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This topic is for people who
have trouble sleeping because they work a night shift or rotating shifts. If
you have trouble sleeping because of other reasons, see the topic
Shift work sleep
disorder is trouble sleeping because you work nights or rotating shifts. You
also may have this problem if you have trouble staying awake or alert when you
are supposed to work your shift. You may not be able to sleep during the day,
and you may not feel rested with the sleep you do get.
sleep disorder involves a problem with your body's 24-hour internal clock, or
circadian rhythm. Light and dark help your body know
when to be active and when to rest. Light is a cue to be awake, while dark
tells your body to sleep. When you work at night and sleep during the day, your
body's internal clock needs to reset to let you sleep during the day. Sometimes
that's hard to do.
This sleep disorder usually is a problem for
people who work all night. But people who work an early morning shift—for
example, starting at 4 a.m.—also may have sleep problems. Rotating shift work
also can be hard. In these shifts, people work the day shift on some days and
the night shift on others.
Many people who work nights get plenty
of restful sleep during the day. Some people are "night owls," and they adjust
well to working at night. So getting enough good sleep is not a problem for
everyone who works nights.
Many people have trouble sleeping once
in a while, especially if they are getting used to a new work shift. But be
sure to talk to your doctor if you have trouble sleeping or you have trouble
staying alert when you are supposed to be awake. You could have a sleep
problem. Or you may have another medical problem that causes
doctor will use a
sleep diary(What is a PDF document?) and possibly
sleep studies to see if you have sleep problems from
shift work. He or she will ask questions about your work hours, when you sleep,
how much you sleep, and how you feel when you wake up. Your doctor also will
ask if you feel very tired or fall asleep while you're at work.
With a sleep diary, you keep track of when you sleep, how much you sleep,
and how you feel when you wake up. You write down this information for a week
or two. Your doctor will look at it when you're done.
several sleep studies you might have so your doctor can find out why you're not
sleeping well. These usually are done in a sleep lab.
doctor thinks that you have shift work sleep disorder, you might have a test
called actigraphy. For this test, you wear a device on your wrist that looks
like a watch. The device measures your movement during the day and at night. It
helps your doctor learn when you are awake and when you are asleep.
Shift work can increase
stress, and that may make you more likely to get sick.
Lack of sleep from shift work can increase the chance of car accidents and
on-the-job accidents. It also can lead to trouble concentrating at work and
poor job performance.
Experts also have found that shift workers
have a higher chance of getting some health problems, such as colds and the flu, than people who work days.1
Experts don't know exactly why this sleep disorder raises
the risk of health problems. But they suspect that shift work may cause
problems because, if you work at night, your body makes less
melatonin than it needs.
Melatonin is a hormone that helps control sleeping and waking cycles. It also
plays a role in keeping you healthy by making your
immune system strong and preventing the growth of
Light and dark affect how the body makes melatonin. Most
melatonin is made at night. During the day, light tells your body to make less
melatonin. If you work at night in artificial light, your body may be making
less melatonin than it needs.
Sometimes sleep problems can be fixed only by switching to a regular work
schedule—working in the day and sleeping at night.
But many people
are able to work the night shift by making a few changes. You can help yourself
get good sleep by keeping your sleeping environment dark and quiet and by
taking good care of yourself overall. In some cases, prescription medicine or
over-the-counter supplements may help.
Ask your doctor if you should try a dietary supplement or medicine.
Doctors usually advise people to use a supplement or medicine only for a short
Your doctor also may have you try treatment with light
(phototherapy) before a work shift to help you stay alert.
find that the caffeine in coffee or soda drinks helps you stay alert. But use
caffeine only early in your shift, or it could keep you awake when you get home
in the morning.
Van Mark A, et al. (2006). Shift work and pathological conditions. Journal of Occupational Medicine and Toxicology, 1: 25. Published online Dec. 11, 2006 (doi: 10.1186/1745-6673-1-25).
Czeisler CA, et al. (2005). Modafinil for excessive sleepiness associated with shift-work sleep disorder. New England Journal of Medicine, 353(5): 476–486.
December 1, 2011
Anne C. Poinier, MD - Internal Medicine & Lisa S. Weinstock, MD - Psychiatry
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