sleep - even if you’re not able to sleep for all of it, you will still benefit from the opportunity to rest.
You may feel tempted to catch up on the news on your phone.. Try and resist the temptation! When you’re tired, it’s much easier to while away more time than you intended to before you switch off. Aim for a digital detox until after your sleep.
Follow the same routine to prepare for bed on day or night shifts. This will encourage pattern recognition and get the body ready for sleep – a light snack, a warm bath or shower, brushing your teeth, soothing music, relaxation exercises or meditation could be part of a wind down routine. The more often you practice a relaxation technique, the easier it will be to quickly and deeply relax.
5. Prepare your environment
Avoid having a clock or alarm clock where you can see it during your rest time. Looking at the time may make you feel anxious.
Use blackout curtains or drapes to make your bedroom as dark as possible. A comfortable eye mask can also help.
If you sleep in a noisy environment, you can soundproof the bedroom with double-glazing, carpets, heavy curtains and wall insulation. Ear plugs can also help to preserve your peace and quiet. Some people find white noise from a fan or white noise machine can help to drown out disturbing sounds.
6. Recovering between shifts
Try and find time for exercise before your next shift starts. If you can stay physically fit, your body will be better able to cope with changes to the body clock, and you’ll feel less fatigued overall.
When you’re trying to return to a natural day shift pattern, remember that bright light is a powerful signal to your body clock. Light alarm clocks and light boxes that mimic the sun’s colour spectrum and intensity can help to reset wake cycles.
You can download these sleep tips for night shift workers below.
For more detailed advice about how to cope with specific shift patterns and why, please send me an email or you can find me at @drophiebostock on instagram.