How to cope with rotating shift work

By Dr Pushpa Chandra

Mar 22

Working night shifts comes with challenges, including the high risk of shift work sleep disorder. Millions of workers work a rotating shift—changing from day to night or evening to morning regularly. This eliminates any chance of the body adapting to a specific schedule (which generally takes about seven days), and contributes further to disturbed or insufficient sleep.

Working night shifts comes with challenges, including the high risk of shift work sleep disorder.

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What are the special challenges of rotating shifts?

All shift workers tend to suffer from low quality sleep. Humans are naturally diurnal, and our bodies are programmed to want to sleep during the night and be awake during the day. This means people are constantly sleep deprived, with all of the problems this causes. However, night workers can adapt to their schedule and ultimately get better sleep. Rotating shifts preclude long-term adaptation and make the situation worse.

What is the best way to schedule shifts?

There's some discussion on this. Traditionally, shifts are rotated every seven days - but as that is about how long it takes your body to adjust to the new schedule, this means that as soon as you adjust, you change to another rotating shift. Some authorities suggest a longer period. However, it's more common to recommend a shorter one, two to three days, because it's actually better to not adapt at all than to adapt and then adapt again. It's also best for shifts to rotate forward—day to night—as it's easier for most people to adjust to moving ahead rather than back. This means that you should leave at least 48 hours after a night shift before returning to a day shift.

How can you cope better with rotating shifts?

A gradual change of time is less harsh on your body than a sudden one. If your schedule allows, then try to adjust sleep time during the time between shifts by no more than an hour or two a day. Napping during the lunch break can also help, if you have a long enough break—but be aware that some people experience a few minutes of grogginess after a nap, although the benefits may last for several hours.

Eating better helps, and you should take into account your schedule when eating. For example, on night shifts, you should eat a high protein breakfast before your shift, but only a light lunch, as food eaten at night is often digested poorly - resulting in stomach problems.

On night shifts, you should eat a high protein breakfast before your shift, but only a light lunch.

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Make sure to schedule some ‘me’ time and some ‘family’ time. A rotating shift is even more challenging for your spouse and children. Kids can struggle understanding a schedule that means they only see you one week in three, or for two weeks out of the month. It helps to sit down with them and explain what's going on. Irregular schedules can affect family relationships and friendships, and damaged relationships can then cause mental health problems.

Avoid pharmaceutical sleep aids—it's too easy to become dependent on them. Also be careful with stimulants. Only drink coffee early on a shift and stop taking caffeine eight hours before the end of your shift, so you can sleep when you get back. Try to get plenty of light right before your shift—use a light box if needed. If driving back when it's light, wearing sunglasses can help reduce the tendency of sunlight to wake us up. Always exercise before work, rather than after, regardless of your schedule that week. If you are taking prescription medication, talk to your doctor about adjusting your schedule, and potentially your dosage. Some medications are less effective if taken at a different part of your daily ‘cycle’, and with a rotating shift, that cycle never settles down.

Avoid pharmaceutical sleep aids—it's too easy to become dependent on them.

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Practice good sleep hygiene, such as not reading in bed or drinking alcohol right before sleeping.

Coping with a rotating shift can be difficult. In healthcare, rotating shifts are common, and not all employers will work with nurses on their schedule. It’s therefore important for healthcare workers to work to protect their health as best as possible when working this difficult schedule.

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About the Author

Dr. Pushpa Chandra is a Vancouver based Naturopathic Physician with an integrative approach to healthcare. Her background includes over 27 years of acute care hospital experience as a registered nurse and 22 years at BC Children's Hospital in critical care, working with the province's sickest children. Her special interests include research in circadian rhythm disruption, sports medicine and pediatrics. As a competitive sports enthusiast, Dr Pushpa completed ultramarathons and marathons in all 7 continents including North Pole, Antarctica and Mt Everest. As a shift worker she has been using the ingredients of AWAKE and ASLEEP to boost her performance, endurance and overall health.

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