What is Shift Work Sleep Disorder?

Do you work the night shift or have a changing/rotating shift schedule?

Many people who do work these shifts experience symptoms of what is known as shift work disorder or shift work sleep disorder (SWSD). This disorder can be experienced in conjunction with obstructive sleep apnea (OSA) as well. Shift work schedules include night shifts, early morning shifts, overnight shifts, or regularly rotating shifts. Basically, any shift you work when most other people would be sleeping or resting can cause shift work disorder. The symptoms of shift work disorder are similar to those of sleep apnea and can likewise put you at risk for other health conditions.

Common Symptoms of Shift Work Disorder:

• Excessive daytime sleepiness (EDS)
• Difficulty falling or staying asleep
• Difficulty concentrating
• Morning headaches
• Fatigue
• Irritability

Shift work disorder can also lead to work place mistakes, injuries, and poor attendance, motor vehicle accidents, and drug or alcohol abuse. This disorder can even put a strain on your relationships, if left untreated.

If you have already been diagnosed with sleep apnea, shift work disorder can increase the severity of your sleep apnea. One study has even shown that after working a night shift, 50% of the patients studied had an increased apnea-hypopnea index (AHI)*, which is a measure of how many times breathing is either partially or completely obstructed per hour during sleep.

Why Shift Work Sleep Disorder Happens:

We all have an internal clock, also known as the circadian system/rhythm. Shift work confuses your body and the alignment between your internal clock and the external world/clock. For example, let us say it is 7:00am and you just got off work and want to go to bed. Even though you are exhausted and want to sleep, your body and mind knows it is the morning and will try to prepare for normal morning activities, like being awake, eating breakfast, or showering. Now you are fighting a battle with your body and mind by trying to go to sleep. This is similar to what we refer to as “jet lag”, when our internal clock has not yet synced up with our external stimuli. Fortunately, most people can adapt if their shift time is consistent. However if you have a rotating shift, your circadian system may not be able to adjust, leaving you sleep deprived.

What you can do to help/adjust SWSD:

• Avoid rotating shifts
• Avoid consecutive night shifts
• Avoid long commutes
• Use bright light therapy when waking or while working
• Avoid bright light after your shift and while trying to sleep; Wear sunglasses; Use blackout curtains in your bedroom
• Avoid caffeine towards the end of your shift
• Take steps to avoid being disturbed while sleeping
• Try to stick to a regular sleep schedule
• Take naps when possible

If these sleep habits and behavioral changes do not work, then you should speak to your doctor about possibly prescribing medication based on your symptoms. They may prescribe a stimulant to help keep you awake and alert during your shift. Common examples include Nuvigil or Provigil. If you have more trouble staying or falling asleep after your shift, then they may prescribe a sleep aid like Ambien or Lunesta. It is important to take these medications only as prescribed by your doctor.

- Page Maryyanek

* A. Laudencka 1, J. J. Klawe, M. Tafil-Klawe, P. Złomańczuk (2007)

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.