Why Am I Always Tired? A Shift Worker's Checklist

I have worked shifts for 40 years: The King's Regiment from 1986 to 1989, then Jacobs Biscuits, HM Prison Service at Strangeways, Walton and Guys Marsh, and Budweiser UK. For a lot of those years I ran on empty and thought that was just the price of the job. It isn't, or at least not all of it. Most of the tiredness I carried came from a handful of habits I could change.

In my experience of working almost every shift pattern possible, I always felt most tired on 4 on 4 off, which included two day shifts followed by two night shifts. My body just never settled into its circadian pattern, and by the end of the last night shift, I was always tired.

This checklist is the one I wish someone had handed me. It is not a diagnosis. It is a practical way to find which part of your shift life is draining you, starting with the most common culprits.

Why am I always tired when I work shifts?

Shift work asks your body to sleep when it expects to be awake and to work when it expects to sleep. That alone makes daytime sleep shorter and lighter for most people. Add a rota that changes every few days, an energy drink at 3am, a drink to unwind after the shift and a bedroom full of daylight and traffic, and the tiredness stacks up.

The good news is that each of those is something you can check. You will rarely fix everything, but fixing two or three usually makes a clear difference.

The 8-point shift fatigue checklist

1. Are you getting 7-8 hours in every 24? The HSE says most adults need 7-8 hours of sleep a day. Add up your real sleep, including naps, across a whole block, not just your best day. If you are regularly on 5 or 6 hours, start here. My guide Is 6 Hours of Sleep Enough? goes deeper.
2. Is your body clock being pulled back and forth? Rotating rotas and flipping back to days on your rest days keep your body clock unsettled. I know how it feels to get up early after your last night shift to make the most of your day off, then hit that dreaded jet-lag feeling by the afternoon. UK clocks go back this weekend, on Sunday 25 October, so anyone on nights that night works an extra hour and the next day's body clock feels it too. See how to fix your sleep schedule after a block of nights.
3. When is your last caffeine? It's 3 o'clock in the morning and you hit that wall. No amount of coffee or Red Bull really helps, but you drink it anyway, then pay for it when you get home and lie there wired. The HSE advises using caffeine only occasionally and not relying on it to keep you awake. My caffeine cut-off guide shows when to stop for your bedtime.
4. Is the after-shift drink your "me time"? For a day worker, the evening is their time. After nights, a drink in the morning can feel like the same thing. I've been there, and I paid for it later at 2am on the next shift. The HSE advises avoiding alcohol because it lowers the quality of sleep.
5. Is your bedroom dark enough? Daylight leaking round a curtain is enough to keep sleep light. The HSE suggests heavy curtains, blackout blinds or eye shades. My comparison of blackout blinds and blackout curtains covers the cheap fixes.
6. Is noise breaking your sleep? Even on a quiet street, cars and kids playing out can keep you wide awake when all you want to do is sleep. The HSE suggests telling close neighbours your sleep times, and using earplugs, white noise or background music to mask outside noise. Start with earplugs for sleeping and a steady sound such as brown noise.
7. What, and when, are you eating? The HSE says regular light meals or snacks are less likely to cause drowsiness than a single heavy meal. A big plate at 3am is a fast way to feel worse at 4am.
8. Are you moving at the right time? The HSE suggests moderate exercise before a shift to help alertness, and avoiding vigorous exercise just before sleep because it raises your body temperature.

Which checklist point should you start with?

Use your main complaint to pick a starting point.

How does short sleep build up without you noticing?

Short sleep adds up, and you are a poor judge of how much it is costing you. In a 2003 study published in the journal SLEEP, Van Dongen and colleagues put 48 healthy adults aged 21 to 38 on 4, 6 or 8 hours in bed a night for 14 days. Restricting sleep to 6 hours or less produced thinking and reaction deficits equivalent to up to 2 nights without any sleep at all.

The part every shift worker should remember: the participants were largely unaware of how impaired they had become. Their sleepiness ratings rose at first, then levelled off, while their performance kept getting worse.

That matches what I've seen on every rota I've worked. By the third or fourth night, people say they feel "fine" because they have got used to the feeling. A lie-in on your days off helps, but it doesn't wipe the slate clean, which I cover in Can You Catch Up on Sleep?

Why is shift fatigue a safety issue, not just a feeling?

The HSE describes fatigue as a decline in mental or physical performance that results from prolonged exertion, and links it to excessive working time and poorly designed shift patterns. More than 3.5 million people work shifts in the UK.

The HSE says fatigue is said to cost the UK £115-240 million a year in work accidents alone, and that it has been implicated in 20% of accidents on major roads. That last figure is the one that matters most after a night shift, because the drive home is when many of us are at our lowest.

The HSE's advice for shift workers is plain: if you feel sleepy while driving, stop and take a short nap if it is safe to do so, and consider public transport or a taxi instead of driving. My guide to microsleep and the drive home explains the warning signs.

I always needed to pull over for a nap of around 15 minutes on the Rainford bypass when driving home after night shifts at Budweiser. Without that recharge, I would never have made it home safely. If you feel tired, pull over and take a nap. It's simply not worth the risk of driving tired, for the sake of 15 minutes' rest.

When should you speak to your GP?

This checklist covers lifestyle and rota habits. It can't rule anything else out. If tiredness lasts for weeks despite good sleep, see your GP. Do the same if you still feel exhausted after several rest days of proper sleep, or if the tiredness is getting worse rather than better.

It helps to take a simple record with you: your shift pattern, roughly when and how long you slept each day, and your caffeine and alcohol. If your employer has an occupational health service, it may also be able to look at your rota with you.

The bottom line

Always feeling tired on shifts is common, but it isn't something you just have to live with. Work through the checklist, fix the two or three points that apply to you, and give it a full block before you judge the result. Check how your rota is affecting you with the Sleep Atlas Score and log your real hours in the Sleep Debt & Fatigue Logger.

Then protect the sleep you do get. Sleyp is a free sleep-sounds player built for day sleepers: 13 sounds, a custom timer and a wake-up chime, all free in your browser. Keep the page open while you sleep so the timer and chime can run. Try Sleyp free. The Sleyp iOS app is coming soon.

More in this series: shift patterns explained · 4 on 4 off shift pattern · continental shift pattern · fixing your sleep schedule after nights · can you catch up on sleep? · night shift survival guide · how to sleep during the day

Sources

• Van Dongen et al. (2003), The cumulative cost of additional wakefulness, SLEEP 26(2)
• Health and Safety Executive: Human factors, fatigue
• Health and Safety Executive: Hints and tips for shift workers