By: Zahid Jadwat and Muskaan Ayesha
Working non-traditional hours, such as overnight, early morning, or rotating shifts, forces the body to operate against its natural 24-hour cycle, known as the circadian rhythm. This misalignment is a primary cause of shift work sleep disorder (SWSD), a condition affecting 10% to 40% of individuals in these roles. The disorder is characterised by insomnia, excessive sleepiness, and fatigue, which can severely impair daily functioning and overall well-being.
Michelle Baker, Chairperson of the Allied Group for the South Africa Society of Sleep, explains that every person has a natural propensity for sleep, whether as an “early bird or night owl.” She notes, “Shift work requires sleep at unusual times, disrupting this ‘blueprint’.”
This disruption interferes with the body’s internal clock, which primarily responds to light and dark cues to regulate sleep, hormone secretion, and metabolism. The immediate biological consequences include mood changes like anxiety and depression, gastric disturbances, headaches, and cognitive issues often described as “brain fog.”
SMread: Breaking the Stigma: Addiction as a Mental Health Issue
The broader health implications
The health risks associated with long-term shift work extend beyond sleep-related issues. Research links it to a higher prevalence of serious health problems. The constant battle against the body’s internal clock can lead to an increased risk of cardiovascular events, high blood pressure, digestive problems such as reflux and ulcers, and metabolic issues like weight gain and diabetes.
Studies also indicate that the disruption of melatonin and cortisol production can suppress the immune system, making workers more susceptible to common illnesses and even increasing the risk for certain types of cancer.
The mental health toll is also significant. Baker confirms that conditions such as depression and anxiety are common outcomes. The fatigue, difficulty concentrating, and mood disturbances associated with SWSD can lead to social avoidance and an overall decline in quality of life.
“Burnout is common in the trajectory of shift work,” Baker states, highlighting the cumulative effect of these challenges. The constant sleep deprivation and circadian disruption can also impair cognitive performance and alertness, increasing the risk of accidents both at work and during commutes.
One worker in food manufacturing described his experience of rotating shifts, where a single week could swing from nights to days:
“During the day it’s much easier because naturally you can sleep at night. But when I work afternoon or night shift, I usually get only about five hours of sleep. I get home around 2:30 am, and I’m up by 7 am. That’s tough for me and something I always struggle with. It interferes with my routine and I feel extremely exhausted most of the time.”
He shared how the lack of proper rest bleeds into every area of life:
“It’s extremely difficult to do other things like go to the gym or the shops, and it even affects relationships because if someone says, ‘Let’s do something,’ you don’t have the desire. The lack of sleep affects mental health. I get irritated, agitated, and even my self-esteem and anxiety are affected. People might say you can nap during the day, but sometimes I just lie there exhausted and still can’t fall asleep.”
This personal account echoes what researchers and clinicians have long observed: sleep disruption does not remain confined to the night but spills into emotional health, motivation, energy levels, and cognitive functioning.
SMread: Scream Therapy: A Quick Fix or a Long-Term Solution for Mental Health?
The small positives and support systems
Not all shift work experiences are bleak. For some, supportive environments and flexible schedules can make a difference. Gabisile, who works as a cashier at Uncle Faouzi, described both the challenges and benefits:
“Month-end we are usually more busy. During the week my shifts are 4 to 3, and weekends it’s 4 to 11. When I work morning shifts, I go to bed around 8 and wake up around 6. If it’s night shift, I’ll be up by 10. I feel tired and sleepy sometimes, but I love my sleep so it can never be enough.”
Still, workplace culture helped balance the strain:
“I like the staff in my work environment. We are family here, and our boss has our best interests, so it’s comfortable. There are good parts about both shifts. Day shift gives me evenings free, and night shift frees up my mornings.”
SMread: Your Place, Your Mind: How Environment Shapes Mental Health
Protecting workers’ health
To mitigate the impact of shift work, experts recommend a combination of personal strategies and employer support. For individuals, protecting sleep is paramount. This includes creating a dark, quiet environment for daytime rest, managing caffeine timing, and maintaining a consistent schedule where possible. Baker advises: “Protect and honour your sleep, exercise and social interaction as a priority. Get help if you need it ASAP.”
Employers, too, carry responsibility. Recommendations include predictable rotating schedules that minimise disruption, ensuring long breaks between shifts, and offering facilities like nap rooms. Providing education on sleep and fatigue management, along with wellness resources like onsite gyms and healthy meals, can help employees feel supported and healthier over time.
Shift work remains a reality for many industries, but as these stories and research show, its toll is very real. With awareness, adjustment, and support, the impact on health can be lessened, even if the body’s natural clock never fully adjusts.
Image: Labour Research Department
