Sleepio for shift workers

Image of Dr Sophie Bostock
by Dr Sophie Bostock

The Sleepio program is based on Cognitive Behavioral Therapy for Insomnia, or ‘CBTi’ for short. CBTi consists of proven strategies to address the cognitive (or thought-related) and behavioral (lifestyle and schedule-related) reasons that lead to being unable to sleep.

Sleep improvement techniques for all
All the cognitive tools and techniques in the program, such as those to tackle the ‘racing mind’, will be useful for everyone who is worried about getting enough sleep. Relaxation techniques such as Autogenic training and Mindfulness can help you get to sleep at any time of day or night. Lifestyle advice about the role of exercise and alcohol, for example, will be relevant to everyone, regardless of what time they go to sleep.

Adaptations for shift workers
Sleepio also includes a daily Sleep Diary and scheduling tool. These were designed to help long term poor sleepers adopt regular sleep and wake routines. These tools assume that you can choose what time you go to sleep at night, so are less relevant to shift workers. Below we suggest some simple adaptations you can make in order to track your progress.

Many shift workers have successfully completed the program. Sleepio’s ‘Graduates’ often share tips and advice on Sleepio’s online community. If you’d like help with personalizing the Sleepio program, we highly recommend asking questions in the Shift Work discussion, or joining the weekly sleep expert session.

Session by session advice on adapting Sleepio for shift workers

Sleep Test
The program starts with a detailed questionnaire about your typical sleep patterns over the last 2-4 weeks. This can be hard to answer when sleep is heavily dependent on your shifts. If possible, take a mental ‘average’ of your recent sleep pattern. Alternatively, choose your most common shift pattern, or your typical rest day schedule. The important thing is that you can compare your progress over time, so keep a note of the reference schedule you have used to answer these questions.

Core Session 1: Sleep Efficiency adaptation
The Prof will calculate your Sleep Efficiency, the proportion of time in bed you spend asleep. The Sleep Diary assumes that you sleep in one block during the night. If you typically sleep in two or more blocks (such as a post-shift 4hr sleep, and a pre-shift 3-hr nap) add the combined blocks of time together when you complete the diary. Although the clock time you go to sleep will be inaccurate, you will still be able to track your total hours of sleep time, and Sleep Efficiency over time.

Core Session 2
Progressive muscle relaxation will be a useful tool to help you get to sleep at any time of day or night. Sleep hygiene or lifestyle advice is all relevant for shift workers.

Core Session 3
Poor sleepers are advised to strengthen the bed-sleep connection by getting out of bed if they cannot sleep for 15 minutes or more. If you can’t sleep during the day after a night shift, it’s important to avoid moving into full daylight if you intend to try and go back to sleep, since light is a strong stimulant for alertness. The Prof introduces ‘Sleep Restriction’ to help increase Sleep Efficiency in Session 3. Most shift workers will already have restricted or short sleep and will be unable to follow the Prof’s advice to adopt a new night-time sleep window. Most people still find it interesting and useful to learn about the concept of sleep restriction, even if they cannot apply the Prof’s recommended schedule.

Core Session 4
Session 4 is particularly useful for shift workers since it explains a number of cognitive and relaxation techniques to help you wind down at the end of a shift.

Core Session 5
Session 5 helps to address troublesome thoughts about sleep. Listen to audio recordings on Paradoxical thinking and Mindfulness as you drift off to sleep.

Core Session 6 and beyond
After Session 6 you become a Graduate of the program. You will have access to a Graduate Common Room discussion, which provides long term support from other users. You can still re-visit the Prof to review your sleep diaries and repeat any aspects of the program in the Library for the full duration of your subscription.

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