How Shift Work Affects Your Mental Health & What You Can Do

Although there are many different types of nurses, most nurses do some kind of shift work, usually in a hospital, long-term care facility, or skilled nursing facility. Because of this, and the hectic healthcare environments in these facilities, mental health problems and burnout in nurses is increasingly common. While issues like the COVID-19 pandemic and a long-standing nursing shortage are often blamed for these problems, studies show that classic nurse burnout symptoms such as fatigue and depression have long been associated with shift work. 

By understanding how shift work affects your mental health, there are some things you can do to minimize the havoc that shift work can wreak on your body and emotions.

How shift work affects the brain

There’s no doubt about it—working the night shift can take a toll on your brain. A 2019 study found that people who work night shifts over a period of time had “impaired working memory, processing speed and cognitive flexibility after a night shift, and more operational errors, occupational accidents and injuries, as compared to day shift workers…” Researchers believe these problems occur because night shift work disrupts the body's natural sleep patterns, also known as circadian rhythms.

When you don't get enough sleep, it can make it difficult to focus and concentrate. It can also make it hard to make decisions and solve problems. In addition, research has shown that working the night shift can increase your risk of developing depression and other mental health issues.

How does night shift affect women?

Working night shifts can have a significant impact on women, both physically and emotionally. According to research, “Some studies have found that shift work impacts women's sleep, fatigue, and certain other aspects of their well-being more negatively than it does men.” 

Night shifts can disrupt the body's natural sleep-wake cycle and hormones leading to fatigue and an increased risk for many chronic health problems. 

1. Fatigue and/or Lack of Energy

Working the night shift can be tough on the body, causing interrupted sleep patterns and disruption of the natural circadian rhythm. That’s because the brain releases melatonin when it’s dark at night causing you to become drowsy and fall asleep. 

During the day or when lights are on, a person produces less melatonin and therefore has difficulty falling asleep or staying asleep which results in fatigue when the person wakes up. The result is having less energy throughout the day.

2. Insomnia

Insomnia and excessive drowsiness that lasts for at least 3 months in conjunction with rotating shift work schedules are symptoms of shift work sleep disorder. These sleep disruptions are thought to be caused by decreases in the levels of dopamine, serotonin, and noradrenaline because of disruptions to one’s normal circadian rhythm (light/dark sleep cycle).

3. Difficulty Concentrating

Not surprisingly, shift work can also make it hard to concentrate. If you’ve ever found yourself zoning out in front of the TV or computer in your uniform after work, you know what I mean. You plan to watch some of your favorite Netflix shows and half an hour later, you find yourself in the present and don’t remember anything you’ve been watching. Or you arrive home after a long shift, pop something in the microwave to eat because you’re starving, and then find it in there the next morning because you forgot about it.

The research is clear. Shiftwork and long shifts take a toll on not only your body but also your brain. If you’re also finding it difficult to sleep or get quality sleep, concentrating will be even harder when you’re awake.

4. Obesity

Shift work can cause a domino effect that starts with sleep deprivation that then cascades into a number of nasty health problems. 

Obesity is a common health problem for female shift workers. This is because lack of sleep results in a drop in leptin (a hormone that suppresses appetite), and a subsequent rise in ghrelin (a hormone that triggers hunger). This can cause you to feel like a tired, ravenous fiend, with hunger and exhaustion driving you to reach for foods loaded in sugar, salt, and carbs. 

5. Weaker Immune System

Shift work can also mess with your immune system. Blood sample studies of healthcare workers who work night shifts and those who recently worked a night shift show higher numbers of monocytes and T-cells than day shift workers have. This shows that night shift work alters the immune response of night shift workers.

Likewise, healthcare workers (like nurses) who work the night shift are more likely to test positive for COVID-19 than their day working counterparts which suggests that people who work night shifts have a greater susceptibility to infection.

6. Headaches

A common complaint among shift workers is headaches, especially cluster headaches. These headaches are often caused by disruptions in circadian rhythms, which control when we feel tired and when we feel alert. When our body doesn't experience consistent sleep patterns, it can lead to tension headaches or migraines. 

As if that weren't enough, shift workers also tend to skimp on healthy habits like exercise, nutrition, and proper hydration due to fatigue and busy schedules, leading to further discomfort and headaches. Drinking too much coffee to try and stay awake and alert can also contribute to headaches in shift workers.

7. Fertility Problems

Most internal body processes, including fertility, follow a circadian rhythm, a roughly 24-hour cycle regulated by hormones and other factors. This rhythm can be disrupted by shift work, particularly for women who work rotating shifts or night shifts. 

Studies show that working night shifts can impact women’s reproductive health by disrupting hormones and potentially causing fertility issues. Women who do this type of shift work are more likely to experience difficulties conceiving and carrying a pregnancy to term. In fact, hormonal imbalances, heightened stress levels, and reduced sleep can all contribute to fertility problems in female shift workers.

8. Chronic Health Problems 

Shift work can have a major impact on our bodily functions and overall health as nurses, including increased risk for chronic inflammation-related health issues such as diabetes, heart disease, digestive problems, and even cancer. Again, this is because shift work disrupts our natural sleep and eating patterns, causing chronic stress that can contribute to inflammation. 

In addition, shift workers often have less access to healthy food options at work and less time or energy for exercise and other forms of self-care. These factors all contribute to the increased risk for health problems related to inflammation related to shift work.

9. Depression

A growing body of research suggests that shift work can also contribute to mental health issues such as depression. “Research suggests that shift workers may be as much as 33% more likely to have depression than those working a regular daytime schedule.” This may be due to the fact that those who work night shifts have “significantly lower levels of serotonin” which is associated with depression, anxiety, and anger. 

Depression in those who work shift work may also be due to disruptive sleep patterns and lack of regular social interaction. Not surprisingly, constantly changing schedules can make it difficult for individuals to establish healthy routines and cope with stress. 

10. Anxiety

When it comes to our daily routines, humans are creatures of habit. We thrive on schedules and routines because they give us a sense of predictability and stability. When these routines are disrupted, like they are with shift work, it can cause feelings of stress and anxiety. Shift work disrupts this natural routine and leads to difficulties falling asleep and excessive fatigue during waking hours.

As mentioned above, those who work shift work often have lower levels of serotonin as well which can result in anxiety.

11. Irritability & Low Mood

Another side effect of shift work is irritability and low mood. This can occur when our internal clock is repeatedly disrupted by constantly changing work schedules, resulting in fatigue, difficulty concentrating, and overall dissatisfaction with life. People who work night shifts also miss out on social opportunities and may not get enough time to exercise or spend time with loved ones, all of which can contribute to negative emotions. 

12. Family & Relationship Conflicts

Women who work night shifts also face challenges with balancing work and family life, as children or other family members may need care during traditional daytime hours. Although child care and other responsibilities are increasingly shared now between both partners, the majority of these responsibilities still fall on the shoulders of women.

What can you do to reduce the negative effects of shift work?

Although shift work can be challenging sometimes, we knew it was part of the profession when we became nurses. Knowing this, here are some ways to manage it and make shift work work for you.

1. Set up an optimal sleep environment

Your brain’s main cue to sleep is darkness. Find some blackout blinds or even stuff tinfoil or cardboard cut to size into your bedroom window so you can make your sleep space as dark as possible. A sleep mask from your local dollar store will also work.

Noise or extraneous sounds can also interfere with your sleep. So, consider using some earplugs and a source of white noise such as a portable fan to drown out environmental noise that might rouse you from your much-needed sleep.

Also, avoid sources of blue light at least an hour before you go to bed. This includes most portable devices such as your phone and tablet as well as computers and TVs. You can also use blue light blocking glasses or try one of the blue light blocking apps if you can’t seem to put your phone down just before you go to sleep.

2. Limit caffeine and alcohol intake

Studies show that it’s best to avoid caffeine intake at least 6 hours before you plan to sleep. And while alcohol may help you chill out and make you drowsy initially, it can interfere with deeper levels of REM sleep needed for cellular growth and repair.

3. Look for work with flexible scheduling

One of the best things you can do to protect your health and minimize the negative effects of shift work is look for nursing jobs with flexible hours. Being tied to a rotation of shift work that’s dragging you down is a recipe for not only burnout but poor health as well. 

Nursing jobs with flexible schedules are increasingly common through nursing agencies and increasingly popular platforms like connectRN. Per diem nursing jobs are another great option because you can pick and choose what days, shifts, or length of contract you want to work. 

Also, look for employers who offer self scheduling for nurses. Having the ability to schedule shifts that work best for you can help you organize your work around the times when you know you sleep best.

4. Inform your family & friends about your sleep schedule

There’s a reason why we need to sleep for approximately one third of every day or we struggle to function properly. You need to protect your sleep schedule as a nurse working shift work which means telling your family and friends when you’ll have your phone off and won’t be responding to messages.

5. Do some physical activity or exercise regularly

You don’t need a gym membership or have to do any weight lifting if you don’t want to. Simply go outside for a walk so you can get some fresh air and clear your mind in nature. It will do wonders for not only reducing depression and anxiety but it will also help you sleep better.

By knowing how shift work can affect your mental health and how you can minimize its negative effects, you’ll be able to ensure you thrive as a nurse doing what you love.