Arguably one of the most important shifts, night shifts see many people working through normal sleeping hours to provide constant support in essential roles. However, night shift work has been linked to many health concerns, including a higher risk for vascular events, infections, metabolic disturbances, gastrointestinal problems, fertility issues, mood disorder and even some types of cancers. (1-4) 

Although this may appear worrying, there are, in fact, many ways in which you can support your body and health while working night shifts. Read our nutritionist’s top nine tips to support sleep and introduce healthy dietary and lifestyle habits: 

Sleep is governed by your circadian rhythm, an in-built mechanism which runs on a 24-hour clock, cycling between sleep and wakefulness. Shifting your wake phase forward, for example when transitioning from day shifts to night shifts, can leave the body out of sync and often lead to significantly less sleep, with chronic sleep deprivation linked to impairments in neurobehavioural performance. (1) Sleep deprivation may also increase risk of accidents when driving, with each hour of sleep lost considered almost three times as potent as one gram of alcohol per kilogram of body weight; that’s the equivalent of four shots for a person weighing 70 kilograms per hour of sleep lost. (1) With this in mind, the first three tips for night shift workers focus on sleep support.

The stimulating effects of caffeine can counteract feelings of sleepiness often experienced during night shifts. For maximum benefits, consider drinking small amounts of caffeine regularly at the start of a night shift (around 20mg of caffeine per hour) to enhance wakefulness (see image 1 to find out how much caffeine is in your drink). (5) Avoid caffeine for at least six hours prior to the end of your shift to balance the detrimental effects caffeine may have on sleep. (6) As it affects people differently, you may need to extend the 6h caffeine avoidance period if sleep is affected.

Caffeine can also have a diuretic effect and lead to dehydration. Ensuring ample consumption of electrolyte-containing fluids will support proper hydration while preventing the need for urination during sleep. Drinks containing electrolytes include tomato juice, orange juice and mineral water. Consider reducing your fluid intake during the last hours of your shift to avoid the need for urination while sleeping. 

Light is considered the most potent stimulus for resetting the body clock, important when changing shift patterns. (7) Benefit with maximum natural light exposure on waking and before the start of a night shift to signal the start of the day and improve night-time alertness. (8) Natural light is preferable, but if this is not possible, consider the use of a lightbox, such as Lumie Vitamin L. Intermittent exposure is thought to be sufficient to reset the body clock. (9)

The sleep hormone melatonin may be negatively affected by working night shifts, with night shift workers found to have lower concentrations of the hormone over a 24h period. (10) This may be due to both the exposure of bright lights during a shift, as well as exposure to daylight at the end of a shift. Counteract these effects by using blackout blinds or curtains in the bedroom and wearing sunglasses on your commute home. (8) Wearing blue light-blocking glasses towards the end of your shift may also improve sleep quality and melatonin levels. (11) 

Sleep is not only governed by the circadian rhythm, but also influenced by the pressure of sleep that builds up throughout the day. This refers to the rising levels of adenosine in areas of the brain that promote arousal, where it acts as an inhibitory neurotransmitter, inducing sleepiness at the end of the day. Especially when starting to work night shifts, this mechanism can cause sleepiness and may impact on work performance. Taking a short nap during your break could ease the transition from day shifts to night shifts as this has been shown to decrease sleepiness and improve performance. (12) For best results, consider taking your nap between 2-3am when your body is likely to expect its deepest sleep phase following a normal shift pattern, and for a period of 20-40 minutes.

Night shift work increases the risk of weight gain and obesity, as well as of gastrointestinal symptoms and peptic ulcer disease. (13-15) Therefore, knowing how to combine night shifts with maintaining a healthy diet is important for protecting overall health and nutritional status. Since working night shifts may make healthy eating more challenging, consider preparing food ahead of a shift pattern and make sure you have healthy snacks available at all times.

As working night shifts often disrupts normal eating habits, sticking to your normal day shift eating pattern will allow for more social interaction and opportunity to eat with your family. (17) Eating a hearty, balanced meal before the start of your shift provides energy for the evening, while consuming a small breakfast at the end of your shift prevents sleep disturbances from feeling hungry.

Night shifts are notorious for easily available unhealthy snacks, such as sugary and processed foods, which provide a false, short-term sense of energy. Since night shift workers tend to display decreased levels of leptin, the satiety hormone, you may also run the risk of over-eating. (18) Therefore, prepare healthy, low-GL snacks to consume throughout your shift to support a healthy waist line and sustain energy levels. It’s actually best to refrain from eating between midnight and 6am, when you are most likely to be sleeping on a day shift pattern. (16) 

Need some healthy snack inspiration? Try these: 

• Prepare chopped vegetables and fruit, which can be served with an array of dips, including: celery and cottage cheese, apple and hazelnut butter, snow peas and guacamole, or berries with Greek yoghurt topped with a handful of nuts and a couple of slices of dark chocolate if you need something sweeter
• Consider hearty vegetable and lentil soups to keep you warm and provide a nutrient-packed dish
• Prepare grilled meat (or halloumi) and vegetable kebabs with brown rice 

Research suggests that night shift workers may have an increased leukocyte count, a marker for inflammation associated with metabolic syndrome and a risk for cardiovascular events. (19) To protect your cells from free radical damage linked to circulating leukocytes, increase your antioxidant intake by consuming antioxidant-rich foods, such as green tea, berries, herbs and spices, cacao and beans.

While inflammation may increase risk for heart disease, the omega-3 fatty acid EPA is the pre-cursor to anti-inflammatory eicosanoids and considered cardio-protective. Supplement with a high-dose EPA fish or algae oil to reap the benefits. 

Night shifts are often considered anti-social but it is just as important to maintain healthy lifestyle practices during night shifts as it is during day shifts for both mental and physical health.

Considering that cardiovascular health may be at risk for night shift workers, research suggests that exercise can help. (20) Consider exercising before your shift, rather than after, to get the blood pumping, provide an energising effect and help shift the body clock. Exercising outdoors at the start of your shift will provide the added benefit of daylight exposure to reset your body clock. Alternatively, if you have regular breaks during your night shift, consider small, 10 minute bursts of exercise, which may be just as beneficial. (20).

The body has an in-build thermostat, leading to increases in core body temperature during the day and a reduction at night. Under normal circumstances, the body preserves energy during sleep with your core body temperature likely to be at its lowest between 2am and 6am. Make sure you wrap up warm during this time, and consider the use of a fan during the day while sleeping.

With the major impact night shifts have on your daily rhythm, the trick is to stick as closely to your normal routine as possible, using naps to help transition between night shifts and day shifts. (7) Nevertheless, an estimated 10% of the population will struggle to adapt to night shifts and experience chronic sleepiness and insomnia as a result. (1) If you are affected, talk to your occupational health team to discuss alternative arrangements.

1. Morrison, I., Flower, D., Hurley, J., MacFadyen, R.J. (2013). ‘Working the night shift: a necessary time for training or a risk to health and safety?’, Royal College of Physicians of Edinburgh, 43, pp. 230–5
2. Fossum, I.N., Bjorvatn, B., Waage, S., Palleson, S. (2013). ‘Effects of shift and night work in the offshore petroleum industry: a systematic review’, Industrial health, 51, (5), pp. 530-44. 
   
3. Vyas, M.V., et al. (2012). ‘Shift work and vascular events: systematic review and meta-analysis’, BMJ (Clinical research ed.), 26;345:e4800. doi: 10.1136/bmj.e4800. 
   
4. Mohren, D.C., Jansen, N.W., Kant, I.J., Galama, J., van den Brandt, P.A., Swaen, G.M. (2002). ‘Prevalence of common infections among employees in different work schedules’, Journal of occupational and environmental medicine, 44, (11), pp. 1003-11. 
   
5. Wyatt, J.K., Cajochen, C., Ritz-De Cecco, A., Czeisler, C.A., Dijk, D.J. (2004). ‘Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness’, Sleep, 27 (3), pp. 374-81 
   
6. Drake, C., Roehrs, T., Shambroom, J., Roth, T. (2013). ‘Caffeine Effects on Sleep Taken 0, 3, or 6 Hours before Going to Bed’, Journal of clinical sleep medicine, 9 (11), pp. 1195-1200. 
   
7. Mosendane, T., Mosendane, T., & Raal, F. J. (2008). ‘Shift work and its effects on the cardiovascular system’, Cardiovascular journal of Africa, 19 (4), 210–215. 
   
8. Yoon, I.Y., Jeong, D.U., Kwon, K.B., Kang, S.B., Song, B.G. (2002). ‘Bright light exposure at night and light attenuation in the morning improve adaptation of night shift workers', Sleep, 25 (3), pp. 351-6. 
   
9. Rimmer, D.W., et al. (2000). ‘Dynamic resetting of the human circadian pacemaker by intermittent bright light’, American journal of physiology, 279, (5), R1574-R1579 
   
10. Hunter, C.M. & Figueiro, M.G. (2017). ‘Measuring Light at Night and Melatonin Levels in Shift Workers: A Review of the Literature.’ Biological nursing for research, 19 (4), pp. 365-374. doi: 10.1177/1099800417714069. 
    
11. Ostrin, L.A., Abbott, K.S., & Queener, H.M. (2017). ‘Attenuation of short wavelengths alters sleep and the ipRGC pupil response’, Ophthalmic and physiological optics, 37, (4), pp. 440-450. 
    
12. Ruggiero, J.S., & Redeker, N.S. (2014). ‘Effects of napping on sleepiness and sleep-related performance deficits in night-shift workers: a systematic review’, Biological research for nursing, 16, (2), pp. 134-42. 
    
13. Sun, M., Feng, W., Wang, F., et al. (2017). ‘Meta‐analysis on shift work and risks of specific obesity types’, Obesity reviews, 19, (1), pp. 28-40. 
    
14. Amani, R., & Gill, T. (2013). ‘Shiftworking, nutrition and obesity: implications for workforce health- a systematic review', Asia Pacific journal of clinical nutrition, 22, (4), pp. 505-15.
15. Knutsson, A., Bøggild, H. (2010) ‘Gastrointestinal disorders among shift workers’, Scandinavian Journal of Work, Environment and Health, 36, (2), pp. 85-95 
    
16.  Lowden. A., Moreno, C., Holmbäck, U., Lennernäs, M., Tucker, P. (2010). ‘Eating and shift work – effects on habits, metabolism and performance’, Scandinavian Journal of Work, Environment and Health, 36, (2), pp.150-162 
    
17. Atkinson, G., Fullick, S., Grindey, C,. Maclaren, D. (2008). ‘Exercise, energy balance and the shift worker’, Sports Medicine, 38, (8), pp. 671-85. 
    
18. Longo, V. D., & Panda, S. (2016). ‘Fasting, Circadian Rhythms, and Time-Restricted Feeding in Healthy Lifespan’, Cell metabolism, 23, (6), pp. 1048–1059. 
    
19. Sookoian, S., Gemma, C., Fernández Gianotti, T., Burgueño, A., Alvarez, A., González, C.D., Pirola, C.J. (2007). ‘Effects of rotating shift work on biomarkers of metabolic syndrome and inflammation’, Journal of internal medicine, 261, (3), pp. 285-292. 
    
20. Lim, S.T., Min, S.K., Kwon, Y.C., Park, S.K., Park, H. (2015). ‘Effects of intermittent exercise on biomarkers of cardiovascular risk in night shift workers’, Atherosclerosis, 242, (1), pp. 186-90