What is Shift Work Sleep Disorder?

Shift work sleep disorder (SWSD) is a chronic medical condition affecting persons who work nontraditional hours, typically second or third shift rather than a standard 9-to-5 job. Working evening or nighttime hours can disrupt the body’s circadian rhythm or natural sleep-wake cycle, leading to abbreviated rest intervals and an overall loss of sleep. Persons with SWSD commonly experience insomnia, grogginess, extreme sleepiness, poor concentration, and mood swings. Not everyone who works a night shift develops a sleep disorder; individuals who are natural “night owls” cope better than those who are not. Women and older workers tend to be more susceptible.

About one in five fulltime American workers are employed during nontraditional hours. According to the Cleveland Clinic, as many as 40 percent may suffer from SWSD. If you work a non-9 to 5 job and are having trouble getting adequate rest, contact a primary care physician or sleep specialist at Baptist Health. 

What Are the Symptoms of Shift Work Sleep Disorder?

Shift work sleep disorder is marked by the following symptoms:

• Insomnia
• Extreme sleepiness
• Fatigue and a lack of energy
• Loss of focus
• Irritability and mood swings
• Poor-quality sleep
• Depression

SWSD can result in a variety of negative consequences, including accidents, health problems, antisocial behavior, relationship issues, and alcohol or drug dependency. 

What Causes Shift Work Sleep Disorder? 

A nontraditional work schedule is the primary cause of shift work sleep disorder. This might include employment in:

• Night shifts
• Evening shifts
• Early morning (pre-dawn) shifts
• Rotating shifts

Any shift requiring wakefulness when the body wants sleep can interfere with a person’s circadian rhythm. For example, the body produces a hormone called melatonin that aids in bringing on sleepiness. Darkness triggers the production of melatonin. Working at night requires light, which curtails the melatonin supply. The body responds by producing melatonin at odd hours, leading to sleepiness when you need to be awake and insomnia when you want to sleep. 

How Is Shift Work Sleep Disorder Diagnosed?

There are several steps for diagnosing SWSD:

• Documentation of symptoms: Your physician will make a record of your symptoms, including any problems you have with sleeping. He or she will want to know the nature of your work schedule. A physical exam is also likely, to identify the possible health consequences of your condition.
• Sleep diary: You may be asked to keep a sleep diary, which is a self-reported record of when you sleep, for how long, and how rested you feel on waking up. The time period covered might be a week or two. Your doctor will be interested to see what kind of sleep pattern you’ve developed, in response to your working nontraditional hours. 
• Sleep study: Depending on the severity of your symptoms, you may be asked to undergo a sleep study. Your physiological behaviors will be monitored and recorded by a medical team during a period of rest. Sleep studies are conducted at home or in specialized medical facilities.

The symptoms of SWSD are similar to those of other sleep disorders, so one facet of the diagnostic process will be the elimination of other potential explanations, including sleep apnea and narcolepsy.

How Is Shift Work Sleep Disorder Treated?

Lifestyle changes may be the most effective means of dealing with SWSD but medical options are sometimes utilized:

• Supplements: Sleep aids, including melatonin supplements, are a relatively safe means of achieving restful sleep. Melatonin can be purchased over the counter. 
• Medications: Your physician may also prescribe a sleeping pill. These include benzodiazepines. These can be taken with the goal of establishing a regular sleep pattern, but are potentially addictive and also have undesirable side effects. 
• Light therapy: Light therapy is another method for establishing a regular pattern of sleep. Exposure to light during daylight hours – either natural outdoor light or lamps when working inside – restricts the production of melatonin to those time periods when sleep is appropriate.

How Do I Cope with Shift Work Sleep Disorder?

There are a number of steps you can take to reduce the impact of nightshift work on your ability to achieve restful sleep:

• Establish and maintain a schedule for sleeping when home from work.
• Reduce your exposure to light sources when you’re ready to sleep.
• Ask your family to cooperate by limiting noise and interruptions while you’re sleeping.
• Use a white-noise machine to mask more abrupt, sleep-disturbing sounds around the house. 
• Request that delivery people not ring the doorbell when dropping off packages.
• Use a sleep aid, such as melatonin, prior to bedtime. 
• Limit the number of second or third shifts you work, if possible.

We’ll Help Put to Rest Your Fears About a Lack of Sleep

Working nontraditional hours can be hard on your body, both on the job and when you come home to rest and recuperate. If you suspect that you’ve developed shift work sleep disorder, see your Baptist Health primary care physician or sleep specialist