Category Archives: Night Shift

Anxiety and Sleep

Anxiety is more common than ever – especially with everything going on in our lives and around the world.  Anxious, racing thoughts not only interfere with our comfort and focus during the day, they often also keep us from getting the kind of quality sleep that we desperately need.

The number of antianxiety prescriptions dispensed have increased by over 35% during this pandemic including those for Xanax, Klonopin, and Ativan. Medications for sleep disorders increased by 15%.  Though these drugs act fast and do work, they are usually used short-term and at the lowest effective dose closely monitored by a health care provider.

Xanax, Klonopin, Ativan, and Valium are all benzodiazepines (a class of sedating drugs), which can cause a host of issues including memory problems, drowsiness, confusion, and addiction.  They can be very difficult to discontinue and should not be stopped abruptly as severe withdrawal syndrome can develop that can include anxiety, irritability, and seizures in some cases. When combined with alcohol or other sedating drugs, overdose can occur.

Drugs such as Ambien and Lunesta are used by many, but they also have many downsides. They can limit REM sleep causing a hangover effect, brain fog, and memory problems.  Most people have also heard the stories of episodes of sleep walking, sleep driving, and other odd behaviors that can occur.  This can happen at any time during use. People have no recollection that they did these things the following day.  Both benzodiazepines and the above sleep drugs carry the FDA’s black box warning for serious side effects.

Is there a better way?  After all, sleep is important for our body, mind, and spirit!

First and foremost, don’t wait.  If you are having sleep problems, take action now!

Here are some tips to improve sleep quality.

  • Because sleep is so important, MAKE IT A PRIORITY.
  • Address any biological issues that affect your sleep such as chronic pain, sleep apnea, acid reflux, untreated thyroid issues, heart conditions, etc.
  • Treat mental health conditions and substance use disorders that you’re aware of.
  • Go to sleep when you are truly tired.
  • Go to bed and wake up on a regular schedule.
  • Develop good sleep hygiene.
  • Create a restful sleeping environment
  • Your bedroom should be a peaceful place for rest.
  • Control comfortable temperature, lighting and noise
  • If you have a pet that disturbs you, consider having him/her sleep elsewhere.
  • Make sure your bed is comfortable – not too soft or too hard, not too small.
  • Exercise regularly, but not too late in the day as it will keep you alert.
  • Eat light at night.  Too much food or drink at night can keep you up.
  • Avoid caffeine, alcohol, nicotine, and other chemicals that interfere with sleep.
  • If you’re going to nap, do it early in the day.
  • Try to relax before bed.
  • Warm bath or shower, quiet music, a good book (not exciting), meditation, gentle yoga, etc. to relax mind/body/spirit.
  • Are you a worrier?  Write down every concern that comes to mind before going to bed.  If you wake up in the middle of the night ruminating on worries, write them down at that time, too!
  • Try sound therapy (soothing sounds to lull you to sleep)
  • Keep technology out of your bedroom.
  • Keep your clock out of your sight.
  • If you simply cannot sleep, get out of bed and occupy yourself with something relaxing.
  • Cognitive behavioral therapy (CBT) uses techniques that specifically address the root cause of insomnia.
  • Consider natural supplements such as melatonin, magnesium, l-theanine, GABA, and 5-HTP to help calm the brain and promote healthy sleep.  Talk to your healthcare provider about them.  Be aware, however, that some physicians may not be familiar with these supplements and their effect on sleep. 

Seek professional help if these tips are not working for you.  Sleep disorders, anxiety, panic attacks, depression, and other mental health issues are not things to put off. Your mental well-being is extremely important, especially with all the stresses going on right now. Waiting to get treatment until the pandemic is over could make you feel worse over time.

Tips for Shift Workers

Work schedules that fall anywhere outside the hours of 7 am to 6 pm are considered shift work. These schedules may consist of fixed hours, rotating or split shifts, or irregular work times. According to the Bureau of Labor Statistics, roughly 16% of full-time salary and wage workers in the U.S. worked non-daytime shifts in 2017 and 2018. Recently, many employees have also been forced to take on shift work in recent months due to the COVID-19 pandemic.

Alarm clock in the middle of the night insomnia or dreaming

Common occupations that require shift work include:

  • Food preparers and servers
  • Hairdressers, fitness trainers, and other personal care professionals
  • Sales and retail staff
  • Police officers, firefighters, and other first responders
  • Doctors, nurses, and other medical staff
  • Transportation, warehouse, and manufacturing plant workers

Shift work can be demanding when it comes to getting a good night’s sleep, especially for those who work night, early morning, or rotating shifts. Over time these employees may develop shift work disorder, a condition characterized by insomnia symptoms when they attempt to sleep and excessive tiredness while they are at work. Shift work disorder not only causes cognitive impairments and physical complications but also affects occupational performance and makes workers more prone to errors and accidents.

Getting a good night’s rest and feeling alert upon waking is essential for any shift worker, regardless of their specific profession. For many, adopting a consistent sleep schedule and creating a bedroom environment conducive to rest can have a huge impact.

How To Set a Night Work Sleep Schedule

Sleep consistency is key for many employees working night shift schedules. If you wake up at 5 pm for your night shift and normally go to sleep at 8 am after getting home from work, then you also should maintain this sleep-wake schedule on your days off.

Obviously, this can be difficult to accomplish. Make sure significant others, children, roommates, and anyone else sharing your roof understands the importance of your designated sleep time. They should not wake you up unless there’s a true emergency.

Light and noise exposure may be other issues for sleeping during the day. Try drawing the shades or sleeping with an eye mask if your bedroom tends to be bright during the day. Earplugs and white noise machines can be effective at blocking outside sounds. Unless you are on call, consider turning your phone off while you sleep.

Rather than immediately going to bed, some shift workers prefer to stay up for a few hours after arriving home as one might do after a day at work on a traditional 9-5 schedule. This way, they can wake up closer to the time when they start their next night shift. For others, a split-nap schedule is more effective. This entails napping for a few hours after getting home in the morning and then sleeping for longer in the hours leading up to the next shift’s start time.

Before going to bed, consider a hot shower or bath, meditation, or another relaxing activity. Consuming alcohol before bed can lead to sleep disruptions. Although alcohol has sedative properties that help you fall asleep more easily, you may experience sleep disturbances or fragmented sleep as your body breaks down the alcohol. Some shift workers take melatonin supplements to fall asleep during the day, but you should consult with your doctor or another licensed physician before taking melatonin because it can have an impact on your sleep-wake rhythms.

Finding the right system for you may require some trial and error. The key is getting enough sleep every 24 hours. The National Sleep Foundation recommends seven to nine hours of daily sleep for most adults between the ages of 18 and 64, and seven to eight hours of sleep for most adults 65 and older. Some adults can get by on slightly less or may need slightly more sleep, but we don’t recommend fewer than five to six hours or more than 10 to 11 hours of sleep per day.

Tips for Staying Awake During Shift Work

While you are at work during an irregular shift, strategies to stay refreshed and alert may include:

  • Caffeine in moderation: Caffeine can provide an energy boost for shift workers, but it should be consumed carefully and in moderation. A cup of coffee or caffeinated soda is recommended at the beginning of your shift. The caffeine will usually take effect within 15-20 minutes. Moderate amounts of caffeine every one to two hours will be more effective than heavy amounts. You should avoid consuming caffeine within three to four hours of the time you plan to go to sleep.
  • Get the blood moving: If you have enough time during a scheduled break, consider a brief workout or a jog around your workplace. Even a small amount of exercise can provide an energy boost.
  • Take a nap: You can also snooze on your break if you’d rather sleep than exercise. A nap of 10-20 minutes is considered ideal because you won’t enter deep sleep and feel excessively groggy when it’s time to wake up. For some shift workers, the “coffee nap” can be effective. This strategy involves drinking a cup of coffee and then taking a nap that lasts 15-20 minutes. Your wake-up time will coincide with the caffeine in the coffee taking effect.
  • Exercise caution: People who experience sleep problems due to shift work are at higher risk of on-the-job errors and accidents. The same is true of employees who are new to shift work, or those who are working shifts that are longer than usual.
  • Consider a post-work snooze: Drowsy driving accidents are another hazard associated with shift work. According to the most recent statistics, midnight to 6 am is one of the most dangerous periods of the day for drowsy driving. If your workplace does not have a room where you can nap undisturbed, you can try dozing for a few minutes in your car before leaving the property. If you begin to feel drowsy behind the wheel, pull over at the next available opportunity where you can park safely and nap for a few minutes.

Tips for Employees With Rotating Shifts

Fixed shift work creates plenty of sleep challenges for employees, but rotating shifts that involve different start and times for shifts during a given week or month can exacerbate these issues. Rotating shifts vary by workplace, but some of the most common rotating schedules for employees include the following:

  • Dupont: This schedule operates on a four-week cycle and consists of four different teams covering 12-hour shifts. A given team will work blocks of both day and night shifts lasting three to four days, interspersed with one to three consecutive days off. Each team also receives a seven-day block of days off for every four-week period.
  • Panama: Also known as 2-2-3 or the Pitman, the Panama schedule consists of four teams. Two teams trade day shifts throughout the week in two- or three-day blocks, while the other two teams trade off night shifts in two- or three-day blocks. Each team will receive seven non-consecutive days off every two weeks.
  • Southern Swing: This schedule requires employees to work eight hours per shift for seven consecutive days. After each seven-day block of work, employees receive two to three days off. Upon returning to work, the employee’s team will adopt different hours from the previous seven-hour block. Most Southern Swing schedules rotate teams between day, swing, and night shifts.

Shift workers with rotating schedules should prepare for shift changes by adjusting their sleep times. Let’s say you are currently working a day shift and planning to rotate to a night shift the following week. You should gradually delay your bedtime by one or two hours each night a few days prior to starting the night shift if possible. This will help you get enough rest and avoid sudden changes.

Some rotating shifts are better for sleep than others. For example, rotating from day to afternoon to night shifts is a more natural progression that is easier on your body compared to rotating in the opposite direction or in random patterns. Rotating shifts every two to three days may also be better for workers than rotating their shifts every five to seven days, and too many consecutive night shifts can be problematic.

If you work a rotating schedule and the routine is wearing you down, consider having a word with your supervisor. They may be able to adjust your shifts or rotations and provide a schedule that is better for your sleep schedule.

Source:  Sleep Foundation