Sleepless on Shift Work? Try These CBT-i Methods Backed by Science
5 interventions to try!
INSOMNIA
One week you’re on nights, the next you’re back on days. Your body never knows what time it is, and your sleep pays the price. For many shift workers, this rotating schedule feels like being in a constant state of jet lag—without the vacation.
Take Alex, a 29-year-old ER nurse. After a run of three night shifts, Alex would spend the next week trying to flip back to a daytime schedule, only to lie awake at night, staring at the ceiling. Exhaustion never seemed to go away, and the stress of not sleeping made it even worse.
If this sounds familiar, you’re not alone. Research shows that shift work significantly increases the risk of insomnia, with up to 40% of night shift workers reporting chronic sleep difficulties (Wagstaff & Sigstad Lie, 2011). Beyond fatigue, disrupted sleep can affect focus, mood, and long-term health.
The good news is that there are evidence-based solutions. Cognitive Behavioral Therapy for Insomnia (CBT-i), the gold-standard treatment for chronic insomnia, can be adapted to help shift workers manage their unique challenges.
Why Shift Work Disrupts Sleep (and Fuels Insomnia)
If you work shifts, you don’t need me to tell you how disruptive it can be—you already know what it feels like to try to sleep when your body just won’t cooperate. Still, it’s helpful to step back and look at why this happens, because understanding the science makes it easier to see how change is possible.
Our bodies run on a natural circadian rhythm—an internal clock that regulates when we feel awake and when we feel sleepy. For most people, this rhythm aligns with daylight: alert during the day, winding down at night. But for shift workers, the schedule often runs directly against this built-in system.
When your work hours rotate between days, evenings, and nights, your circadian rhythm can’t find a stable pattern. The result is circadian misalignment—your body wants to be awake when you’re trying to sleep, and sleepy when you need to be alert.
Common sleep challenges for shift workers with insomnia include:
Difficulty falling asleep during the day, even when exhausted.
Frequent awakenings from noise, light, or daytime activity outside.
Trouble flipping schedules after several days on nights or evenings.
Sleep-related anxiety, worrying about not getting enough rest before a shift.
This cycle isn’t just frustrating. Research has shown that shift workers are at greater risk of insomnia, depression, and even cardiovascular problems when sleep issues persist long-term (Kecklund & Axelsson, 2016).
What Is CBT-i and How Can It Help Insomnia?
CBT-i is the leading, evidence-based treatment for chronic insomnia. Unlike sleeping pills, which may offer short-term relief, CBT-i helps you retrain your mind and body for long-term, healthier sleep patterns.
At its core, CBT-i works by:
Changing unhelpful sleep habits (like lying in bed awake for hours).
Addressing anxious thoughts about insomnia (the “If I don’t sleep now, I’ll crash at work” spiral).
Strengthening your natural sleep drive and circadian rhythm.
For shift workers, CBT-i is especially relevant because it doesn’t rely on a perfect 9-to-5 routine—which isn’t realistic. Instead, its tools can be adapted to fit irregular hours, helping you:
Make the most of the sleep windows you do have.
Reduce the anxiety that comes from not sleeping “on schedule.”
Improve sleep efficiency, so the rest you do get is deeper and more restorative.
Why Standard Sleep Advice Doesn’t Work for Shift Work Insomnia
If you’ve ever Googled “how to sleep better”, you’ve probably run into the same list of tips: cut back on caffeine, avoid screens before bed, stick to a regular bedtime, keep your bedroom dark and quiet. These suggestions—often called sleep hygiene—can be helpful, but they’re usually designed for a 9-to-5 lifestyle.
For shift workers, these standard tips often fall flat. You can blackout your windows, wear earplugs, and avoid coffee after midnight—but if your body clock is completely misaligned, those steps may not make much of a difference.
This is where CBT-i stands apart. Instead of giving you a one-size-fits-all list of dos and don’ts, CBT-i helps you work with your body’s sleep system—even when your schedule is unpredictable. The goal isn’t to force perfect sleep, but to improve the quality and consistency of the sleep you can get.
5 CBT-i Techniques for Insomnia That Help Shift Workers
1. Sleep Restriction Therapy (SRT) with Flexibility
Spending long hours in bed awake actually weakens your body’s sleep drive. SRT helps by limiting time in bed to the hours you’re really sleeping, then gradually building up as your sleep improves.
2. Stimulus Control — Bed = Sleep Only
Your brain learns habits around sleep. If you’re used to scrolling, worrying, or just lying awake in bed, your body starts to associate the bedroom with wakefulness.
3. Restructuring Sleep Thoughts — Letting Go of Perfection
Shift workers often put huge pressure on themselves: “If I don’t get a full 8 hours, I’ll fail at work tomorrow.” These thoughts fuel anxiety, making it harder to sleep.
CBT-i helps reframe these beliefs—focusing on quality, not perfection.
4. Relaxation Training — Easing the Post-Shift Adrenaline
After demanding shifts, your nervous system can stay on high alert. Relaxation training bridges the gap between “work mode” and “sleep mode.”
5. Consistent Anchor Points — Stability Amid Chaos
Even if your bedtime changes, certain routines can stay consistent: meal times, light exposure, or a brief exercise routine. These “anchors” help stabilize your body clock.
A Note on Sleep Hygiene
Sleep hygiene—things like limiting caffeine, turning off screens before bed, and making your bedroom dark and quiet—does matter. But on its own, it’s not enough.
Focusing only on sleep hygiene is like brushing your teeth to fix a cavity: it won’t solve the underlying problem, though it may prevent things from getting worse.
Does CBT-i Work for Shift Work Insomnia?
Most of the research on CBT-i has focused on people with fairly regular schedules. But there’s growing evidence that CBT-i helps shift workers too—even when sleep windows are irregular.
A systematic review by Jarrin et al. (2018) found that CBT-i significantly improved sleep efficiency, reduced sleep onset latency, and decreased fatigue.
Morin et al. (2015) showed that participants not only slept better after CBT-i but also reported improved concentration, mood, and overall functioning.
While results for shift workers may not always be as dramatic as for those with standard sleep patterns, the improvements are still meaningful. CBT-i reduces the struggle, helps consolidate rest into deeper sleep, and lowers anxiety that fuels insomnia.
CBT-i for Shift Work: Putting It All Together
Shift work will always be demanding, and no treatment can fully erase the challenges of rotating schedules. But that doesn’t mean you’re powerless. CBT-i gives you practical tools to improve sleep quality, reduce anxiety, and make the most of the rest opportunities you do have.
And that’s the heart of CBT-i: not creating “perfect” sleep, but retraining your body and mind to rest more effectively—even when your hours are unpredictable.
If you’ve been battling sleepless nights while working shifts, know that you’re not alone—and it doesn’t have to stay this way.
CBT-i is the most effective, research-backed treatment for insomnia, and with the right adaptations, it can help you regain control of your sleep.
👉 If you’re ready to explore how CBT-i can support your rest, focus, and overall well-being, I offer therapy online across British Columbia and much of Canada. Book a free 15-minute consultation today to see if this approach is right for you.
References
Jarrin, D. C., Alvaro, P. K., Bouchard, M. A., Jarrin, S. D., Drake, C. L., & Morin, C. M. (2018). Insomnia and shift work: How cognitive behavioral therapy can help. Sleep Medicine Clinics, 13(2), 215-223.
Kecklund, G., & Axelsson, J. (2016). Health consequences of shift work and insufficient sleep. BMJ, 355, i5210.
Morin, C. M., et al. (2015). Cognitive behavioral therapy for insomnia: State of the science and future directions. Annual Review of Clinical Psychology, 11, 439–463.
Wagstaff, A. S., & Sigstad Lie, J. A. (2011). Shift and night work and long working hours—a systematic review of safety implications. Scandinavian Journal of Work, Environment & Health, 37(3), 173–185.
TL;DR: Shift Work and Sleepless Nights — Can CBT-i Help?
Shift work throws your body’s natural sleep rhythm out of sync, making quality rest feel impossible. Standard tips like avoiding caffeine or screens often fall short because they don’t address the unique challenges of rotating schedules. Cognitive Behavioral Therapy for Insomnia (CBT-i) offers research-backed strategies that can be adapted to shift work, including sleep restriction, stimulus control, relaxation training, reframing anxious thoughts, and keeping consistent anchor points. While it won’t erase the demands of shift work, CBT-i can help you sleep more efficiently, reduce stress, and regain control over your rest.
Frequently Asked Questions About CBT-i and Shift Work
1. Can CBT-i help with shift work insomnia?
Yes. While most research on CBT-i focuses on people with regular schedules, growing evidence shows that it also helps shift workers. CBT-i techniques can be adapted to irregular sleep windows, improving sleep efficiency and reducing anxiety about not sleeping.
2. Is CBT-i more effective than sleeping pills for shift workers?
Sleeping pills may provide short-term relief, but they don’t address the underlying causes of insomnia. CBT-i is considered the gold-standard treatment because it produces longer-lasting improvements without dependency or side effects.
3. How long does CBT-i take to work?
Most people notice improvements within 4–8 weeks of practicing CBT-i techniques. For shift workers, progress may be gradual, but even small changes—like falling asleep faster or reducing nighttime awakenings—can make a meaningful difference.
4. What if my shifts keep changing? Will CBT-i still work?
Yes. CBT-i is flexible and can be applied to rotating schedules. While you may not achieve a perfect 8-hour sleep block, CBT-i helps you maximize rest quality and consistency, even when your schedule is unpredictable.
5. Do I need a therapist to do CBT-i, or can I try it on my own?
You can definitely implement CBT-i on your own. There are many helpful self-guided books on CBT-i, such as End the Insomnia Struggle: A Step by Step Guide to Help You Get to Sleep and Stay Asleep by Coleen Ernstrom PH.D. and Alsiha Brosse PH.D. or Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications by Jade Wu PH.D.. However, if you continue to struggle with implementing the strategies and knowledge in these books, it might be time to connect with a therapist.