Employer guide to managing sleep and shift work

November 30, 2023

For business owners, plan sponsors and administrators

Employers may face unique challenges when they manage employees who work nontraditional hours (outside 9 a.m. to 5 p.m. workdays), particularly when schedules are designed around shift work.

Shift workers may have sleep issues that can have impacts in the workplace and at home. We adapted this guide provided by our medical director, Cleveland Clinic Canada, so you and your employees can better understand and manage sleep and shift work.

“In some industries shift work or working irregular hours can contribute to difficulties with getting regular, high-quality and restorative sleep, which can lead to shift work sleep disorder,” explains Dr. Steve Pomedli of Cleveland Clinic Canada, Medical Director for Manulife Group Benefits. 

“While medications are sometimes prescribed in these situations, there are important non-pharmacological tools and strategies that can also help employees improve their sleep quality. These might include sleep scheduling tactics, stress reduction techniques, sleep hygiene strategies, and therapy specifically focused on sleep.” 

What is shift work sleep disorder (SWSD)?

Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder.1 Circadian rhythms are the physical, mental, hormonal, and behavioral changes our bodies follow on a 24-hour cycle. These natural cycles synchronize with our exposure to light and dark cues in our environment. Most people’s shift work schedules will be at odds with their underlying circadian rhythm.

SWSD creates challenges when changing to a different sleep/wake schedule. That results in significant issues with:1

  • Sleeping when you want,
  • Staying asleep,
  • And unwanted sleepiness.

Shift work sleep disorder is common, but not everyone who does shift work experiences SWSD. The disorder affects around 10% to 40% of people who work unconventional shifts for their job..1

What are the symptoms of shift work sleep disorder (SWSD)?

SWSD has two main symptoms:.1

  • Insomnia: Insomnia is the difficulty falling and/or staying asleep. This usually impacts people with SWSD differently based on when they work. Working overnight nights tends to result in employees having trouble falling asleep, while people who work in the evening often have issues staying asleep.
  • Hypersomnia: Hypersomnia presents as extreme sleepiness at unwanted times. People with SWSD tend to experience this while working during the night or early morning hours. Depending on the type of work, this can be very unsafe and impact work performance.

SWSD has other symptoms that include:.1

  • Difficulty concentrating,
  • Headaches,
  • Lack of energy,
  • Decreased alertness while working,
  • And poor mood and irritability.

What are the complications of shift work sleep disorder?

SWSD could lead to several problems if left untreated including:.1

  • Poor work performance: SWSD generally causes difficulty in concentrating and remembering things which can result in poorer performance at work.
  • Higher accident risk: SWSD reduces alertness and reaction time. This increases the chances of employees making errors or being involved in an accident while working. People with SWSD are also more likely to get into a vehicle collision on their commute because of drowsiness.
  • Mood issues: The disorder can impact mood, increase stress levels and irritability, and impact the ability to manage conflict. Those suffering from SWSD are also at higher risk of depression compared to people who don’t have the disorder.
  • Alcohol and substance use: People suffering from sleep problems, including SWSD, may self-medicate with alcohol or drugs in attempt to improve their sleep, which can have other short-term or longer-term health consequences.

Quality sleep is integral to maintaining employee health. Many ongoing health conditions can be negatively impacted by a lack of sleep and SWSD. These issues can also lead to new health issues. SWSD increases the risk for health issues that include:.1

  • Getting sick often, such as with a cold or the flu,
  • High cholesterol levels,
  • Heart disease,
  • Obesity,
  • Gastrointestinal issues,
  • Reproductive issues and/or low testosterone,
  • And several types of cancer.

How long does shift work sleep disorder last?

The symptoms of SWSD tend to persist as long as an employee works unconventional hours.1 When people return to a sleep-wake schedule that follows more regular day-night cycles, the symptoms often will resolve.1 However, for some individuals, sleep issues can continue even after stopping a shift work schedule..1

How is shift work sleep disorder treated?

There is no specific cure for SWSD, but there are some treatments that can help to address the main symptoms.

Treatments include:.1

  • Changes to your work routine or schedule (if possible),
  • Changes to your sleep routine at home,
  • Bright light therapy,
  • Melatonin supplement,
  • Sleep medications,
  • And Wake promoting agents (medications).

How can employers help? Tips for managing work routines and schedules

One aspect of treating SWSD is making adjustments to routines and work schedules. If possible, employers can implement these changes to help mitigate the impacts of shift work on employees:.1,2

  • If possible, decrease the number of night shifts employees work in a row. Limit the number of night shifts to five or fewer in a row, with days off in between. Employers should limit 12-hour shifts to a maximum of four days in a row.
  • After a string of night shifts, provide employees more than 48 hours off, if possible.
  • Avoid employees working extended shifts and putting in excessive overtime.
  • Avoid frequently rotating shifts. It’s more difficult to deal with rotating shifts than it is to work the same shift for a longer period of time.
  • Some rotating shifts are better for sleep than others. For example, rotating from day to afternoon to night shifts is a more natural progression that is easier on circadian rhythms and sleep compared to rotating in the opposite direction or a more abrupt from daytime to nighttime shifts.

We understand employers and employees will look to their benefits plan for support with their sleep. Manulife is reviewing how sleep programs can address issues like insomnia, nightmares, and sleep challenges due to shift work. Watch for our future recommendations on sleep solutions for your group benefits plan.

What can employees do?

Employers also can help shift work employees by letting them know strategies to get better sleep and developing a culture that promotes self-managed wellness.
Sleep tips for night-shift workers:2

  • Consistency in sleep schedule is key for night-shift employees. These employees should maintain the same sleep schedule on days they are working and days off work. This can be a challenge, but it can help if employees make sure their household is aware of this plan and understands the importance of their sleep schedule.
  • The bedroom environment is also important for these employees. Light and noise can create issues when sleeping during the day. Ensure the room is dark and use earplugs or white noise machines to help block outside sounds. If employees are not on call, they should consider turning off their phone while sleeping.
  • Employees should consider what sleep schedule works for them. Some people prefer to stay up after getting home so they can wake up closer to the start of their next night shift. Others prefer a split-nap schedule. This means napping for a few hours after getting home in the morning with a longer sleep in the hours leading up to the next shift.
  • Melatonin supplements can help employees regulate their sleep cycle around shiftwork, but they should consult with a healthcare provider to ensure it is best supporting their sleep rhythms.1
  • Employees should also review their use of caffeine, other stimulants, and alcohol. These can worsen sleep disturbances.

Sleep tip for employees with rotating shifts:2

  • Employees with rotating schedules should prepare for shift changes by slowly adjusting their sleep times. They should gradually change their bedtime by one or two hours each night a few days before their shift change and avoid the disruption of a more sudden sleep schedule change. This will help their body adjust and be more ready for the new schedule when their shift changes.

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