Sleeping for shift workers
The following evidence-based guideline was created specifically for shift workers by the sleep team at the Central Queensland University. It is presented below in full.
Additional tips have been added in italics.
Healthy Sleep Practices for Shift Workers: Consensus Sleep Hygiene Guidelines using a Delphi Methodology. Sleep, 2023 Dec 11;46(12
Introductory Statement
As a shift worker, it can be difficult to get enough good quality sleep, which can impact health, well-being, 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. Prioritize 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.
Additional tip: humans typically have 90min sleep cycles. We will rouse towards the end of 90 minutes and when conditions are right, go back to sleep without even noticing. Being woken in the middle of the 90 min cycle leads to more disruption. So trying to plan your sleep around these intervals in sensible. E.g. Aiming for 6h sleep + 1.5h nap, or 2 x 4.5h sleeps between shifts.
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).
Additional tip: Our waking time can also potentially be divided into 90min cycles – trying to go to sleep at the beginning of a cycle can lead to restless tossing and turning for the next hour or so. A bed time and wake up schedule (adapted for shift times and your 90 min cycle) can assist with this.
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.
Consider avoiding screens and devices in the hour before bed. Blue light from these devices can disrupt melatonin secretion and make it harder to fall 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 (15–20 minutes) 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.
Additional tip: Experiment with your ideal nap time. Set an alarm for 15 minutes, 20 minutes or 25 minutes and see which duration leads to you feeling more refreshed.
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 with adequate ventilation.
- Dark: block out as much light as possible (e.g. use appropriate window furnishings, wear an eye mask). Turn off standby lights on electronic items in your bedroom, cover alarm clock displays, or remove these items from your bedroom (see below).
- 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. Turn off notifications on your mobile – you can set an automatic schedule for this.
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. If you need to use your bedroom as a workspace, set this up away from your bed and consider screening it from view.
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.
On the other hand, morning light exposure when returning to day shifts can help you reset your circadian rhythm more quickly.
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.
Caffeine naps can be useful. Caffeine takes 20-30 minutes to absorb & reach peak effect. A cup of coffee prior to a short nap means the added alertness from the caffeine will be taking effect as you wake up.
Observe your own body’s response to different doses of caffeine, and regulate your intake for optimal effectiveness. Does a small flat white “last” 4,6 or 8h for you? What about a cup of tea or a can of coke? What happens when you drink more coffee than usual, or too close to bedtime? What other sources of caffeine might you be consuming (cacao, chocolate, energy drinks etc)?
Guideline 12. Consider nicotine consumption
Avoid nicotine entirely, or at a minimum, 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 and supplements have stimulating effects, and ideally, shouldn’t be taken near bedtime. Examples can include some anti-depressants, B vitamins, and amino acids such as taurine. 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.
Protein-based meals and snacks may be best overnight – yoghurt, nuts, eggs are examples of minimally processed protein rich snacks. Aim to eat any meal at least 2h before going to bed.
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 nighttime exercise doesn’t disrupt sleep for most people; however, it’s also important to spend time winding down before bed.
Allow 1-2h after exertion before going to 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.
Ideas include fixing a warm milky drink and reading a book- perhaps one that you have read before.
NB: These guidelines are intended to be used as a general tool to improve shift worker sleep. For optimal use, shift workers should seek expert advice (e.g. general practitioner, sleep physician) in employing these guidelines, particularly to understand how time-dependent elements (e.g. medication use, light exposure) may require tailoring.
*Denotes individual guidelines that were specifically created for shift workers, with remaining guidelines representative of existing advice that has been tailored for this population.
** Italics represents the authors personal opinion.
Additional references:
Healthy Sleep Practices for Shift Workers | Sleep Health Foundation
Shriane, A. E., Rigney, G., Ferguson, S. A., Bin, Y. S., & Vincent, G. E. (2023). Healthy Sleep Practices for Shift Workers: Consensus Sleep Hygiene Guidelines using a Delphi Methodology. Sleep, 2023 Dec 11;46(12) https://pubmed.ncbi.nlm.nih.gov/37429599/
Caffeine, Food, Alcohol, Smoking and Sleep | Sleep Health Foundation
Guide to Sleep Hygiene for Shift Work (nursinglicensemap.com)
Sleep, a book by Nick Littlehales, a comprehensive guide to tailoring your sleep for better performance. Summary here