Help Me Make it Through the Night (Shift)

Laura A. Stokowski, RN, MS

Disclosures

January 24, 2012

In This Article

A Good Day's Sleep

The other significant health risk comes from the nature of sleep itself when one works at night and sleeps during the day. Fatigue in night-shift workers is the result of a classic one-two punch: shorter duration and poorer quality of sleep. Daytime sleep is more fragmented and less restorative than nighttime sleep. Night workers are not only deprived of more restful sleep, their sleep deprivation is compounded by sleep loss that builds over successive shifts because their sleep times are shorter, often by 1-4 hours, compared with night sleepers.[22] This results in a cumulative "sleep debt" and feelings of chronic fatigue that can't easily be erased with "catch-up" sleep.[23]

More than half of night-shift nurses (56%) in a study using sleep diaries were found to be sleep-deprived.[24]Night nurses more often report low-quality sleep and are more likely to use medication to get to sleep.[25]Those who work long stretches or more than 4 shifts per week are more likely to report sleep disturbances.

To make matters worse, many night-shift workers are already sleep-deprived on their first shift. This is a consequence of the tendency to switch back to a "normal" (day) schedule on their days off, so that many nurses rise early on their first work day, go to work that night, and end up staying awake for up to 24 hours or longer.

Sleep expert Ann Rogers differentiates between "fatigue" and "sleepiness." Sleepiness is a tendency to fall asleep, whereas fatigue is an overwhelming sense of tiredness, lack of energy, and exhaustion.[26] Both affect night workers. Night-shift nurses report struggling to stay awake during their shifts, and studies show that nurses do, indeed, regularly fall asleep for brief periods during the night shift or in the car on the way home in the morning.[27,28] Fatigue, on the other hand, is associated with impaired physical and cognitive functioning[26] and contributes to the increased tendency for errors.

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