Q: I have an irregular work schedule. Sometimes I'm called in early in the morning, and sometimes it's late at night. How do I make sure I get the sleep I need to perform at my best?

Shift work consists of any work schedule that falls outside of the traditional 9-5 day. Our bodies are programmed through circadian rhythms to be asleep at night and awake during the day. When people start playing around with these times (especially working before 6:30am or starting work after 4:30pm), our circadian rhythms lose their normal timing and they become at risk for developing shift work sleep disorder (SWSD). SWSD consists of insomnia or excessive sleepiness, and working during the "off" hours can become extremely difficult. Oftentimes, those with SWSD can suffer from headaches, trouble concentrating, weight gain, and fatigue.

Not every shift worker develops SWSD, but if you notice some of the above symptoms, you should consider seeking treatment as it puts patients at greater risk for poor work efficiency, reduced attention and concentration, irritability, and car and work accidents.

Regardless of whether or not you have SWSD, working hours that are "off" from the typical 9-5 day can lead to sleep deprivation. As a result, attempting to gain some regularity with sleep is extremely beneficial. Creativity is key when dealing with shift work.

1. As best you can, try to commit to a steady sleep-wake schedule seven days a week,  and don't sleep in on the days when you don't need to go to work until later or have off. If an extended 7 or 8 hour sleep period daily is impossible, experiment with two 3 to 4 hour sleep episodes during the day, with a more "normal" 7 or 8 hour sleep period on the days off.

2. Though admittedly not always possible, try to avoid any extended or overtime shifts. If you work rotating shifts, attempt to have them scheduled in a clockwise direction. This will enable you to delay your work schedule later and later each shift. This is much easier on the body than jumping around from early shifts to late shifts that often rotate.

3. Whenever you set aside specific times for sleep, make sure to protect them for that sole purpose. Limit any phone calls, housework, errands, and meetings. Have family and friends help out to ensure your sleep time is uninterrupted. Keep your bedroom quiet, dark (use blackout shades), and cool. A white noise machine can be beneficial if you have to sleep during daytime hours. If you are unable to sleep, get out of bed, do something relaxing and return to bed only when sleepy. However, still try to maintain the consistent wake time that you have set every day.

4. Brief naps can also be helpful. It's best to schedule them at the same time of day if necessary. Naps can be taken before work and, if allowed, during the earlier part of the shift to help with excessive sleepiness. If you find that you have difficulty driving home, take a short nap before leaving work. Caffeine is also useful, but should not be consumed as it gets closer to your bedtime.

If you find that you still have difficulty obtaining quality sleep during your off hours, consider seeking treatment with a sleep specialist. Cognitive behavior therapy for insomnia (a very effective, behavioral, non-drug approach to insomnia treatment) may be indicated in addition to shift work treatments. Other treatment options may include bright light therapy. In addition, certain medications can help promote wakefulness during work hours, whereas sleeping pills may help patients gain a better night's sleep.


Shelby Freedman Harris, Psy.D., C.BSM is Director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center at Montefiore Medical Center and Assistant Professor of Neurology as well as Psychiatry at the Albert Einstein College of Medicine. She is board certified in Behavioral Sleep Medicine by the American Academy of Sleep Medicine. A graduate of Brown University, Dr. Harris received her doctorate in clinical psychology from Ferkauf Graduate School of Psychology, Yeshiva University. Dr. Harris completed her predoctoral internship at Montefiore Medical Center where she trained in the Sleep-Wake Disorders Center, and has received advanced postdoctoral training in Cognitive Behavior Therapy (CBT) for anxiety and depressive disorders.

As a licensed psychologist, Dr. Harris specializes in behavioral sleep medicine and CBT for anxiety and depression. She has published and presented research on the neuropsychological effects of insomnia in older adults as well as behavioral treatments for insomnia, parasomnias, narcolepsy and excessive daytime sleepiness. Dr. Harris currently supervises students from the Montefiore Psychology Internship, Ferkauf Graduate School of Psychology Cognitive Behavior Therapy Program and the Sleep-Wake Disorders Center Fellowship. Dr. Harris is a consultant for the
New York Times "Consults Blog" and is frequently quoted in the media, including The New York Times "Well Blog", The Huffington Post, The New Yorker, Wall Street Journal, Cosmopolitan, and Fitness Magazine. She has appeared on ABC7-NY's Eyewitness News and ABC's Primetime: Live.