How to take care of yourself when working the night shift

UNITED STATES – When Ms Samantha Shaw took a new job as a research technician for a sleep-related study at Brigham and Women’s Hospital Massachusetts in 2021, she was excited to work on a cause that felt personal: She had trouble falling and staying asleep since high school.

The researchers were looking into whether a medication could help with excessive daytime sleepiness in people who worked night shifts – often in transportation or construction – that started between 3 and 7am.

Ms Shaw, 27, found the work enjoyable. She also became a shift worker herself – often clocking in between 2 and 4am, heading home in the early afternoon and then slinking into bed at around 6pm.

Despite her exhaustion, she would struggle to fall asleep, sometimes getting fewer than four or five hours of sleep before it was time to wake up. She began drinking up to six cups of coffee a day, developed frequent colds and had little time to make friends.

Insomnia, poor sleep quality and short sleep duration are common among the 11 million people in the United States who work night shifts, according to federal officials. And shift workers often struggle to follow healthy diets or maintain relationships with family and friends.

That can have serious long-term consequences for health, said Dr Jeanne F. Duffy, a professor of medicine at Harvard Medical School who co-led the study at Brigham and Women’s Hospital.

How shift work affects you

Research suggests that shift workers have higher risks of developing health conditions such as gastrointestinal disorders, mood disorders and cardiovascular disease. They are also more likely to be involved in car crashes and develop infections such as colds and stomach viruses.

“Our whole physiology is oriented to being asleep at night and awake during the day,” Dr Duffy said. “So, when you try to stay awake at night to work, you’re fighting this internal biology.”

Shift workers are also at higher risk for obesity and Type 2 diabetes, said Dr Michelle Drerup, director of the Behavioral Sleep Medicine Program at Cleveland Clinic. That is in part because it is challenging to eat healthily while working at night, she added.

When “lunch time” comes around at 12.30am, for example, what is available for a worker to eat? “Well, it’s stuff in the vending machine if they haven’t prepared food,” Dr Drerup said.

Night-shift hours have also been described as “unsocial” in the scientific literature because they conflict with the usual rhythms of society. That can strain family dynamics and, as in Ms Shaw’s experience, put a damper on socialising.

If a worker then tries to keep up with social and health responsibilities at the cost of his or her rest, he or she is left with less time to recover from work, said occupational hygienist Imelda Wong, who is also an epidemiologist who works for the Ministry of Health in British Columbia.

What to do during and after work

Sleep experts make many of the same health recommendations for shift workers as they do for everyone else.

Maintaining a healthy diet is key to preventing some of the chronic diseases shift workers are at risk for. When working unusual hours, prepare healthy foods that are easy to take to work, such as vegetables, hummus, fresh fruit and almonds, Dr Drerup said.

“Planning ahead is essential,” she added, such as doubling recipes and freezing individual portions during the weekend or days off.

If your energy is flagging during a shift, a 15- to 20-minute power nap can help you feel more alert and refreshed, Dr Duffy said.

To make falling asleep easier when you get home, be mindful of how much caffeine you consume throughout your shift. Dr Drerup recommended limiting yourself to no more than two cups of coffee within the first few hours of your shift, and to avoid drinking any for the last four to five hours.

Once you are home, dim the lights in your house. Bright lights cue your body to wake up, which can make it harder to fall asleep, Dr Wong said. Then, get to sleep as quickly as possible, she added.

Blackout curtains, sleep masks and white-noise machines can help create a sleep-conducive environment, Dr Drerup said.

If you have daytime responsibilities that you cannot sleep through, such as meeting your kids at the school bus, Dr Drerup said, try to schedule naps before and after such interruptions.

A shared responsibility

Although there are many things you can do to make shift work a little less hard on your body, some of that responsibility falls on employers too, Dr Wong said. They can help night-shift workers by avoiding scheduling them for consecutive nights, keeping shifts to eight hours or less and providing meal and rest breaks, according to the National Institute for Occupational Safety and Health.

As for Ms Shaw, the more than two years of overnight work heightened her appreciation for how disruptive shift work can be. The study she was working on ended in April, and she said it took her about four months to return to her normal sleep pattern.

Asked if she would work those hours again, she was hesitant. It would depend on the project, Ms Shaw said, “because it did take a toll on my physical and mental health”. NYTIMES