Managing Shift Work Sleep Disorder (SWSD)

Understanding Shift Work Sleep Disorder (SWSD)

According to International Classifications of Sleep Disorders, shift work sleep disorder is a circadian rhythm sleep disorder due to unusual sleep patterns caused by changing work schedules. People with SWSD often characterized by insomnia, and excessive sleepiness during work hours. This disorder usually occurs in people with non-traditional work hours i.e. split shift, graveyard shift, rotating shifts.

Each of us has an internal clock that sends a signal to our body to eat, sleep or even have sex. Many of our body's systems are calibrated to the appearance and disappearance of the natural light. Whenever the optic nerve senses light, there’s a tiny region of the brain in the hypothalamus called SCN (suprachiasmatic nucleus) which sends the signal to raise our temperature, heart rate, blood pressure, and delay the release of melatonin - a hormone that regulates sleep. When our internal clock misaligns with the work or social schedule, it disrupts the usual pattern or the circadian rhythm resulting in different sleep disorders.

Negative Effects of SWSD

People with SWSD are more likely to sleep fewer than 6 hours during workdays. According to the Cleveland Clinic, 25-30% of shift workers experience symptoms of the disorder such as excessive sleepiness or insomnia. Having less sleep affects their daily tasks such as driving.

Chronic sleep deprivation among people with SWSD is dangerous as it impacts the health targeting mental, heart, and digestive systems. 

Diagnosing SWSD
It is best to consult your doctor and help you get treated shall you have shift work sleep disorder. To help you evaluate symptoms and sleep patterns, you may check the following conditions:
  • You feel drowsy when at work or even in your “off-time”.
  • You are not productive at work i.e can’t think quickly or make good decisions.
  • You have trouble falling asleep when it is time to sleep.
  • You cannot sleep 7-9 hours continuously.
  • You have an unusual heart rate and breathing during sleeping.
Lifestyle Management of SWSD
If erratic work or social schedules cannot be helped, lifestyle changes can be made to optimize one’s sleep and attain good health. Below are some tips:
  • Check your work schedule before making any plans especially if your off-duty time varies as well. This will give you enough time to get some rest before going back to work or plan which social events you can attend.
  • Darken your bedroom using blackout curtains. The dark, cool bedroom makes it conducive to sleep. You may also use comfortable eye masks that block light to help you sleep faster.
  • Limit your light exposure at the end of your shift by wearing sunglasses when you’re on your way home.
  • Take naps whenever possible.
  • Inform your family or friends if you don’t want to be disturbed during your sleep so you can fully recuperate.
  • Keep rituals before going to bed. This creates a habit that sends a signal to your brain that it is time for sleep regardless of the time of the day.
  • When diagnosed, physicians may recommend sleep aids such as melatonin, hypnotics, or sedatives for a short period of time.
  • Others may recommend cognitive-behavioural, and light therapy.
Shift workers’ daily schedules do not correlate with the sunlight and sunset disrupting the circadian rhythm. When deprived of good, quality sleep, it can affect mental, and physical well-being. Lifestyle management, however, plays a crucial role so we avoid negative effects of shift work sleep disorder.

Johns Hopkins Center for Sleep at Howard County General Hospital

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