About 20 million Americans have rotating shift work, which means they work varying shifts that often include overnights. University of Minnesota Physicians (M Physicians) Neurologist and Sleep Specialist Michael Howell, MD, says that’s a problem.

Michael Howell, MD

Dr. Howell has spent 20 years researching and treating patients with sleep disorders, and he also educates doctors, communities and others on the importance of sleep health. The impacts of rotating shift work on someone’s sleep and health are concerning for him. 

“Human beings did not evolve to have rotating shift work,” he explains, “And when you suddenly try to shift your sleep, it is like you are suddenly trying to sleep on a different side of the planet. Our brains and physiology did not evolve for that. And so, not surprisingly, we have significant consequences from it.”

Most notably, rotating shift work and its related sleep pattern irregularities can lead to health problems like:

  • Having trouble sleeping when someone would like to sleep
  • Experiencing difficulty staying awake while someone is trying to work
  • Work-related errors, falling asleep on the job and impaired judgment 
  • Greater risk for cardiovascular disease, strokes, heart attacks, cancer or mental illness

To make it more difficult, there is no medication that can help someone manage changes in sleep patterns either. 

So, what can patients do about it?

Reducing Health Risks From Irregular Sleep Patterns

Dr. Howell explains that it comes down to reducing the harm someone may experience, and that it’s most helpful if someone knows a few days ahead of time that they may need to drastically change their sleep schedule. 

With that kind of heads up, Dr. Howell says that someone can usually start adjusting their circadian rhythm–the body’s natural sleep schedule–but that it depends on what the goal is. 

“It’s different for individuals who may need to wake up at 4 a.m. to get to work versus those who may need to shift their sleep schedule so they can work an overnight shift,” he says. 

The first step for both, though, is to understand what each individual’s intrinsic circadian rhythm is. For example, Dr. Howell asks, “Are you naturally someone who falls asleep at 10 p.m. every night or are you someone who falls asleep at midnight or later?”

What time someone usually goes to sleep and wakes up matters, because that’s the starting place for how to adjust. 

Dr. Howell explains that, in general, people can move about two hours of circadian rhythm a day. “So if the goal is to flip circadian rhythm so you are sleeping exactly 12 hours from when your starting point is, you would need six days to do that, under the best of circumstances, and people don’t always get that much notice,” he notes. 

But that isn’t the only part that matters. 

Managing Additional Factors That May Impact Sleep

Dr. Howell also stresses that everyone needs to take stock of their health when it comes to sleep, including working with their doctor to determine if they may have an underlying sleep disorder like sleep apnea, insomnia or restless leg syndrome. 

“Patients need to address those conditions, as well as minimize other influences that can affect sleep like caffeine or alcohol consumption,” he says, noting that deficiencies in nutrients like iron or Vitamin D can also negatively impact sleep. 

“Challenges in those areas will also make managing sleep schedules with rotating shift work even harder,” he explains. 

Dr. Howell also advises that it’s important to have a healthy bedroom environment, one that is cool, dark and quiet. Ear plugs or eye masks can be helpful, he says, if they can accomplish that. He also advises to pay attention to what you are doing when you are awake. Get exercise every day, eat a diet high in protein and low in processed foods.  

The best thing Dr. Howell says someone who is going into shift work can do, though, is to come up with a plan to address potential impacts on sleep. He emphasizes that patients shouldn’t have to wait until they’re experiencing a problem to do something about it.

“If you’re already in it, though, and have trouble waking up refreshed, if you have trouble staying alert, especially if you have trouble driving, then you definitely need to go in and see a clinician,” he explains. 

Regularly seeing a primary care provider is usually the best place to start. They can help patients get the resources they need to improve their health all around, which might include seeing a sleep specialist like Dr. Howell.