Assessing sleep-wake disturbances in shift workers

Nightshift workers can experience reduced sleep quality and quantity, resulting in sleepiness and impaired alertness and performance during their shift. This can have health and safety implications and worsen quality of life.

The effect of shift work on a person’s sleep–wake cycle varies—it depends on their:

• sleep requirements
• chronotype (preferred time to sleep)
• nature of shift work (frequency and timing of shifts, opportunities to rest during or between shifts).

Nonwork commitments (eg caregiving duties) can further reduce opportunities to sleep, compounding the problem.

Impairment associated with sleep disturbance may not always be evident in a shift worker—strategies to reduce the risk of harm associated with these impairments should be undertaken (eg include extra checks when performing critical tasks, avoid driving home if possible).

If a nightshift worker has excessive sleepiness during shifts and trouble sleeping between shifts:

• ask them to keep a sleep diary
• measure their sleepiness with the Epworth sleepiness scale
• consider screening them for conditions that are more prevalent among shift workers (eg cardiovascular disease, diabetes, obesity, depression, obstructive sleep apnoea, insomnia, restless leg syndrome)
• advise them to practice the interventions recommended here.