One of the aspects of clinical medicine that many healthcare workers find challenging is shift work, particularly shift work that involves working overnight. Nearly one out of every five nurses who work night shifts develops shift work disorder (SWD) because of the chronic disruption they endure with regard to their sleep-wake cycle. Indeed, when circadian rhythms are thrown off by nontraditional schedules, several troubling symptoms can arise. For instance, SWD often involves drowsiness and excessive sleepiness, as well as changes in hormone levels, hunger, body temperature, and alertness. These symptoms can negatively impact not only work but also personal lives and have long-term harmful effects on physical health as well as mental health.
While lifestyle changes can help in the treatment of SWD, nurses and perhaps physicians, often are unable to overcome their symptoms while continuing their shift work. Researchers are therefore interested in other ways to improve SWD. A new study has shown that both cognitive behavioral therapy (CBT) and sleep hygiene interventions can help with insomnia that accompanies shift work.
For this study, researchers analyzed data from 83 shift workers. The study participants received either a sleep hygiene intervention, a CBT intervention with a group, or a self-help CBT intervention and were evaluated before, immediately after, and 6 months following their interventions.
The researchers found that all 3 types of interventions improved symptoms in shift workers. Specifically, the participants enjoyed improvements in perceived insomnia severity, restedness, recovery after working a shift, symptoms of burnout, and sleep-related dysfunctional beliefs. They also improved their total sleep time after these interventions, as measured through actigraphy. While there were no significant differences in the impact of the different sleep interventions, CBT seemed slightly more effective in improving symptoms related to mood.
Ongoing research should help to determine how to best overcome SWD and improve quality of life amongst those who want to continue shift work. A protocol has recently been proposed to evaluate the potential impact of acupuncture on nurses who work overnight. These data will improve our ability to empower healthcare workers to work overnight without suffering consequences to their health.
Jarnefelt, H. et al. (2020). Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting. Int Arch Occup Environ Health, 93(5), 535-550.
Ning, Y. et al. (2020). The fMRI study for acupuncture on shift work sleep disorder: Study protocol for a randomized controlled neuroimaging trial. Medicine (Baltimore), 99(36), e2068