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Home » Optimizing Sleep Timing for Night Shift Workers
RESEARCH UPDATE

Optimizing Sleep Timing for Night Shift Workers

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A man yawns in front of a flat-screen computer monitor

April 1, 2024
Xavier Preud’homme, MD
From The Carlat Psychotherapy Report
Issue Links: Editorial Information

Xavier Preud'homme, MD. Dr. Preud’homme has no financial relationships with companies related to this material.

SLEEP DISORDERS

REVIEW OF: Cheng WJ et al, Sleep, 2022;45(4):zsac034

STUDY TYPE: Randomized cross-over design

Learning Objectives

1. Identify the impact of sleep timing on sleep duration and quality in individuals with shift work disorder.

2. Recognize the effects of sleep timing on attention and daytime somnolence in individuals with shift work disorder.


Night shift work is an occupational hazard. One in five shift workers have problems with sleep, attention, and wakefulness that qualify for a diagnosis of shift work disorder. Management of this disorder involves appropriate timing of light and darkness, but no one has looked at the question of when sleep should occur. This study examined that issue by comparing morning sleep (ie, after the night shift) to evening sleep (ie, before the night shift) in people with shift work disorder.

Sixty adults were randomized to a morning (9 AM – 5 PM) or an evening (3 PM – 11 PM) sleep schedule for the first week of the intervention, crossing over to the other schedule for the second week (30 in each arm). The average age was 30 years; 80% were women; and 66% worked as night-shift nurses. The diagnosis of shift work disorder was made with ICSD-3 criteria and confirmed by a 14-day sleep log. Adherence to the protocol was monitored with daily sleep and actigraphy data. No participant used prescribed sleep aids or stimulants during the study period.

The evening sleep protocol resulted in a 30-minute longer duration of sleep (5.3 vs. 4.8 hours) as well as improvements in sleep quality and daytime somnolence throughout the week. Attention also improved, but only on the day after the first shift. The evening protocol was particularly effective for subjects with an evening chronotype (eg, “night owls”).

CARLAT TAKE

Ask your patients who work the night shift whether they sleep before or after their shift. If a later sleep schedule is compatible with their social and family life, start a conversation about the potential benefits of sleeping in the latter part of the day so they wake about an hour before their shift. 

Reference

Cheng, W. J., Hang, L. W., Kubo, T., Vanttola, P., & Huang, S. C. (2022). Impact of sleep timing on attention, sleepiness, and sleep quality among real-life night shift workers with shift work disorder: a cross-over clinical trial. Sleep, 45(4), zsac034. https://doi.org/10.1093/sleep/zsac034 

Editor’s note: This article appeared in The Carlat Psychotherapy Report under the title “A New Intervention for Shift Work Disorder.”

Psychology and Social Work Research Update
KEYWORDS circadian system sleep sleep disorders
    Xavier Preud’homme, MD

    A New Intervention for Shift-Work Disorder

    More from this author
    www.thecarlatreport.com
    Issue Date: July 18, 2024
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    Table Of Contents
    Psychotherapeutic Approaches to Anorexia Nervosa: A Primer
    Early Signs of Dropout Risk Identified in PTSD Treatment
    Social Anxiety Disorder: Diagnosis and Treatment
    Treating Bipolar Disorder With Interpersonal and Social Rhythm Therapy
    Four Evidence-Based Psychotherapies for PTSD
    Therapist Bonds Improve Loss-of-Control Eating
    Cognitive Remediation: A Game Changer for Clients with Mental Illness
    Dialectical Behavior Therapy for Adolescents
    The Psychotherapy of Avoidant Personalities: A Basic Overview
    Pharmacotherapy for Panic Disorder: What Therapists Need to Know
    Assessing Our Current Understanding of Therapy for Dreams and Nightmares
    Understanding Complex PTSD
    How You Can Use Positive Psychology in Your Practice
    Philosophy of Psychiatry: Key Essentials for Therapists
    Accelerated Experiential-Dynamic Psychotherapy: Special Considerations
    Optimizing Sleep Timing for Night Shift Workers
    When to Offer Advice in Psychotherapy
    Cognitive Behavioral Therapy for Psychosis: A Brief Review
    Understanding TMS: A Primer for Therapists
    Risk Factors for Adverse Childhood Experiences
    Metacognitive Therapy Shows Potential in Treating Schizophrenia
    Advances in Trauma-Focused CBT for Child Sexual Abuse
    CBT With Exposure and Response Prevention for OCD
    Navigating Narcissistic Personality Disorder
    Treating Severe Personality Disorders in Psychotherapy
    Introducing The Carlat Psychotherapy Report
    DBT and Social Rhythm Therapy: A Novel Combination
    Supportive Psychotherapy: An Underappreciated Yet Effective Treatment
    Is CBT Really All That Jazz for Depression?
    Understanding Borderline Personality Disorder: A Closer Look at Psychodynamic Approaches
    Mood Stabilizers in Bipolar Disorder: What Therapists Need to Know
    A Psychiatrist Reflects on Psychotherapy: An Interview with Allen Frances
    Psychological Benefits of Abstaining from Social Media
    The Psychodynamics of Psychopharmacology: Reimagining the “Med Check”
    Strategies for Treating Trauma in Intimate Partner Violence Survivors
    Using Self-Help Skills for Recovery: The WRAP Approach
    Motivational Interviewing: A Tool to Help Treat Substance Use Disorders
    How to Advise Clients About Light Therapy
    Using DBT Skills in Everyday Clinical Practice: An In-Depth Overview for Therapists
    Medications to Treat OCD: What Psychotherapists Need to Know
    Strategies for Managing Panic Disorder
    The WRAP Approach to Recovery: The Essentials
    Exploring the Complexities of Self-Harm Among Youth
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