Shift work sleep disorder Definition
Shift work sleep disorder (SWSD) is a very common sleep disorder which generally affects the shift workers. A shift worker is someone who works at a certain shift which is completely opposite to a normal work shift i.e. 9am to 5 pm job. These shifts can be either rotational or fixed. In most cases the workers have to work at night or in the late evening. Due to such abrupt shifts the natural circadian rhythm (a 24 hour cycle in all living beings which is maintained internally by the body) of the body gets disturbed and invites a family of other sleep disorders. Insomnia and immoderate sleepiness are believed to be very common symptoms of this particular disorder. The shift workers always find it difficult to adjust such irregular sleep and wake schedule and are prone to daytime sleepiness.
Shift work sleep disorder Causes
Some of the main causes of this condition are:
Insomnia is difficulty in falling asleep or staying asleep throughout the night. This can be a common cause of SWSD where the regular sleep pattern gets disturbed and patients have a tendency to sleep at regular waking/day hours. Insomnia is most often considered as co-morbidity (presence of secondary disorders in addition to the primary or main disorder) which gradually develops in the person who is working at a rotational shift.
Sleepiness during waking hours
This is basically a tendency to fall asleep at normal wake schedule. SWSD sufferers tend to fall asleep at times when others actually wake up and carry on with their daily activities. The wake-meter mechanism in the body increases sleepiness as result of stretched wakefulness which usually affects the shift workers.
Disturbance during sleep
Often, ample amount of sleep is not possible due to some kind of distraction during sleep hours. It can either be due to noise, social needs, personal matter or internal disturbance within the body. This can makepeople unable to sleep both during resting hours and waking time.
Sometimes, the timings of shift workers can get extended beyond the normal work shift. As a consequence, they often miss out the healthy sleep schedule which they have been following for quite sometimes. A prolonged interruption of this type can make sleep deprivation a permanent problem.
Shift work sleep disorder Symptoms
Some of the primary symptoms of this disease include:
As discussed above, insomnia may also appear as a symptom of SWSD apart from its cause. People, who are accustomed to working at rotational shifts, normally suffer from insomnia as it continuously builds up due to lack of sleep.
Difficulty in concentrating
Impairment in concentration is almost always associated to sleep disorders. Other than work pressure, unusual sleep and wake timings also lead to physical and mental stress, which hamper work. Patients are not able to focus on their job and always feel drowsy during working hours.
It is usually a condition where a person often feels extreme weariness and exhaustion. This has a direct association to interrupted sleep hours where the body does not get the right amount of rest. The body always has a lack of energy which is directly related to the mental fatigue.
Dull, tingling pain in the head is very much related to SWSD. Working at a stretch during night or evening puts undue strain on the eyes. Due to this, the sensory nerves in the brain are directly affected. Recurrentheadaches cause more problems in sleeping. They may even bring along a host of other abnormalities related to the nervous system.
SWSD often causes mood swings and irritation in patients. They often undergo depression which tends to affect their professional and social life.
Lack of sleep increases the tendency to sleep more, causing acute drowsiness during waking hours.
Shift work sleep disorder Diagnosis
The disorder is normally detected by physical observation when problems like insomnia or sleep deprivation occur. Doctors can easily come to know of this disorder as it largely manifests in the shift workers’ population.
Often, individuals with SWSD are recommended by doctors to visit a sleep center and consult a specialist. Specialists observe the sleep patterns, brain waves, heartbeat, pulse rate, rapid eye movements by attaching certain monitoring devices to the body. After this test, an analytical report is prepared where the entire sleep pattern is dotted out. Based on the result, a treatment program is devised for the patient.
Shift work sleep disorder Treatment
Some of the main methods of treatment recommended for patients of this condition involve:
Recommended sleep/wake scheduling
A proper sleep of 7 to 8 hours is recommendable during daytime. The body and mind has to get adapted to this kind of abnormal sleep schedule. Forwarding rotating shifts after every two weeks is generally advised to be better than taking them backwards. This helps in maintaining a harmony between the sleep cycle and the biological clock. But this particular method is difficult to follow practically. A planned nap for 10 to 30 minutes, during recess hours, is more advisable in order to maintain concentration at work.
Bright light treatment
Artificial bright light treatment can be given normally in the evening or in the first part of the night. This increases activeness and lessens sleepiness at night. Bright light should be avoided in the early morning. This technique does help in improving the circadian rhythm of the body and inducing good sleep, especially in the daytime.
Melatonin is a hormone which is secreted by the pineal gland in the brain. Its main function is to regulate other hormones and maintain the circadian rhythm of the body. This is usually generated for about 12 hours at night. Melatonin can be taken as a drug especially by the night workers. The exact effect of melatonin is not known but it definitely reduces the time to fall asleep, increases the sleeping hours and also enhancesalertness during daytime.
Beverages like tea and coffee, rich in caffeine, are mainly used to increase alertness during work and stay awake for a prolonged duration. Modafinil and Armodafinil are non-amphetamine or non stimulant alertingdrugs for treatment of acute drowsiness/sleepiness.
Some free hand exercises or running is advisable during break in the work area. This not only keeps the body active but also reduces any kind of pain in the body.
SWSD is not harmful and can be tackled with proper lifestyle modification measures. A proper sleep and wake schedule along with a proper diet is what you need to avoid the effects of working at rotational or night shift.