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Sleep Medicine
Shift Work Sleep Disorder (SWSD)
What is it? SWSD is a sleep disorder that affects people who frequently rotate work shifts or work at night. Most people’s internal body clock prefers to sleep at night and stay awake in the daytime. Working at times when the body usually sleeps can cause a disruption in the internal body clock. Because our internal body clocks adjust slowly to a schedule change, people often have difficulty adjusting to different or changing work schedules. Not every shift worker suffers from SWSD.
What are the symptoms?
- Difficulty starting or staying asleep
- Excessive sleepiness when you want or need to be awake
- Difficulty concentrating
- Headaches
- Lack of energy
What are the consequences of SWSD?
- Increased accidents
- Increased work-related errors
- Increased sick leave
- Increased irritability, mood problems, etc.
How is it treated?
Lifestyle Modifications
- Make sleep a priority.
- Attempt to get as much sleep as you need to feel rested and refreshed.
- Follow bedtime rituals and keep a regular sleep schedule – even on weekends or days off.
- Minimize exposure to sunlight on your way home from work by wearing sunglasses.
- At home, ask family and friends to help create a quiet and peaceful sleeping environment.
- Have other household members wear headphones to listen to music or watch TV. Encourage others to avoid vacuuming, dish washing, and other noisy activities during your sleep time.
- Put a “Do Not Disturb” sign on the front door so that delivery people and friends will not knock or ring the doorbell.
- Turn off the ringer on your phone so it won’t disturb you.
- Consider using a “white noise” machine in your bedroom to dampen noises outside your bedroom.
Work-related Modifications
- Decrease the number of night shifts worked in a row.
- Night shift workers sleep less than day workers and become progressively more sleep-deprived over several days.
- You are more likely to recover from sleep deprivation if you can limit your number of third shifts to five or less, with days off in between.
- If you work a 12-hour shift, you should limit work to four shifts in a row.
- After a string of night shifts, you should have more than 48 hours off, if possible.
- Avoid working prolonged shifts and putting in excessive overtime.
- Avoid long commutes, which can take time away from sleeping.
- Avoid frequently rotating shifts.
- It is more difficult to deal with rotating shifts than it is to work the same shift for a longer period of time.
- It can be easier to adjust to a clockwise shift rotation (e.g. going from day to evening to night shift).
- Take breaks during work hours to rest or even nap
- If you plan to nap on a break, keep it brief (15-30 minutes).
- Napping for extended periods of time (greater than 45 minutes) can make it difficult to get up and be alert immediately due to sleep inertia.
- Exposure to bright light while at work can help people stay awake during their shift.
- A cooler work environment can promote alertness. Warm environments can contribute to sleepiness in some people.
Medications
- Over-the-counter and prescription medications have a role in the treatment of SWSD.
- They should only be used after consultation with your doctor.
- Certain medications are habit forming and have potentially dangerous side effects.
- Caffeine in moderation can help you stay alert while at work.
- Some people benefit from prescription medications to help them stay awake, such as modafinil (Provigil) or armodafinil (Nuvigil).
- Sleeping pills can be helpful if you have regular problems falling asleep or staying asleep.
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