shift work disorder, insomnia, sleepiness

shift work disorder, insomnia, sleepinessAre you a shift worker? Then, Thank You! Those that are employed during the evening hours and rotating shifts are owed a debt of gratitude. Our global society and economy would just cease to exist without them. Imagine what would happen if no one was there to fulfill the overnight requirements of a first responder! How much chaos would ensue without someone tending to the communication needs of the banking and transportation industries? Who hasn’t enjoyed social activities with friends that lasted well into the early morning hours?

Shift workers exist in every industry. Manufacturing, transportation, healthcare, military, financial and service driven industries all require shift employment to survive. Shift work is essential for the common good, else people would die, and economies would crumble. Yet, such employment can be equally detrimental to personal health as it is helpful when it results in the symptoms associated with shift work disorder.  Many employees struggle with both insomnia and wakefulness simultaneously.  Hence, the symptoms may feel more intense than if he/she was experiencing just insomnia.

It is important to note that not every shift worker will develop this diagnosis. In fact, a majority of those that work the night shift or rotating shifts are able to adjust and do well. Talk to anyone that naturally identifies with being a “night owl,” and he/she will likely confirm shift work seems like an excellent fit for them. Even some that may not consider themselves night owls would agree they are able to work rotating shifts without minimal difficulty. Yet, for some working such schedules result in difficulty functioning during the day, sleep trouble and other physical ailments. As a shift worker, are you wondering if your job is affecting your health?

What is Shift Work Disorder?

Shift work disorder is classified as a circadian rhythm disorder. Circadian rhythm is a person’s physical and natural sleep/wake cycle for each day. Taking cues from the daylight and darkness your circadian rhythm encourages sleep and wakefulness. So, the daylight signals to your brain it is time to wake up and remain awake. Likewise, the absence of daylight during the evening hours signals to your brain it is time to initiate sleep.

This can be a problem for those that work night shifts and even worse for those that work rotating shifts. Those that work night shift schedules are required to remain awake when the body naturally wants to sleep. Additionally, those that are employed on a rotating shift schedule may experience difficulty falling asleep and excessive sleepiness resulting from the confusion to the circadian rhythm due to an inconsistent work schedule. Shift work disorder occurs when there is an incongruence between the natural circadian rhythm and employment needs for prolonged periods of time. This imbalance is sometimes referred to as a circadian misalignment. Prolonged circadian misalignment can result in shift work disorder for a subgroup of people.

Symptoms of SWD can manifest themselves as the following: prolonged excessive sleepiness or inability to fall asleep as related to the work schedule, mood issues, difficulty concentrating and impairments to occupational and social functioning. Because these symptoms are associated with other sleep disorders, a sleep doctor is the best person to determine if you have shift work disorder. Only a trained sleep specialist is able to diagnose and treat shift work disorder accurately.

Why Does It Matter?

Shift work disorder has many negative ramifications on workers and society. Studies confirm that shift work disorder results in other physical diseases such as gastrointestinal disorders, cancer, obesity, high blood pressure, and cardiovascular disease. Additionally, patients with shift work disorder report higher rates of depression and mood disorders.

Shift worker disorder results in accidents both on the job and on the road. Shift workers report more frequent accidents from drowsy driving than daytime workers. There is also a decreased level of industrial productivity and increased occurrence of mistakes made at work. Shift work can also result in more missed days when compared to daytime workers. Hence, the negative consequences of untreated shift work disorder can are substantial.

What should I do?

As stated, only a trained sleep doctor is able to determine if you have shift work disorder or another sleep disorder. Scheduling an appointment to your healthcare provider is the first step to ensuring better sleep. Together, you and your physician will be able to create a treatment plan that will result in more restorative sleep and better health.

Roth, Thomas. (2012). Shift work disorder: Overview and diagnosis. Journal Clinical Psychiatry, 73(3):e09. doi: 10.4088/JCP.11073br2. Retrieved from https://www.psychiatrist.com/education/Pages/brs01n02.aspx