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The question: I recently started a new job that requires me to work shifts; I am constantly exhausted, and can't seem to get my sleep under control. I don't want to take medications as I'm worried I will become addicted. What can I do?

The answer: Edgar Watson Howe summed it up well when he made the statement that "there is only one thing people like that is good for them; a good night's sleep."

Sleep is a core physiological function and impacts so many important areas of our life: our energy, appetite, motivation, attention/concentration, how efficient we are at work, and even our mood.

Unfortunately, up to one-third of Canadian adults will struggle with ongoing, chronic sleep difficulties – and the proportion is even higher among shift workers.

I am happy to hear that you have reservations about taking sleeping medications; the class of prescription medications that assist with sleep can be very luring, yet are highly addictive, and people often quickly develop tolerance toward them (requiring higher amounts of the medication to achieve beneficial results). Many individuals will also experience rebound insomnia, where sleep problems after medication cessation become worse than they were prior to starting the medications. Importantly, most sleep aids should only be taken for short windows of time such as five to 10 days.

Disturbed sleep is the most commonly reported health side effect of shift work. Shift workers are the highest risk population for sleep problems given that they are operating against environmental clues that reset our internal biological clocks on a daily basis (e.g., light, meal times). As such, it is particularly important for shift workers to pay attention to strategies and tips that can help them improve their sleep.

  • Given the importance of light in impacting our sleep/wake cycle, it is important to decrease light when shifts are complete and it is time to sleep (e.g., wear sunglasses when heading home from work, have black-out blinds in your bedroom), and increase light when it is time to work and be alert (e.g., 15 to 20 minutes exposure to a light box can be of benefit).
  • Develop a pre-bedtime ritual (e.g., read the paper, take a warm bath). Let yourself unwind from your shift.
  • Restrict your bedroom environment for sleeping only. Do not watch TV or read in bed.
  • Schedule short naps (30 to 45 minutes maximum) before evening shifts to increase alertness. If possible, see if your workplace will allow you to build in scheduled naps (many employers are increasingly recognizing the importance of this).
  • Speak to your boss about having less frequent shift rotations (e.g., work a shift for two weeks rather than rotating to a different schedule every couple of days). This allows the body to gain some consistency in sleep patterns. And, if possible, see if you are able to sequence work shifts in a clockwise fashion (e.g., day – evening – night) as this facilitates a more normal sleep pattern.

Behavioural strategies do work, but the key is this: You need to implement these strategies for several weeks or longer to experience the beneficial results. So don't give up, and good luck.

Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network's Million Dollar Neighbourhood and is the psychological consultant to CITY-TV's The Bachelor Canada. Her website is www.drjotisamra.com and she can be followed @drjotisamra .

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