Shift Work Sleep Disorder
Shift Work Sleep Disorder (SWSD) – Definition
Shift work sleep disorder is a sleep disorder that affects people who frequently alternate shifts or work at night, contrary to the body’s natural circadian rhythms, and cannot adjust to their schedule.
Shift work intolerance, although listed as a circadian rhythm-related sleep disorder, should not be regarded as an inner biological clock issue or a sleep disorder alone. It can actually be a composite of three factors, which include, circadian, sleep, and domestic/social factors.
Circadian Rhythms
Circadian rhythm refers to the 24-hour rhythmic output of the body's inner clock that regulates our biological processes. The circadian rhythm is the body's inner resting/wakefulness schedule over the course of a day. It is considered a disorder because so many people suffer from excessive sleepiness and sleep disturbance in trying to adapt to a shift work schedule.
It consists of a constant or recurrent pattern of sleep interruption that results in insomnia or excessive sleepiness. Shift work sleep disorder is common in people who work nontraditional hours, usually between 10:00 pm and 6:00 am.
Sleep during the morning after a night shift is often of short duration and unrefreshing. Treatment should highlight sleep hygiene and the importance of consistency in the sleep / wake schedule.
The most successful work schedules involve shifts that move gradually clockwise, rather than shifts that change irregularly and quickly. Patients should be strongly cautioned against the regular use of alcohol, sedatives or stimulants to decrease sleep disturbances associated with shift work.
Shift Work Sleep Disorder Symptoms
The most common symptoms of shift work sleep disorder are insomnia and excessive sleepiness.
Other symptoms of shift work sleep disorder include:
- Difficulty concentrating
- Disrupted sleep schedule
- Reduced work performance
- Headaches
- Lack of energy
- Difficulties with personal relationships
- Irritability or a depressed mood
- Sleepiness at work
Not every shift worker suffer from shift work sleep disorder. However, if you are a shift worker and experience any of these symptoms, you should talk to your doctor.
Shift Work Sleep Disorder Consequences
Consequences of shift work sleep disorder include:
- Increased work-related errors
- Poor concentration
- Increased sick leave
- Increased accidents
Shift Work Sleep Disorder Diagnosis
Although some people handle well with shift work, others may need to see a sleep medicine specialist. Often there are underlying sleep disorders contributing to the lack of sleep that make it more difficult to work an alternate shift.
The sleep specialist will take a complete sleep history and physical examination to determine whether or not a sleep study is indicated.
The sleep center physician may also want the patient to meet with the behavioral therapist to work on strategies to better improve the quality of sleep and to make adjustments to the patient's present work schedule.
Shift Work Sleep Disorder Treatment
Treatment will be discussed at the time of the consultation and/or after the sleep study if indicated. Treatments may include behavioral or pharmacological remedies that can help alleviate symptoms. PROVIGIL is the only medication indicated for excessive sleepiness associated with shift work sleep disorder.
