Shift work and insomnia

Q:  “I work a swing shift, 4:30 to 1:00 a.m., and have had insomnia for several months now.  Nothing I try seems to be working.  I worry myself sick about not sleeping.  My bed time varies, but I always try to awaken at 10 a.m. consistently.   Now I’m scared I may have fatal familial insomnia.   What can I do?”

First, regarding fatal familial insomnia (FFI), this is very likely an inaccurate, overblown worry without basis.  FFI is genetic and extremely rare.  There is virtually no chance you have it unless you are a direct descendent of someone who has.  And you would undoubtedly know if you did.  So if you are not, then this is one worry you can legitimately cross off your list.

So presuming you have no medical or psychiatric issues causing insomnia — and it’s important to have a checkup to rule this out — then you might begin by looking at thoughts and behaviors.  That’s typically what causes insomnia when there’s no other identifiable basis.

At the very least, it sounds like you do have a lot of negative sleep thoughts. This, at a minimum, is helping to fuel your sleep problems.  In other words, worry about sleep is keeping you up.

Imagine if you could wave a magic wand and instantly get rid of all those negative thoughts, all that worry about FFI, and so on.  Poof, it goes away.  Just imagine the weight that would be lifted off your shoulders.

Now imagine you replaced all that worry with a positive view of sleep.  An expectation that you will sleep solidly and awaken refreshed, every day.

Unfortunately, there is no such thing as a magic wand.  But there are proven ways to do this.  You can reduce negative thinking and replace those thoughts with better, more accurate, and more supportive thoughts for better sleep.  It’s part of cognitive behavioral therapy (CBT) for insomnia.  And it works.

You may also have some behavioral and environmental issues that are keeping you up. These could range from too much caffeine to a snoring bed partner to a bedroom environment that’s too hot for good sleep.  CBT can help you assess all this as well.

Your consistent wake-up time is good.  You might help yourself further by establishing a consistent bed time as well.  It’s possible you’re not sleeping well because you’re allowing too much time in bed.

Most adults need between 7 and 9 hours of sleep.  You should only allow the minimum time you need.  Since you’re having trouble, you might start going to bed no later than 3 a.m. consistently, and awakening at 10 a.m. That gives you 7 hours in bed.  You might try that for a week or two and see what happens.

You can cut that back even further, but many sleep experts say do not go under 5.5 hours unless you are under the supervision of a health care professional who is knowledgeable about sleep.

The idea is to rev up your sleep drive. By only allowing yourself the minimum time in bed, you might produce more robust sleep.

A good CBT-based sleep training system will give you the tools you need, such as logs to accurately track each night’s sleep experience, to help you find your optimal sleep schedule.

Your shift work schedule also presents challenges — to your natural circadian rhythm. It’s important for you to try to mimic a more normal day-night pattern.  It’s a good idea to expose yourself to bright light immediately upon awakening, which should be easy at 10 a.m.  Then, for at least an hour before your bedtime, try to be in subdued lighting, and try to engage in some sort of a consistently relaxing pre-bed routine.  Not too relaxing, you don’t want to fall asleep before you actually get into bed at 3.  Doing all of this might help you.

For your best overall solution, we encourage you to first get a check up with your doctor.  You want to either treat or rule out any medical basis.  Then look into a CBT-based sleep training system.  It might just be a lasting solution for you, as it has been for many people.

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One Comment on “Shift work and insomnia”


  1. […] might help you even if you sleep during some daylight hours and work during some nightime hours.  Shift work is very challenging for sleep, but in general a better strategy might be going for the most […]


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