Shift workers see fatigue as inevitable, face 'soldier through' culture

A recent systemic review of 28 eligible studies involving 1519 participants looked at shift workers’ experiences of fatigue, healthy behaviours and sleep disturbance. Typically defined as any work schedule outside standard daytime hours — including early morning, evening, night and rotating shifts — shift work is common across many industries and poses significant risks to the health of shift workers; risks that are due, in part, to the disruption of healthy sleep-wake schedules.

Themes

Through their review, the researchers generated three analytical themes:

1. Inevitability of fatigue and tiredness
2. Balancing sleep needs with competing responsibilities
3. Obstacles to engaging in healthy behaviours

Through the first theme, the researchers outlined how, regardless of fatigue, shift workers experience a culture where they feel “peer pressure to soldier through” their shifts. “This perception of fatigue as normal, combined with the belief that admitting and discussing fatigue within the workplace shows weakness and a lack of camaraderie, appeared to perpetuate a detrimental workplace culture in which fatigue remains unacknowledged and untreated,” the researchers wrote. “As a result, many workers expressed the belief that fatigue is something they must silently accept and endure rather than to seek support for.”

The second theme highlighted how shift workers struggle to balance the need for daytime sleep with family, leisure and work responsibilities — where family needs are often prioritised over their own sleep. In the third, the researchers describe how, while shift workers often know which actions would benefit their health and reduce fatigue, they find it challenging — due to fatiguing and stressful work — to translate this knowledge into behaviour.

Conclusions

“This qualitative evidence synthesis found that shift workers perceive fatigue as inevitable and experience a workplace culture where fatigue remains unacknowledged, they struggle to balance daytime sleep with competing responsibilities, and they find it difficult to implement behaviors that would reduce fatigue and benefit their sleep and health,” the researchers said in their concluding remarks.

“Behavioral sleep interventions should support shift workers to self-regulate their behavior, thoughts and emotions in fatiguing and stressful work environments, and provide behavioral and psychological support in addition to sleep education.”

The review, titled ‘Shift workers’ experiences and views of sleep disturbance, fatigue and healthy behaviours: a systematic review and qualitative evidence synthesis’ was published open access in Scandinavian Journal of Work, Environment and Health in July. You can read it here.

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