Healthy Sleep Practices for Shift Workers

Healthy Sleep Guidelines for Shift Workers:

• Prioritise your sleep.
• Aim for 7-9 hours of sleep per 24 hours.
• Develop a sleep schedule.
• Develop a bedtime routine.
• Plan your transition to days off.
• Use napping as a helpful tool.
• Consider sleep inertia.
• Create a comfortable sleep environment.
• Use your bed for sleep and intimacy.
• Consider light exposure.
• Consider caffeine intake.
• Consider nicotine consumption.
• Consider alcohol intake.
• Be mindful of medication.
• Consider food intake.
• Consider fluid intake.
• Engage in regular exercise.
• Develop strategies for sleep problems.

As a shift worker, it can be difficult to get enough good quality sleep, which can impact health, wellbeing, job performance, and safety. The following guidelines are designed to provide shift workers with advice on healthy sleep practices, which can improve sleep during rostered periods of work. These guidelines are based on scientific evidence and offer strategies that will work for most people. However, it is important to remember that everyone is different. Please use them as a guide, and incorporate them based on your shift schedule, lifestyle, commitments etc. If you have any concerns or queries about your sleep or managing the effects of shift work, it's important to seek advice from a health professional. Your general practitioner/primary care provider is a good place to start, while sleep physicians and sleep psychologists can help with tailored treatments.

Guideline 1. Prioritise Your Sleep

As a shift worker, it can be difficult to get enough sleep. Make sleep a priority by rescheduling social activities and household tasks where possible, and informing friends, family, and neighbours of your sleep schedule.

Guideline 2. Aim for 7-9 Hours of Sleep per 24 Hours

Your individual sleep needs may differ, but research shows that 7-9 hours is the amount of sleep most healthy adults require. This may be achieved as one single sleep period, or as a main sleep supplemented by a shorter sleep(s). Keep in mind that this is total time spent asleep, not just time in bed.

Guideline 3. Develop a Sleep Schedule

Your sleep schedule should be based on your roster and lifestyle. Try to maintain a similar sleep schedule for each shift type (e.g., Bedtime A for day shifts, Bedtime B for afternoon shifts etc.), remembering to allow a sufficient opportunity for sleep (i.e., 7-9 hours total over 24 hours).

Guideline 4. Develop a Bedtime Routine

Find activities that help you wind down and feel relaxed, and consistently engage in these activities before bed, ideally in a dimly lit and quiet environment. This is particularly beneficial if you have trouble falling asleep.

Guideline 5. Plan Your Transition to Days Off

When transitioning to a block of days off, particularly after working late/night shifts, one strategy that may work for you is to have a short sleep in the morning and go back to bed earlier than your usual bedtime. Some sunlight after waking in the morning can help your body clock realign to the day-night cycle.

Guideline 6. Use Napping as a Helpful Tool

Short naps (15-20minutes) can boost alertness and performance, while longer naps (90 minutes) can reduce sleep debt. Naps less than 15 minutes may be too short to be beneficial, while naps longer than 20 minutes may make you more likely to experience sleep inertia (see Guideline 7). Keep in mind that longer naps should be avoided in the 4-6 hours before your main sleep as they may make it more difficult to fall asleep. Ideally, nap in a quiet, dark, and cool environment for best sleep quality.

Guideline 7. Consider Sleep Inertia

After waking, shift workers may experience sleep inertia - a period of grogginess, where alertness and performance are impaired. This feeling typically lasts 15-30 minutes after waking but can last up to 2 hours. It is important to avoid high-risk tasks (e.g., driving, operating machinery) during this time.

Guideline 8. Create a Comfortable Sleep Environment

Aim to sleep somewhere that is:

• Comfortably cool: 16-20ºC / 60-68ºF with adequate ventilation.
• Dark: block out as much light as possible (e.g., use appropriate window furnishings, wear an eye mask).
• Quiet: block out as much noise as possible (e.g., close doors and windows, use ear plugs, switch off devices). Some people find white noise helpful.

Guideline 9. Use Your Bed for Sleep and Intimacy

Use your bed for sleeping and intimacy only, if possible. Avoid mentally stimulating activities in bed (e.g., playing video games, working on a laptop), and be mindful of sharing your bed with others (e.g., pets) who may disturb your sleep.

Guideline 10. Consider Light Exposure

Exposure to bright light before bed can impact your sleep. Try to limit exposure where possible, for example, by wearing sunglasses while driving home after night shift, or by turning down screen brightness on devices.

Guideline 11. Consider Caffeine Intake

Caffeine can help to improve alertness and performance before and during your shift. However, the effects of caffeine can last for several hours, often longer than you think, and vary greatly between people. Keep in mind that caffeine too close to your bedtime may impact your sleep.

Guideline 12. Consider Nicotine Consumption

Avoid nicotine entirely, or limit nicotine intake in the 6 hours before bed.

Guideline 13. Consider Alcohol Intake

Avoid alcohol as part of your bedtime routine. Some people feel that alcohol helps them fall asleep. However, drinking alcohol close to bedtime, even in small amounts, negatively impacts your sleep quality.

Guideline 14. Be Mindful of Medication

Medications can impact sleep. Some medications have stimulant effects, and ideally, shouldn't be taken near bedtime. Some natural substances, like melatonin, can be helpful for shift workers experiencing sleep problems. Sleep-inducing medications (i.e., sleeping tablets) should usually only be used for short-term or intermittent relief of sleep problems. Always consult a healthcare professional regarding medication use and its impact on your sleep.

Guideline 15. Consider Food Intake

Where possible, limit food intake during night shifts, and if you do eat, opt for smaller, lighter meals. Don't go to bed hungry, as this may negatively impact sleep, but choose a lighter meal before bed that won't cause indigestion or discomfort.

Guideline 16. Consider Fluid Intake

It's important to maintain hydration by drinking plenty of water, however, avoid too much fluid before bed, as this may lead to sleep disturbances to use the toilet.

Guideline 17. Engage in Regular Exercise

Regular exercise is important for general health, and can help you sleep better, so it should be included around your shift schedule and lifestyle. Keep in mind that research now shows that night-time exercise doesn't disrupt sleep for most people, however, it's also important to spend time winding down before bed.

Guideline 18. Develop Strategies for Sleep Problems

If you're unable to sleep, get out of bed and do something relaxing in a quiet, dimly lit environment. Try to limit screen time and clock-watching and go back to bed once you're feeling sleepy. If sleep problems occur more than 3 times/week for several weeks in a row, seek advice from a healthcare professional.

PDF version: Healthy Sleep Practices for Shift Workers (via CQ University)

Other useful links:

• Shift Work
• Fatigue as an Occupational Hazard
• Sleep Health for Emergency Services Personnel
• Sleep Hygiene: Good Sleep Habits
• Drowsy Driving
• Caffeine and Sleep
• Caffeine, Food, Alcohol, Smoking and Sleep
• Napping
• Excessive Daytime Sleepiness
• Common Sleep Disorders

Reference:

Shriane AE, Rigney G, Ferguson SA, Bin YS, Vincent GE. Healthy Sleep Practices for Shift Workers: Consensus Sleep Hygiene Guidelines using a Delphi Methodology. 2022.

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