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Shift Work Sleep Disorder

Shift work sleep disorder is a circadian sleep disorder in which a person experiences a constant or recurrent pattern of sleep interruption due to shift work schedule, resulting in difficulties initiating and maintaining sleep and/or excessive sleepiness when awake. Other symptoms of shift work sleep disorderinclude difficulty concentrating, headaches, and low energy. Non-traditional shifts, particularly rotating shifts, force people to place their sleep window at a time that is not congruent with their underlying circadian clock. Rotating shifts also weaken the signals from the internal clock leading to greater difficulties with sleep and sleepiness. As a result, people with shift work sleep disorder may have trouble staying alert at their work shift and feel their sleep is unrefreshing.

Treating Shift Work Sleep Disorder

Managing shift work sleep disorderis inherently difficult. Research is showing that some shift work schedules are better than others, but shift workers do not always have a choice. Improving the sleep of a shift worker with sleep difficulties requires understanding how the circadian clock works and finding pragmatic solutions to help people keep as strong of a circadian rhythm as is feasible under these unnatural work conditions. Adjusting the internal clock to adapt to a night-time may include properly timed bright and dim light exposures relative to the timing of the sleep window. For example, an individual whose shift ends in the morning who intends to go home and sleep should minimize exposure to light between the end of work and bedtime (e.g., wear sunshade, have blackout shades).

Shift work is often combined with a longer than 8 hour work schedule. As a result, shift workers tend to sleep less than day workers and become more sleep-deprived over several days and therefore need to be cautious when driving and when in environments in which dozing off is dangerous. Sleep specialists can often help shift workers maintain alertness by offering alerting medication or counter fatigue behavioral recommendations. Workers with irregular or rotating shifts are at particularly high risk for accidents and their sleep problem is harder to manage. Young adults and people who describe themselves as “night owls” appear to find it easier to adjust to night and non-traditional work shifts.