Fighting Back Against Night Shifts: Personalized Sleep & Nutrition Interventions

Study in focus: Maaike van der Rhee, Johanneke E. Oosterman, Suzan Wopereis, Gijsbertus T. J. van der Horst, Inês Chaves, Martijn E. T. Dollé, Alex Burdorf, Linda W. M. van Kerkhof & Heidi M. Lammers-Van der Holst.“Personalized sleep and nutritional strategies to combat adverse effects of night shift work: a controlled intervention protocol.”BMC Public Health, 24:2555 (2024). doi:10.1186/s12889-024-2555.

Why this matters

Night work is not just a scheduling inconvenience—it is a direct hit on circadian biology. It drives fragmented, shortened sleep, worsens glucose regulation, and accelerates cardiometabolic and immune risk. But unlike genetics or job demands, sleep and diet are modifiable levers.

This protocol (ClinicalTrials.gov: NCT06147089) takes the next step: testing whether personalized advice—tailored to an individual’s sleep patterns, work demands, and metabolic markers—can buffer night shift risks in the real world.

Study design at a glance

• Population: Male night shift workers, 18–60 y, ≥1 year shift experience, ≥4 night shifts/month.

• Arms (n=25 each):

  1. Sleep intervention (SL)

  2. Nutritional intervention (NU)

  3. Control (no advice)

• Structure:

  • Run-in baseline: 14 days of sleep, food, glucose, and activity monitoring.

  • 3-month intervention: personalized strategies delivered with motivational interviewing.

  • Post-intervention & 12-month follow-up with sleep, glucose, biomarkers, stress, quality of life.

Tools:

• Actigraphy + validated sleep questionnaires (ISI, ESS, PSQI, SWD).

• Continuous glucose monitoring (FreeStyle Libre Pro).

• PhenFlex metabolic challenge test.

• Psychomotor vigilance tasks, stress biomarkers (hair cortisol), diet quality index.

Personalized countermeasures

Sleep strategy (SL group)

• Multiple sleep episodes: split-sleep or naps to minimize prior wakefulness.

• Anchor sleep windows: aligning recovery sleep to circadian pressure.

• Tailored recommendations: e.g., power naps for night-shift sleepiness vs. delayed waking for those with fragmented day sleep.

• Education: circadian hygiene, transitioning between shifts, and recovery planning.

Nutritional strategy (NU group)

• Calorie timing: distribute intake to align with circadian rhythms.

  • Light midnight meal (~20% calories).

  • Breakfast after shift (~25%).

  • Afternoon snack (~15%).

  • Early dinner (~40%).

• Macronutrient timing: carbs → morning, fats → later in the day.

  • Example: breakfast = 75% CHO, dinner = higher fat proportion.

• Personalization via CGM & biomarkers: adjust carb/protein/fat balance by individual glucose and insulin response.

• Food preferences respected (cultural, religious, personal).

Outcomes being tested

• Primary:

  • Sleep duration & quality (actigraphy, PSQI, ISI, ESS).

  • Glucose regulation (CGM: variability, hypo/hyperglycemia, time-in-range).

• Secondary:

  • Blood biomarkers (lipids, HbA1c, liver/kidney, inflammatory cytokines).

  • Anthropometrics (BMI, waist/hip ratio).

  • Psychomotor vigilance (reaction times).

  • Stress markers (hair cortisol, perceived stress scale).

  • Hunger/fatigue dynamics during night shifts.

  • Quality of life & work–life balance.

Strengths

• Personalized tailoring: interventions designed from each worker’s sleep, diet, and glucose data.

• Longitudinal view: 3 months + 1-year follow-up.

• Real-world setting: not just lab-based—capturing everyday pressures and variability.

• Biomarker depth: sleep, glucose, metabolic resilience, inflammation.

Limitations

• Only male participants—limits generalizability.

• Participants can choose intervention arm (increases motivation but introduces selection bias).

• External influences (workplace policy, lifestyle changes, seasonality) may affect outcomes.

Why it’s different

Most studies test short-term fixes (naps, small meals, light therapy). This protocol tests sustainable, personalized strategies in real shift workers over a year—linking sleep, diet, biomarkers, and job demands.

If effective, these interventions could:

• Be rolled into occupational health programs.

• Provide biomarker-driven monitoring (CGM, actigraphy) as routine for high-risk workers.

• Extend employability and reduce long-term cardiometabolic burden in essential 24/7 jobs.

Bottom line

This protocol represents the next generation of shift work countermeasures: personalized sleep and nutrition strategies, informed by real-time data. If it works, night shift protection could move from generic “sleep hygiene” tips to tailored interventions that reshape long-term health trajectories.

Author: R.E. Hengsterman, MSN, MA, M.E., RN

Registered nurse, night-shift administrator, and author of The Shift Worker’s Paradox

Nursewhowrites.com

For educational purposes only. Not medical advice.