Shift Work Sleep Disorder
What is shift work sleep disorder (SWSD)?
Shift work sleep disorder (SWSD) is a sleep disorder that commonly affects those who work non-traditional hours, outside the typical 9 a.m. to 5 p.m. work day. Shift work schedules go against most peoples’ internal body clocks or circadian rhythms. SWSD causes difficulties adjusting to a different sleep/wake schedule, which results in significant issues with falling asleep, staying asleep, and sleeping when desired. About 20% of the fulltime workforce in the United States is involved in some form of shift work.
Symptoms and Causes
What are the symptoms of shift work sleep disorder (SWSD)?
The most common symptoms of SWSD are difficulty sleeping and excessive sleepiness. Other symptoms associated with SWSD can include difficulty concentrating, headaches or lack of energy.
Not every shift worker suffers from SWSD. It is estimated that 10% to 40% of shift workers have SWSD. If you're a shift worker experiencing any of these symptoms, talk to your doctor.
What are the consequences of shift work sleep disorder (SWSD)?
Increased likelihood of:
- Accidents and work-related errors.
- Irritability or mood problems.
- Poor coping skills and impaired social functioning.
- Health related complaints — including gastrointestinal, cardiovascular and metabolic problems.
- Drug and alcohol dependency.
Management and Treatment
How can I deal with shift work sleep disorder (SWSD)?
Most shift workers sleep one to four hours less than non-shift workers. It is important to get at least seven to nine hours of sleep every day.
Shift workers must be willing to make sleep a priority. People who work shifts other than a 9 a.m. to 5 p.m. routine might have to prepare for sleep even though it might be daylight outside. This can be done in the following ways:
- Minimize exposure to light on the way home from night shift work to keep morning sunlight from activating the internal “daytime clock.”
- Follow bedtime rituals and try to keep a regular sleep schedule, even on weekends and days off from work.
- At home, ask family and friends to help create a quiet, dark and peaceful setting during sleep time.
- Ask family members to wear headphones to listen to music or watch TV.
- Encourage people in the household to avoid vacuuming, dish washing and other noisy activities while you sleep.
- Put a "Do Not Disturb" sign on the front door so that delivery people and friends will not knock or ring the doorbell.
What can I do to decrease the effects of SWSD?
- Maintain a sleep diary to help identify the problem and monitor its progression over time.
- Decrease the number of night shifts worked in a row. Shift workers working the night shift should limit the number of night shifts to five or less, with days off in between. Shift workers working 12-hour shifts, should limit work to four shifts in a row.
- After a string of night shifts, take more than 48 hours off, if possible.
- Avoid extended work hours. Avoid working prolonged shifts and putting in excessive overtime. Make sure to have time to sleep and participate in family and social activities.
- Avoid long commutes, which can take time away from sleeping.
- Avoid frequently rotating shifts. It’s more difficult to deal with rotating shifts than it is to work the same shift for a longer period of time.
- Get enough sleep on days off. Practice good sleep hygiene by planning and arranging a sleep schedule and by avoiding caffeine, alcohol and nicotine. Do not start a night shift with sleep deprivation.
- Plan a nap before or during the night shift. Naps can improve alertness in night shift workers.
- Avoid drowsy driving. If you’re too sleepy to drive home from your shift, take a power nap first, or find an alternative ride home.
- Caffeine and prescription wake-promoting drugs such as modafinil (Provigil®) or armodafinil (Nuvigil®) have some role in promoting wakefulness during work hours. But the best strategy is to get adequate sleep.
- Sleep aids at times can be prescribed if difficulty sleeping persists despite following the above measures.
- Appropriate light exposure during the early part of the shift can improve alertness during the shift.