How to find a balance with shift work, sleep and mental health

The University of Kentucky Public Relations and Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Rebecca Honaker, research director for the Kentucky Occupational Safety and Health Surveillance program, and Patrick Maloney, occupational epidemiologist at the Kentucky Injury Prevention and Research Center (KIPRC).

LEXINGTON, Ky. (June 6, 2023) — Many shift workers work outside of the typical 6 a.m. to  6 p.m. traditional daytime working hours. Nontraditional shiftwork can include working rotational shifts, fixed night shifts, or extended days. According to data from the 2017–2018 American Time Use Survey, 6% of all U.S. workers have evening shift schedules, 4% work nights and 2% work rotating schedules. Men, racial and ethnic minorities and those with family income below the poverty level are more likely to do shift work.

Shift workers often have to be awake and alert when their bodies’ natural rhythms are signaling that it is time to sleep. This leads many shift workers to get less and lower-quality sleep. Some common sleep problems faced by shift workers include:

• Chronic insomnia
• Sleep disturbances
• Poor-quality sleep
• Shorter sleep duration (less than seven hours a day)

Research suggests that the sleep problems that come with shift work are associated with higher risks for mental health problems and burnout. A number of studies have explored the effects of shift work on mental health and have found that shift work has a variety of impacts on mental health and behaviors, including:

• Increased rates of depression and anxiety
• Increased risk of suicidal ideation
• Higher usage of drug and alcohol to help stay awake or to help go to sleep
• Decline in cognitive function
• Dissatisfaction with overall well-being

If you or a loved one do shift work, here are a few common problems and possible interventions for improving quality of life. 

• I have trouble getting to sleep and I’m often tired. If possible, stick to a consistent sleep schedule, even on days off, to reduce the impact on your body’s natural rhythms. 
• I feel alone or isolated from friends and family. Schedule time with friends or family that is exclusively for socializing that fits both of your schedules. 
• I feel run down and exhausted. It may seem counterintuitive, but exercise! Even 5-30 minutes of purposeful, brisk activity a day can be beneficial. Before or after work are popular times!
• Work is wearing me down. Discuss sources of workplace stress with coworkers and employers, and discuss ways to reduce or counteract them.
• Sleeping doesn’t seem to help revitalize me. As painful as it may be, medication is generally not the answer. Sleep aids may help with quantity of sleep, but often reduce its quality. Try creating a better sleep environment with blackout shades and white noise to improve quality of sleep before medicating.

Workplaces can also take action to support the mental health of shift workers. Some recommendations that workplaces can implement include:

• Limit night work as much as possible.
• Limit the number of consecutive night shifts.
• Set adequate rest days between shifts, particularly after night shifts.
• Tailor mental health supports to the needs of shift workers.
• For example, accessing mental health resources outside of business hours.
• Rotate shifts clockwise, rather than counterclockwise.
• Check in with team members frequently.
• Create a work culture that supports employees’ mental health.
• Educate employees about sleep and mental health, and encourage them to consult with their doctor if needed.