Insomnia When You Work Nights or Rotating Shifts
Work with a licensed sleep psychologist. Covered by insurance. Delivered virtually.
Virtual CBT-I with a licensed clinical psychologist, across 39 states and Washington, D.C. RISE bills major insurance plans directly; network status, benefits and out-of-pocket costs are verified with your plan before treatment begins.
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Shift work insomnia is trouble sleeping in people whose schedule fights their body clock: nights, early starts, rotating shifts. Two things are usually happening at once, a body clock pointed the wrong way and insomnia layered on top of it. Cognitive Behavioral Therapy for Insomnia (CBT-I) treats the second, adapted to the schedule you actually work rather than one you do not have.
What is shift work insomnia and how common is it?
Difficulty sleeping in people working nights, early starts, or rotating shifts. Two things are usually happening at once. The circadian part is the body clock being asked to sleep when it is signalling wake, which is a scheduling and light-exposure problem. The insomnia part is the learned wakefulness that builds after months of lying awake in a bright bedroom at 9am. They need different handling, and the second is what CBT-I treats.
What are the signs and symptoms of shift work insomnia?
Lying awake through a day sleep you badly need
Getting home exhausted and not sleeping is the complaint that brings most shift workers in. Exhaustion and sleep drive are not the same thing, and a body clock signalling wake will override tiredness.
Sleeping on shift days, not on days off
Many people manage a workable day sleep and then cannot sleep at night on their rest days, which is the schedule pulling in two directions at once.
Dreading the changeover
On a rotating rota, the two or three days around a swing are often the worst, and the anticipation of them starts several days early.
Sleep that does not restore
Daytime sleep is more fragmented and lighter than night sleep for physiological reasons, so seven hours of it does not feel like seven hours.
If this sounds familiar
Shift work insomnia is treatable. CBT-I is the non-drug treatment the American Academy of Sleep Medicine recommends as first-line care for chronic insomnia.
Check Insurance & Get StartedStated qualitatively because prevalence estimates for shift work sleep problems vary widely by industry, rotation speed, and how the condition is defined. Specialist counts are from the American Board of Sleep Medicine's public directory (my.absm.org), counted 2026-09-03 with scripts/count-absm-directory.mjs against the snapshot committed at data/sources/absm-snapshot-2026-09-03.html. It is a certification roster rather than an availability roster, so it overstates how many clinicians are reachable.
Why shift workers rarely get to a sleep specialist
The barrier here is not only supply. It is that specialist sleep clinics keep the hours shift workers cannot make, and the appointment is offered in the middle of the period they are supposed to be asleep.
- Clinic hours are the hours you sleep: A 2pm appointment is the middle of the night for someone working nights. Getting to it means losing the sleep the appointment is meant to fix, which is a poor trade to make weekly for two months.
- The advice usually assumes a schedule you do not have: Standard sleep hygiene advice is written for people who sleep at night: consistent bedtime, dark room in the evening, no naps. Some of it inverts for shift work and some of it does not apply, and working out which is the clinical skill.
- The specialists are scarce to begin with: The American Board of Sleep Medicine's public directory of certified behavioral sleep medicine specialists lists 203 practice locations across 38 states and the District of Columbia, with twelve states carrying none at all. Shift work is concentrated in industries and regions that do not track where those listings are.
Telehealth fixes the scheduling problem directly: sessions book around a rota rather than around clinic hours, including outside the standard working day. What it does not do is change the shifts. If your assessment shows the main problem is circadian rather than insomnia, your clinician will say so, and say what a sleep physician can offer that CBT-I cannot.
How is shift work insomnia treated?
CBT-I for shift workers is the standard protocol built around a real rota rather than a fixed bedtime. The honest limit is worth stating: it does not remove the circadian mismatch of working nights. What it treats is the insomnia sitting on top of that mismatch, which for most people is the part that is getting worse over time and the part that responds.
What CBT-I techniques are used for shift work insomnia?
Anchor sleep
protecting a fixed core sleep period that survives the rotation
Stimulus control
adapted for a bedroom used at odd hours, so the bed keeps meaning sleep
Light management
timing exposure and avoidance around your actual shifts
Sleep scheduling
built on the rota you work rather than a standard bedtime
Cognitive restructuring
working on the anticipatory dread around changeovers
First-line care
The American Academy of Sleep Medicine recommends CBT-I as first-line treatment for chronic insomnia
Time-limited
A structured course of weekly sessions, not an ongoing prescription
No medication
CBT-I involves no medication. Prescribing stays with your existing clinician
How you get matched to the right treatment
There is one intake, not a menu. You complete a structured sleep and clinical assessment, a licensed RISE clinician reviews your symptoms, history, screening results and insurance, and they match you to the format that fits: one-to-one CBT-I with a sleep psychologist, or prescription digital CBT-I, which delivers the same protocol through an app in about five to ten minutes a day. You do not pick the format and neither does a referring clinician. RISE evaluates and matches.
Both are CBT-I: two ways of delivering one protocol. The match turns on trade-offs, mostly cost, how quickly a clinician is available, whether a weekly appointment fits your schedule, how much support you want, and what else is going on medically. Live video is available in either, and you can step up from the digital program to sessions with a psychologist if that turns out to be what you need.
RISE bills major insurance plans directly; network status, benefits and out-of-pocket costs are verified with your plan before treatment begins.
RISE clinicians are licensed clinical psychologists. They do not prescribe medication. Starting, adjusting, tapering or stopping any sleep medication stays with your prescribing clinician unless that is specifically coordinated with them.
“I wish more people knew about this. I can finally sleep better without a cocktail of medications every night.”
The sleep psychologists
All of our clinicians are licensed in the states we cover, board-certified in behavioral sleep medicine or licensed psychologists with specialized training in CBT-I.
Dr. Jane Dyonzak
Ph.D., FAASM
Licensed Clinical Psychologist and Fellow of the American Academy of Sleep Medicine with 20+ years specializing in sleep and behavioral medicine. Dr. Dyonzak has served as a consultant to sleep disorders centers and principal investigator for clinical trials on sleep medications and devices.
Dr. Lauren Neaman
Psy.D., A-CBT
Licensed Clinical Psychologist and Diplomate of the Academy of Cognitive and Behavioral Therapies. Dr. Neaman completed advanced training through the University of Pennsylvania's Behavioral Sleep Medicine program and specializes in insomnia, anxiety disorders, and circadian rhythm issues.
Dr. Benjamin Pfeifer
Ph.D.
Founding clinician at RISE Sleep Clinic specializing in treating adults with insomnia and sleep disorders. Dr. Pfeifer completed his Ph.D. at The Ohio State University and holds PSYPACT authorization for telehealth practice. His background includes work with veterans at VA Ann Arbor Healthcare System.
Dr. Daniella Marchetti
Ph.D., DBSM
Licensed Clinical Health Psychologist and Diplomate in Behavioral Sleep Medicine. Dr. Marchetti specializes in insomnia treatment, CPAP adherence, nightmare therapy, and circadian rhythm disorders. She earned her doctorate from the University of Miami and completed her fellowship at the Miami VA Medical Center.
Frequently Asked Questions
Do I need a sleep doctor or a sleep therapist for shift work sleep problems?
How do I sleep better on night shift?
Can this fix the problem if I keep working nights?
Can appointments fit around a rota?
Is shift work sleep disorder the same as insomnia?
Ready to treat shift work insomnia?
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Check Insurance & Get StartedMedically reviewed by Dr. Chester Wu, MD — Double Board-Certified in Psychiatry and Sleep Medicine. Last reviewed 2026-09-06.
A physician reviews the clinical content on this page; the treatment itself is delivered by licensed psychologists. Those are deliberately two roles and two people.