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What is shift work sleep disorder?

Shift work sleep disorder is a condition that entails insomnia and/or excessive sleepiness. It occurs in individuals who work nights or rotate shifts. Some of the professions most at risk for shift work sleep disorder include paramedics, doctors, nurses, police officers, security guards, factory workers, and night cleaning crews. When you work irregular shifts, your body can become confused, leading to issues with sleep, fatigue, missed days at work and an increased incidence of accidents on the job.

Causes

Why does the night shift make you sleepy?

Each person is deeply entrenched in their circadian rhythm, the body’s natural way of regulating sleep and waking time. When you must sleep during the day and work at night, you are going against the natural rhythm of your mind and body. Rotating shifts are even more confusing for the body because it is unable to accurately predict your waking and sleeping hours. In order to ensure your body is healthy and properly functioning, you need regular, restful sleep.

How to prevent or ease the burden of shift work sleep disorder?

Fortunately, if your job does require you to work outside of conventional office hours, there are some steps you can follow to help your body adjust accordingly:

If you are able to schedule days off in between shifts, this can be beneficial in allowing your body to catch up on some much-needed rest.
Expose yourself to bright lights during your shifts, when possible. This can help better regulate your circadian rhythm.
When you must sleep during the day, use blackout curtains. When your body feels sunlight, it is trained to think you should be awake, even if you are incredibly tired.
Ask your friends and family to avoid calling while you sleep. If necessary, turn your phone off or place it in another room.
Limit caffeine intake, especially in the later part of your shift.
Adhere to a regular waking and sleeping schedule, if possible.

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Symptoms

What are the symptoms of shift work sleep disorder?

The symptoms of shift work sleep disorder depend on the individual and the extent to which their sleep has been disrupted. Some of the most common symptoms of this condition include:

Insomnia
Excessive sleepiness
Irritability
Depression
Headaches
Inability to focus
Memory impairment

These direct symptoms may lead to consequences in other areas of a person’s life. Some of these consequences are:

Missed days at work
Increased risk of on-the-job accidents
Negative consequences in one’s social life
Higher risk of other health conditions
Risk of dependency on alcohol and drugs as a coping mechanism

In order to ensure the health of your body and mind, it’s a good idea to pay a visit to an experienced medical professional. A doctor can help diagnose your condition and guide you on the path toward relief.

Diagnosis

How is shift work sleep disorder diagnosed?

Shift work sleep disorder is often ignored by patients. They see their condition as something they cannot change, owing to their work schedule. However, a doctor’s visit is incredibly useful in determining the extent of your condition. Your doctor can provide you with assistance in developing better sleep hygiene. They may also recommend you wear a sensor for a few weeks or go to a sleep clinic if additional studies could be useful.

When you do decide to see a doctor for your shift work sleep disorder, they will diagnose you based on the following criteria:

You must experience insomnia while attempting to sleep and/or drowsiness while awake.
Your overall sleep time must be reduced due to your work schedule. Typically, this reduction lies between one to four hours nightly.
Symptoms have been ongoing for a period of at least three months and align with your shift work schedule.
Your symptoms cannot be attributed to any other medical condition, sleep disorder, medication, etc.

If no additional tests are ordered, your doctor may conduct a physical exam and ask you to keep a sleep log for a couple of weeks. Based on your medical history and the results of the sleep log, your doctor will be able to diagnose you with shift work sleep disorder. You can then begin seeking treatment.

Treatment

How is shift work sleep disorder treated?

To treat shift work disorder, your doctor may recommend some of the tips discussed earlier in this article. Above all, proper sleep hygiene is key to maintaining a well-rested and properly functioning body and mind. If altering your behavioral patterns proves unsuccessful, they can prescribe sleep aids to help you get to rest and/or stimulants to help you stay alert on the job. A visit to a sleep clinic may also prove useful in evaluating and treating your condition. Speak with a medical professional for a more individualized prognosis regarding the treatment of your shift work sleep disorder.

References

Kam, K. Avoiding Shift Work Sleep Disorder (SWD) On the Night Shift: Tips for Better Sleep. WebMD. https://www.webmd.com/sleep-disorders/features/night-shift-sleep

Shift Work Disorder Diagnosis: Requirements and Tests. Sleep Foundation. (2020, October 16). https://www.sleepfoundation.org/shift-work-disorder/diagnosis

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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