SHIFT WORK SLEEP DISORDER

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What is Shift Work?

In the United States, shift work is defined as any regular work schedule that falls outside the standard work day of 9am to 5pm. Shift work includes swing shifts, which begin the afternoon and end around midnight; and night or graveyard shifts, which begin in the late evening and end in the early morning. The term may also be applied to continuous shifts that span up to 40 consecutive hours at a time; these schedules are common in industries that require round-the- clock coverage, such as healthcare and firefighting.

Most shift workers follow the same schedule on a day-to-day basis. This is known as a same shift pattern. Other workers may work an early shift one day, and then a night shift the next; this is known as a multiple shift pattern.

Shift work is found in virtually every industry, but most commonly in fields like healthcare and medicine, law enforcement and security, firefighting, transportation, food service, hospitality and the military. According to the latest data from the Bureau of Labor Statistics (BLS), roughly 15% of the country’s full-time wage and salary workers follow some sort of shift work schedule. Of this group:

  • 4.7% work evening shifts
  • 3.2% work night shifts
  • 3.1% follow a multiple shift schedule
  • 2.5% follow a rotating shift schedule
  • Employees agree to shift work for a number of reasons. In many industries, irregular hours are a standard part of the job, and shift work may be the only available schedule for some positions. Shift work is also ideal for parents of young children, college students and other employees with conflicts that may interfere with a traditional work day. And although the Fair Labor Standards Act (FLSA) does not require employers to compensate shift workers with extra pay, most employees that agree to shift work ? particularly night shifts ? will experience an increase in their earnings, provided most of their shift falls outside normal working hours. A pay bump for shift work is commonly referred to as a differential. Shift work can also be lucrative for employers, since these schedules enables companies and organizations to remain active, productive and profitable 24 hours a day.

    However, shift work has also been linked to certain health problems, including a condition known as shift work sleep disorder (SWSD). SWSD affects your circadian rhythm, an internal timekeeper that dictates when, how and how long you sleep every day. Symptoms of SWSD include insomnia, excessive sleepiness and fatigue, headaches and lack of concentration. As a result, SWSD can lead to more serious disorders like depression and anxiety, and it is considered a risk factor for both work- and non-work-related accidents, injuries and fatalities.

    This article will explore the causes and effects of shift work sleep disorder, as well as treatment options for SWSD and some strategies for mitigating the effects of this disorder in different industries where shift work is common.

    Shift Work and Sleep

    First, let’s look at how circadian rhythm works. Circadian rhythm is tied to the brain, specifically the suprachiasmatic nucleus (SCN) region of the hypothalamus. The SCN controls different homeostatic processes throughout the body, including the secretion of melatonin, a hormone that triggers feelings of sleepiness. The SCN coordinates all of these processes to follow a 24-hour cycle, known as the circadian clock, and uses environmental factors like light and temperature to determine the time of day. This is why we naturally feel alert and well-rested during the period known as biological day, when it is relatively warmer and light outside, and then begin to feel sleepy during the biological nightperiod, when it is darker and cooler.

    In humans, the circadian sleep cycle consists of three distinct segments.

  • The first segment features two stages of light sleep.
  • The second segment features two stages of deep sleep, also known as slow-wave sleep.
  • Together, the first and second segments are known as nonrapid eye movement (non-REM) sleep.
  • The third segment consists of rapid eye movement (REM) sleep.
  • Adults will typically complete this circadian cycle every 90 to 120 minutes, resulting in roughly four to six cycles per sleep. However, employees who adapt to a shift work schedule must alter their sleep routine, which goes against the natural feelings associated with biological day and night. These changes slow down the secretion of melatonin and other SCN processes, which in turn can disrupt circadian cycle pattern. According to the Journal of Clinical Sleep Medicine, sleep loss associated with shift work primarily affects the second segment (slow-wave sleep) and third segment (REM sleep) of the circadian cycle.

    Due to the many variations of shift work hours and schedules found in today’s workforce, the effects of SWSD often differ from person to person. Additionally, many physicians have noted that there is a fine line between the expected physical and cognitive effects of working irregular shifts, and a diagnosable disorder like SWSD. However, some trends have been widely reported in people with SWSD. Consider the following statistics:

  • 63% percent of shift workers believe they get enough sleep with their work schedule, compared to 89% of non-shift workers. (National Sleep Foundation)
  • 25% to 30% of shift workers report excessive sleepiness or insomnia. (National Sleep Foundation)
  • Roughly 10% of night and rotating shift employees have shift work sleep disorder. (National Sleep Foundation)
  • Rapid shift rotations are more closely associated with reduced total sleep than intermittent rotations with at least three weeks per shift schedule. Rapid counterclockwise rotations can be especially disruptive. (Journal of Clinical Sleep Medicine)
  • Between 10% and 20% of night work employees report falling asleep during their shift. (Journal of Clinical Sleep Medicine)
  • In the United States, $40 billion is lost every year due to alertness-related accidents and poor work performance. (Journal of Clinical Sleep Medicine)
  • Car crashes cause 22% of work-related deaths. In 7% of these accidents, drowsiness or falling asleep are considered the primary crash factors. (National Institute for Occupational Safety and Health)
  • In the car manufacturing industry, 30% to 50% more accidents occur during the night shift. (Journal of Clinical Sleep Medicine)
  • Improving rest conditions for on-call medical interns to maximums of 16 consecutive hours of work and 60 hours per week has been found to reduce medical errors. (Journal of Clinical Sleep Medicine)
  • Medical interns with shifts longer than 24 hours are more than twice as likely to be involved in a car crash, and five times as likely to be involved in a ‘near-miss’ incident while driving home from work. (New England Journal of Medicine)
  • Some shift work employees will not experience sleep problems whatsoever. This is especially true of people with ‘night owl’ tendencies, who feel more focused and energetic after dark. However, most shift workers do not receive an adequate amount of sleep. The recommended amount of sleep for healthy adults is seven to nine hours per day or night, but shift workers ? particularly ? night shift workers ? typically sleep five to six hours per day or night. Shift employees also tend to work more hours per week than non-shift employees. Even for those who do not develop a disorder from their shift work, reduced sleeping hours combined with longer weeks put these employees at greater risk of on-the-job accidents. Other problems associated with these patterns include poor work performance and drowsy or unfocused driving during the commute to and from work.

    Shift Work Sleep Disorder

    Shift work sleep disorder (SWSD) is defined as the difficulty of “falling asleep, staying asleep, or non-restorative sleep for at least one month”. Many health experts liken the disorder to jet lag, a period of exhaustion and excessive sleepiness that often affects travelers who move between different time zones; both SWSD and jet lag are considered circadian conditions.

    Signs of SWSD will vary between individuals, but some of the most common symptoms include:

  • Sleep onset insomnia, characterized by the inability to fall asleep quickly
  • Sleep maintenance insomnia, characterized by the inability to remain asleep throughout the night
  • Fatigue and drowsiness while awake
  • Microsleep, or involuntary sleep that lasts for a few seconds
  • Poor concentration
  • Slow reaction time
  • Irritability
  • Headaches
  • Nausea and indigestion
  • In addition to these general symptoms, physicians have also pinpointed several health risks associated with long-term SWSD. Because disrupted circadian rhythms can affect your appetite and eating habits, SWSD has been linked to higher risks of obesity, gastrointestinal disorders ulcers and heart disease, as well as metabolic diseases like diabetes. Menstrual irregularities have also been reported in females with SWSD. In addition, some studies have suggested a possible connection between SWSD and certain types of cancer; however, other studies have been unable to establish a definitive link. And due to reduced immuno-health, people with SWSD are considered more susceptible to contagious diseases like flu and the common cold.

    Mental health is another factor to consider. If untreated, prolonged SWSD decrease one’s overall wellbeing, and may lead to feelings of depression and/or anxiety. Shift workers often feel out of balance with other people due to their irregular schedules, and this may affect their personal relationships with others.

    The good news is that SWSD is highly treatable, and several different treatment methods are currently offered to sleep-affected shift workers. If you have been diagnosed with SWSD or believe you have acquired sleep problems related to a shift work schedule, first consider meeting with your direct supervisor to discuss your schedule. You may be able to alleviate your SWSD symptoms by simply readjusting to a traditional workday shift. If a complete readjustment isn’t possible, then ask if you can stagger your shifts to allow for longer rest periods between workdays. For instance, you shouldn’t work more than four consecutive 12-hour days without a rest period of at least 48 hours.

    However, schedule changes may not be feasible in certain industries or workplaces. Another potential quick-fix treatment idea: napping before work. Just one hour of additional sleep has been proven to increase alertness and restfulness, particularly if you work a night shift. If you follow a fixed shift schedule, you should try to maintain the same sleep patterns every day of the week, even on days off; reverting to a different sleep schedule means you will essentially have to ‘start over’ once the work week begins, and this transition period can take a serious toll on your body and mind.

    Additionally, people with SWSD can alleviate some of their symptoms by following these guidelines at home and at work:

  • Maintain a regular ‘sleep diary’; record the time you go to bed and get up in the morning, as well as any disruptions or other issues that occur.
  • Determine a feasible sleep schedule that will enable you to get between seven and nine hours of sleep on a daily basis. Be sure to share this schedule with your partner, family members, roommates and anyone else with whom you share a residence; minimizing disturbances and interruptions is key to an effective sleep schedule.
  • No matter what time of day you sleep, make sure your bedroom or sleeping area is dark, quiet and temperature-controlled.
  • Abstain from stimulants like alcohol, nicotine and caffeine during periods when you plan to sleep.
  • Expose yourself to bright lights whenever your ‘day’ begins. By the same token, avoid bright lights when you are winding down and preparing to sleep. These measures help your circadian rhythm adjust to a shift work schedule, since the 24-hour cycle is largely influenced by daylight and darkness.
  • If you have a long commute, try to coordinate a carpooling or ride-sharing program with your coworkers; this will cut down on the amount you have to drive to and from work.
  • Avoid taking overtime shifts or agreeing to work extended hours; the extra pay may be tempting, but long shifts only further increase your risk of a workplace accident.
  • If you work night shifts, consider taking Vitamin D supplements. Vitamin D is a nutrient found in natural sunlight, and supplements can increase your wakefulness and boost overall immuno-health.
  • If these methods are not effective, you may be able to take medication to relieve your SWSD symptoms. Prescription sleep aids, including hypnotics like ProSom®, Ativan® or Valium®, should only be taken after you have consulted with a physician, as these medications can be addictive and carry some negative side effects. Melatonin supplements, on the other hand, are considered non-habit-forming and cause few side effects. Other shift workers will rely on caffeinated beverages or caffeine supplements to carry them through their shift. This can increase your alertness for a while, but caffeine can also have cause people to ‘crash’ when the effects wear off, making them excessively tired instead.

    Sleep Help for Shift Work by Profession

    Now that we have discussed the causes, effects and treatments for SWSD, let’s look at the impact this disorder has on specific occupations ? and strategies these employees can use to minimize the symptoms.

    Nurses and Doctors

  • Nurses Are Talking about: Working the Night ShiftIn addition to tips for nurses with shift-related sleep problems, this article from Medscape also discusses some perks of working late shifts. These include fewer patients to tend to, more time for student nurses to study, tighter working relationships with other night shift employees and the relatively calm after-hours atmosphere of most healthcare facilities.
  • The Night Shift, Nurses and Sleep DeprivationWritten by Michael J. Bresus, Ph.D., this Psychology Today article explores the connection between night shifts and sleep problems like insomnia and daytime fatigue. Mr. Bresus also tackles the risks associated with sleep-deprived nurses providing patient care.
  • Surviving a Night ShiftThis report from MedicalProtection.org includes some guidelines for doctors and nurses to follow before, during and after their night shift. These include receiving an adequate amount of sleep, keeping healthy eating and drinking habits throughout the day, avoiding caffeine near the end of a shift and abstaining from sleeping pills as much as possible.
  • 7 Tips to Stay Awake During Night ShiftThis post on the Nerdy Nurse blog covers physical strategies for remaining alert and vigilant during night shift, such as drinking an adequate amount of water and keeping cool, as well as mental activities that keep your mind busy and allow you to stay focused.
  • 19 Ideas for Shift Nurses to Get More SleepPublished by Scrubs magazine in 2015, this listicle looks at strategies for creating and following a shift work sleep schedule. The article also features sleep-time recommendations for nurses with rotating shift schedules.
  • Sleep Disorders among Physicians in Shift WorkThis journal article from 2014 discusses the “possible causes, contributing factors and consequences of sleep disorders in physicians”. The text also looks at ways doctors can practice healthy sleep hygiene and get enough rest when they are working or on call.
  • Should Your Doctor Be Napping on the Job?Penned by two licensed physicians, this 2011 article from Time explores the benefits of workplace napping for doctors, nurses and other medical personnel who normally work non-traditional hours. The study also addresses the dangers of receiving medical treatment from sleep-deprived healthcare professionals.

  • Law Enforcement Officers and Security

  • Sleep Disorders and Law Enforcement OfficersThis report from the National Institute of Justice discusses some of the most common sleep issues affecting police officers, sheriffs, state troopers and other law enforcement officers (LEOs). The report found that roughly 46% of LEOs have fallen asleep at the wheel at least once, while more than a quarter of respondents say this happens once or twice per month.
  • Understanding and Surviving Shift Work Sleep DeprivationThis article from Officer.com introduces the causes and effects of SWSD, and ways for LEOs to mitigate the effects of this disorder. The post concludes with a lengthy list of techniques for both getting through a night shift and maintaining your general wellbeing on and off the clock.
  • Police and Sleep Problems: Are You a 40 Percenter?Roughly 40% of law enforcement officials struggle with insomnia and other sleep disorders. This article from Police One includes ways for officers to self-identify sleep issues, as well as some strategies for getting enough rest and boosting on-the-job performance during shifts.
  • State Police Officer Sleep Patterns and Fast Food ConsumptionPublished by The International Journal of Police Science & Management, this article focuses on the link between poor dietary habits and sleep hygiene among state law enforcement officials. According to the author’s findings, the average state police officer consumes fast food meals at least four times per week.
  • 10 Ways Police Officers Can Get Better SleepThis Police One post features 10 tips for LEOs who struggle with sleep issues. These include abstaining from nicotine and alcohol while off the clock, reserving the bedroom for sleep and sex only, creating a set sleep schedule and cleaning pillows on a regular basis.
  • Sleep Disorders Linked to Poor Health and Reduced Occupational Performance in Police OfficersPublished by the National Sleep Foundation, this article summarizes a recent survey of nearly 5,000 LEOs. The findings: roughly 6.5% struggle with insomnia, and 28.5% of respondents experience fatigue on a regular basis.
  • Security Guard Tips: 10 Ways to Stay Awake During the Graveyard ShiftNight shifts are common in the security sector, and many of these schedules involve a solitary work environment. This article from SilverTrac makes a few suggestions for graveyard security guards, including proper diet and hydration, ‘responsible caffeination’, and regular exercise.
  • Self-reported Health and Well-being Amongst Night Security GuardsThis journal article first appeared in Ergonomics, and draws a comparison between the sleep habits of night-shift security personnel and the rest of the public. The findings conclude that security guards are two to three times as likely to suffer from fatigue.  

  • Firefighters and Emergency Responders

  • Study Shows Firefighters Don’t Get Enough SleepPublished by Fire Rescue magazine, this article discusses a study conducted by the International Association of Fire Chiefs (IAFC). The study found that a large percentage of respondents were sleep-deprived, while less than 10% do not follow a healthy diet or exercise on a regular basis.
  • Firefighter Deaths Could Be Linked to Poor SleepHelen Regan of Time magazine explores the connection between sleep deprivation and on-the-job accidents, injuries and fatalities for firefighters. Citing a study by the Journal of Clinical Sleep Medicine, the article reports that roughly 37% of firefighters suffer from some sort of sleep disorder.
  • Firefighter Health, Wellness and FitnessSleep deprivation is just one of the topics covered in this comprehensive guide from the U.S. Fire Administration. Other areas of discussion include the high incidence rates of cancer and respiratory disease among career firefighters, as well as several links to other online resources.
  • Firefighter Sleep: 7 Ways to Improve Your Crews’ Sleep and SafetyShift work is standard for many firefighters nationwide, and this article from Fire Chief explores ways that chiefs and supervisors can minimize risks and ensure the overall wellbeing of their firefighters. These strategies include firehouse logistical evaluation, crew sleep assessments and effective shift scheduling.
  • The Effects of Sleep Deprivation on Firefighters and EMS RespondersPublished by faculty members at the Oregon Health & Science University, this detailed report addresses the physiological effects of sleep deprivation, as well as some patterns observed in firefighters and responders who do not get enough sleep.
  • Study Measures Effect of Sleep Deprivation on EMS ProvidersThis 2012 article from the Journal of Emergency Medical Services looks at the impact of sleep deprivation on your physical, emotional and mental wellbeing. The study found that fatigued responders were 1.9 times as likely to be involved in an on-the-job accident as well-rested responders, 2.2 times as likely to commit a serious error and 3.6 times as likely to be involved in ‘safety-compromising behaviors’.

  • Pilots, Flight Crews and Air Traffic Controllers

  • The Airline Pilots’ Guide to Fighting Fatigue: This report from the Air Line Pilots Association discusses the role proper sleep plays in mood, functionality and on-the-job performance. The article also features strategies for handling fatigue in the air, on the road and at home on days off.
  • The Effects of Commuting on Flying FatiguePublished by National Academies Press, this article focuses on the relationship between driving to and from work and flying professionally, specifically how these combined factors can put pilots at risk for on-the-job accidents.
  • Do Pilots Get Enough Sleep?The New York Times answers this tricky question in a 2009 editorial that looks at the risks of working 15-hour days, the benefits of ‘power-napping’ during down periods and measures the aviation industry has taken to minimize pilot fatigue.
  • Crew Schedules, Sleep Deprivation, and Aviation Performance: Most professional pilots and flight crews must follow a shift work schedule at least once during their career, and for many it is the norm. This article from the Association of Psychological Science (APS) features case studies involving crashes related to sleep-deprived pilots or crews, as well as some tips for ensuring all flight personnel are well-rested and able to carry out their required duties.
  • Fatigued in the BackThis report from the Flight Safety Foundation highlights a study by the Federal Aviation Administration (FAA), which noted the relationship between sleep deprivation and poor on-the-job performance from flight attendants. One key finding: many attendants struggle with sleep issues because they work long shifts, and are anxious about getting enough sleep during their scheduled rest periods.
  • Rapid Counterclockwise Shift Rotation in Air Traffic Control: Effects on Sleep and Night WorkAir traffic controllers must often follow rotational shift work schedules, and these irregular hours can impact on-the-job performance. One troubling statistic: more than 90% of controllers with rotating shifts slept for an average of 2.2 hours between the end and start of different workdays.
  • FAA Study: Air Traffic Controllers’ Schedules Can Lead to FatigueThe air traffic control sector has endured scrutiny over worker fatigue for years, and this NPR article profiles a 2015 study by NASA officials on behalf of the FAA. The study found that the average controller gets between 5.8 and 3.4 hours of sleep on a daily basis, depending on their scheduled shift; 70% reported ‘dozing off’ at work, while 18% have been involved in an on-the-job accident.

  • Military Service members 

  • Active Duty Military Personnel Prone to Sleep Disorders and Short Sleep Duration:  The American Academy of Sleep Medicine (AASM) published this survey of active-duty service members in 2013. Respondents reported an average daily sleep time of 5.74 hours, with 41.8% saying they sleep less than five hours per day or night. Roughly one quarter of respondents experienced insomnia, as well.
  • Soldiers and Sleep: The Military’s Shifting StanceA number of events ? including wartime friendly-fire incidents ? led the military to adopt stricter sleep guidelines for active-duty soldiers and other personnel. This article from Sleep.org discusses some of these measures, including the ‘Performance Triad’ ? a comprehensive sleep, diet and fitness regimen for troops to follow.
  • Insufficient Sleep for Active Duty Soldiers a Big Health ProblemThis report from the Centers for Disease Control (CDC) uses data findings to discuss the important role that sleep plays in a soldier’s daily routine. According to the report, insufficient sleep is most commonly reported among soldiers aged 18 to 34 (14.2%) and 35 to 44 (13.8%).
  • How to Develop Healthy Sleep HabitsThis post from Real Warriors debunks several myths related to soldier sleep and health, and also explores some effective strategies for getting enough sleep when you’re on active or reserve duty. Tips include maintaining a healthy sleep environment, following a proper diet and relaxing before bedtime.
  • Up All Night: How Soldiers Deal with Sleep DeprivationThis Sleep.org post investigates some of the best-practice ways for military personnel to get enough sleep. Napping, exercising, and relying on other soldiers are all outlined; the article also suggests self-imposed sleep deprivation during training in order to adequately prepare for the real thing.

  • Railroad Workers

  • Fatigue Status of the U.S. Railroad IndustryThis extensive report from the U.S. Department of Transportation looks at sleep patterns and trends among signalmen, maintenance of way workers, dispatchers and other railroad employees. The study finds that the average employee receives less than seven hours of sleep per night, and that the amount of sleep is correlated with weekly on-off work schedules.
  • Railroader’s Guide to Healthy SleepCreated by the Division of Sleep Medicine at Harvard Medical School, this website is dedicated to exploring the sleep patterns of railroad workers. In addition to a guide to shift work sleep disorder, the site features video tutorials, blog posts and other resources to help readers understand sleep science, improving sleep habits and remaining restful and alert both on and off the clock.
  • FRA Releases New Study on Rail Worker FatigueThis blog post from Progressive Railroading discusses the result of a recent study by the Federal Railroad Administration. Key findings include: 65% of sleep-deprived workers are ‘above chance’ to be involved in a human-factor accident, and only 2.4% of railroad workers with a sleep disorder seek treatment for their condition(s).
  • Rail Workers: Deadly Tired… but Still WorkingWritten by railroad industry veteran Georgetta Gregory, this post published by the National Transportation Safety Bureau uses real-life case studies to examine the possible link between sleep deprivation and fatal train accidents.
  • Work Schedules and Sleep Patterns of Sleep DispatchersDispatchers play a crucial role in the safety and day-to-day operations of the railroad industry, and must be alert and focused whenever they are working. This statistical analysis from the Federal Railroad Administration explores sleep patterns and problems among dispatchers using a wide range of metrics.

  • Industrial and Manufacturing Workers

  • Shift Work, Sleep Deprivation and Industrial AccidentsThis article from Robson Forensic notes that industrial workers with sleep problems are twice as likely to die in a work-related accident, and 70% more likely to be injured in one. The article also finds that workers are most likely to feel tired between 12pm and 6pm, and 6am to 12pm.
  • Safe and Productive Shift WorkThis Industryweek article by Garrett Burnett of the National Institute for Occupational Safety and Health draws a connection between healthy sleep habits among shift workers and safer work environments. Mr. Burnett includes scheduling recommendations, such as avoiding rapid shift changes and minimizing the weekly number of long/overtime shifts.
  • Fatigue and Shift WorkAccording to this report from Union Electrical (UE), 27% of machine operators, fabricators, laborers and assemblers work non-traditional shift schedules. The article goes on to compare the sleep patterns of first, second and third shift workers, as well as discuss the physiological, mental and social problems that may arise from disrupted circadian rhythms.
  • Shift-work Disorder and Sleep-related Environmental Factors in the Manufacturing IndustryThis journal article discusses a survey of more than 500 Japanese industrial workers about their sleep patterns, work routines, lifestyle and family life. Of the respondents, a staggering 62.8% were ultimately diagnosed with shift work disorder.
  • Rotational ShiftworkThis handy guide from the Canadian Centre for Occupational Health and Safety answers some important questions about rotating shift schedules and the effect they can have on industrial personnel. The questions include ‘What are the effects on circadian rhythms?’, ‘Can shiftwork aggravate existing conditions?’ and ‘What are some strategies for improvement?’

  • Waiters, Bartenders and Other Service Employees

  • In Service Sector, No Rest for the WorkingThis New York Times feature interviews a Taco Bell employee from Tampa, a Perkins server from Minneapolis and other service employees who work swing or graveyard shifts. These employees discuss the physical and mental toll these schedules can take, as well as family and social issues that may arise.
  • Why Working in the Restaurant Industry Can Be Hard on Your Mental HealthKara Baskin of The Boston Globe profiles chefs, waiters and other service industry personnel who struggle to maintain a healthy work-life balance. The author draws a link between work-related sleep deprivation and mental health problems.
  • Coping with Post-shift InsomniaThis blog post from Tales of the Cocktail discusses a common trend among bar and restaurant employees: the inability to fall asleep after a swing or late shift has ended. The author’s strategies for staving off this issue include melatonin supplements, a solid exercise routine and a consistent sleep schedule for on and off days.
  • How to Maintain a Healthy Lifestyle While Working in RestaurantsThe service industry can be hard on your body, mind and general outlook ? and this is largely due to work-related sleep deprivation and its effects. This post from Sirvo discusses meeting with a manager to find the right schedule, eating a good ‘breakfast’ not long after getting up for the day, abstaining from tobacco products, and other helpful tips aimed at restaurant employees.
  • Restaurant Workers’ ‘Nightcare’ Double WhammyThis op-ed from LA Weekly follows a group of restaurant employees seeking out childcare providers that offer nighttime services. The article offers a few suggestions for parents facing this decision, as well as the impact these late schedules can have on the relationship between parents and their children.
  • Hospitality Workers

  • 6 Ways to Improve Your Sleep as a Hospitality WorkerPublished on Typsy in 2016, this blog post explores some strategies for managing sleep hygiene and habits when you work in hospitality. The author suggests following the same sleep schedule throughout the week, receiving roughly eight hours of sleep every day and avoiding stimulants and exercise right before bed.
  • Sleep Patterns, Work, and Strain among Young Students in Hospitality and TourismAccording to this Swiss study that first appeared in Industrial Health, college students working in the hospitality and tourism industry reported a higher incidence of sleep problems after working long shifts. Additionally, the authors draw a link between weekend work schedules and strained relationships with others.
  • The Association Between Shift Work and Depression in Hotel WorkersShift work is especially common for employees at hotels, motels and other lodging facilities with round-the-clock help desks. The authors of this study from South Korea surveyed more than 700 hotel employees in Seoul, and noted a strong link between depression and rotating shifts at any time of day.
  • Casino and Hospitality Labor ManagementThis strategic guide for labor managers and analysts looks at three common schedules in the gaming industry: the ‘continental shift’, which begins at 2am; the ‘casino shift’, which begins at 4am; and the ‘production shift’, which begins at 7am or 8am to correspond with the establishment’s pay schedule.

  • Additional Resources for Shift Workers

    We’ll leave you with a few extra online resources related to shift work sleep disorder, insomnia, sleep hygiene and other related topics. For more information about the relationship between sleep and mental health, check our our guide to anxiety and sleep.

    Sleep Hygiene

  • Sleep Hygiene TipsA comprehensive, bulleted guide to healthy sleep practices from the American Sleep Association.
  • What Is Sleep Hygiene?The National Sleep Foundation answers this question with a two-page tutorial exploring the importance of sleep hygiene and some effective ways to incorporate it into your routine.
  • Twelve Simple Tips to Improve Your SleepThe Division of Sleep Medicine at Harvard Medical School offers a dozen strategies for setting and following a healthy sleep schedule.
  • Sleep Disorders

  • Sleep and Sleep DisordersThe official CDC page dedicated to sleep conditions features data and statistics, a ‘publications and products’ guide and other helpful resources.
  • Sleep Disorders ProblemsThe National Sleep Foundation’s online guide to sleep disorders features articles about REM sleep behavior disorder, insomnia, sleep apnea, restless leg syndrome and other common conditions.
  • Sleep DisordersMedlinePlus, a division of the U.S. National Library of Medicine, offers a an extensive list of online resources about sleep disorders, including sites aimed at niche groups like women, children and the elderly .

  • Sleep Technology

  • Sleep Cycle Alarm Clock: This app available for iPhone and Android devices features an alarm clock designed to analyze your sleep patterns and wake you during the first (light) segment of sleep, allowing you to wake up feeling more refreshed.
  • Sleep GeniusTouted by NASA, this smartphone app features a customizable sleep schedule, a ‘revive cycle alarm’ that wakes you with peaceful sounds, a built-in relaxation program and a power-napping timer.
  • Circadian 24/7 Work SolutionsThis company’s offerings include two software programs designed to help shift workers and aircrew personnel manage fatigue-related risks.
  • Shift Work Sleep Disorder Studies

  • Sleep Loss and Fatigue in Shift Work and Shift Work DisorderOriginally published by Sleep Medical Clinics, this study examines the causes and effects of shift work sleep disorder, and also discusses scheduling strategies that can cut down on risk factors associated with the disorder.
  • Shift Work Sleep Disorder: Prevalence and Consequences Beyond that of Symptomatic Day WorkersThis 2004 study conducted at the Henry Ford Hospital Sleep Disorders and Research Center looks at differences in performance, alertness and other factors between shift workers and traditional daytime workers.
  • Health Disorders of Shift WorkersThis 2003 study that originally appeared in the Occupational Medicine Journal looks at SWSD, as well as other conditions affecting shift workers, such as heart and gastrointestinal disease, cancer and metabolic disorders.

  • Shift Work Disorder

  • Shift Work Sleep Disorder (SWSD)The Cleveland Clinic’s official guide to the disorder outlines key concerns and strategies in a helpful FAQ format.
  • Shift WorkThis four-page SWSD tutorial from Sleep Education covers basic information, symptoms and health risks, self-test and diagnostic procedures and treatments for the disorder.
  • Coping with Shift WorkPublished by the UCLA Sleep Disorders Center, this comprehensive resource aims to help readers deal with “sleep disorders caused by a non-traditional work schedule”.

  • Insomnia

  • InsomniaThe Mayo Clinic’s website features a detailed, multi-page guide to the common symptoms and associated health risks of insomnia, as well as some treatment and self-management strategies.
  • The Insomnia MachineThis extensive feature article from The New York Times looks at some effective alternatives to sleep aids and other medications used to combat insomnia.
  • Insomnia LandLaunched in 2009, this blog features an archive of more than 800 posts about treatment, medication, sleep hygiene tips and other topics related to insomnia, as well as a support forum for people who struggle with the disorder.
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