Safety and Health Aspects of Sleep for Shift Workers

By: Jordan Shealy, Clinical Psychology Associates of North Central Florida, Office Intern                                            CPANCF.COM

 It’s a fact of life that many of our modern conveniences and securities such as power and light, fresh produce delivered from miles away, emergency responses when things go awry in the middle of the night, production of goods, extended shopping hours, transportation, and even  the nightly news depends on workers who do not work a regular daytime work schedule. While some workers prefer longer shifts and more days off, or working non-traditional hours, for many it is part of a larger set of sacrifices, which can have an impact on biological or mental health and family relationships.

Of particular concern to employers is that shift work can impact workplace safety. Much of this is related to effects of sleep deprivation and fatigue which is a known contributor to large numbers of motor vehicle accidents and death.  The National Highway Traffic Safety Administration maintains statistics, conducts research into risk factors, and offers recommendations to employers and employees for reducing risk of drowsiness-related motor vehicle accidents. Unfortunately, sleep deprivation has been cited as a contributing factor to tragic large disasters such as the Chernobyl, Exon Valdez, and Challenger accidents.

Sleep is an integral part of living a healthy life and impacts all aspects of our day like work life, health, safety, mood, family life, and even our sex life. A study conducted by the Henry Ford Hospital Sleep Center and documented by Christopher L. Drake found that individuals with a sleep disorder are at higher risk for behavioral and health-related morbidity related to their sleep-wake symptomatology. (Drake 1453)  Shift workers are particularly vulnerable to sleep disorders, and face challenges in maintaining regular sleep schedules and getting enough sleep.  A worker’s hours of sleep on days off normally differ from when they are scheduled to work, or in some cases, work shifts may vary from week to week or month to month.  Workers who are on rotating shifts average slightly less than 5.5 hours of sleep and workers on regular graveyard shifts regularly average somewhat less than 6 hours (Bennet, 1994). According to the Ohio Sleep Medicine Institute of those who work the night shift, 40-80% has sleep complaints, and 5-20% report moderate to severe sleep problems.

            Shift work can lead to social marginalization due to the mismatch between work, family, and leisure hours.  Some individual experience more challenges with shift work.  Shift-work often interferes with the co-ordination of family timetables. Time pressures associated with shift-work are often a more substantial challenge for those with high family burdens, and can impact marital relationships and children’s education. Workers can develop symptoms of ‘jet lag’ characterized by fatigue, insomnia, disorientation, digestive problems, poor mental agility and decreased performance efficiency (Costa, 2003). Workers who are scheduled through the night display decrements in performance equal to a person suffering from chronic sleep deprivation. (D.I. Tepas et. al., year).  Impacts on safety, efficiency, and relationships may be impacted from sleep-deprivation associated decreased reaction time, interference with short-term memory, reduced vigilance, and mood changes (Bennet, 1994). 

Men working variable shifts exhibited higher rates of heavy drinking, job stress, and emotional problems relative to men working regular shift. Female variable shift workers reported higher rates of sleeping pill, tranquilizer, and alcohol use, as well as lower social network scores, more job stress, and more emotional problems. (Gordon et al, 1986).

Thee bottom line is that regular sleep is important for your health. Realizing this is not the biggest problem for workers; achieving sufficient regular sleep is. The National Sleep Foundation recommends keeping the same sleep schedule on the days you are off as the days you are scheduled to work. This way your body will know when you need to be awake and when you need to be asleep. For those who must sleep during the day, trying to make your bedroom as sound-proof and light-proof as possible are basic steps to help with sleep onset and maintenance.   Light therapy is also an option as artificial light can be used to manipulate your body clock.

There are some behaviors and activities to avoid in trying to maintain a healthy sleep schedule. Minimizing activities you do in your bed or bedroom other than sleeping, such as doing homework, watching T.V., video games, or emailing, is recommended. The more time you spend in your bedroom solely sleeping the easier it is for your body to associate your bed with sleep.  Alcohol is often a culprit in creating or worsening sleep difficulties.  While alcohol right before bed may initially help with sleep onset, it actually makes you more restless throughout the night, compromising quality of sleep.  Sometimes it can create early morning waking in what clinicians recognize as alcohol-related insomnia. 

No one has really found the perfect prescription or non-prescription sleep medicine.  Prescription and over-the-counter sleep aids all have their risks and benefits.   A program of good sleep hygiene and trying cognitive-behavioral sleep therapy with a psychologist familiar with treating sleep problems is usually advised by sleep experts before resorting to medication trials. Discusses psychotherapeutic and non-prescription approaches to treating insomnia. Employers can help their employees maintain better sleep by trying to schedule them on a shift that rotates clockwise, for example: day to evening to night to morning to day. Research has found workers are less tired and have fewer accidents when they are scheduled this way (UCLA Sleep Disorders Center).

Industry Year (http://shift-work.com/articlesnewsletters/shiftwork-articles/employee-shift-work-schedules-an-introduction/)   reported on what shift workers wanted most. Having weekends off and having longer shifts with less days of work a week were among the most popular answers in the survey. Trying to meet the mutual goals of productivity, safety, employee health, and employee satisfaction can be a challenge due to the demands of shift-work and disruption to sleep schedules. Risk reduction and better employee health can often be achieved through a combination of providing employee education to assist with sleep and safety concerns associated with drowsiness/sleep deprivation and employers adopting best practices for shift work.   Often, employers and employees can work together to establish schedules with reduced impact, and to ensure sufficient and restful sleep. Employee Assistance Programs are also often resources to assist employers and employees who may need additional assistance.

Works Cited:

Tepas, D. I., and A. B. Carvalhais. "Sleep Patterns of Shift Workers." Occupational medicine (Philadelphia, Pa.) 5.2 (1989): 199-208.

Drake, Christopher L., et al. "Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers." Sleep 27.8 (2004): 1453-1462.

Bonnet MH. Sleep deprivation. In: Kryger M, Roth T, Dement

WC, eds. Principles and practice of sleep medicine, 2nd edition.

Philadelphia: WB Saunders, 1994:50-68.

 N P Gordon, P D Cleary, C E Parker, and C A Czeisler.  The prevalence and health impact of shiftwork. American Journal of Public Health October 1986: Vol. 76, No. 10, pp. 1225-1228. doi: 10.2105/AJPH.76.10.122

Bordini, Ernest J., PhD. "Sleep Hygiene Recommendations." Sleep Hygiene Handout - Insomnia. Clinical Psychology Associates of North Central Florida, n.d. Web. 14 Apr. 2017.

Sleep Diary. East Perth, W.A.: Health Dept. of Western Australia, 1994. Web.

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4/19/17