Shift Work Sleep Disorder

Written by: SphynxCatVP
Link to original: http://sphynxcatvp.nocturna.org/health/sc-shiftsleep.html

This is likely a more common problem in the vampire community than most realize, for one simple reason: Our tendency to sleep in - or even sleep all day - is very much at odds with having to be up during the day for school or most professional obligations. Attempting to get sleep AND meet obligations sometimes means many of us are sleeping at any time we're not required to be anywhere.

What is shift work sleep disorder?

Shift work sleep disorder typically happens any time an individual is scheduled for work during their habitual hours of sleep, frequently rotating shifts, or irregular work hours. The individual finds it hard to maintain a normal sleep pattern with the frequent changes and disruptions of their sleep schedule, and is unable to get refreshing sleep despite attempts to keep their sleep environment as optimum as possible.

Shift work sleep disorder is especially known among night shift workers who try to keep a daytime schedule on their off days (and is one of the reasons keeping the same hours on their days off is recommended so frequently, even if it's not practical for everyone.)

On a rotating shift, the symptoms may improve after the first week or two, as the body adjusts. For workplaces that shift schedules on a weekly basis, this means that workers NEVER thoroughly adjust to one shift schedule before they have to change to the next. (Thus, it's a little easier on sleep to move forward to later schedules - days, then evenings, then overnights, then days again - rather than going backwards. The forward shift change enables a little bit of "sleeping in" to compensate.)

Anyone having to be awake and functional at hours conflicting with their normal sleep patterns HAVE to make sleep a priority in order to be effective at their jobs or at school.

What are the symptoms?

The symptoms usually include the following:

  • Continual need for extra sleep on days off
  • Impaired marital relations
  • Impaired social relationships
  • Irritability
  • Reduced alertness / excessive sleepiness
  • Reduced perfomance & coordination

Which can have the following consequences:

  • Increased rate of accidents
  • Increased work-related errors
  • Increased sick leave (as people attempt to get enough sleep)
  • Increased irritability, mood problems, etc.

If the sleep pattern is changed and disrupted often enough, the individual will have continual alertness, performance, and coordination issues, and may be prone to what seems like narcolepsy - dropping off to sleep without warning - to someone who's not aware of the shift sleep situation.

The stress from the inability to get stable sleep may result in digestive problems, or aggravate existing digestive complaints. Increased stress levels may also increase your risk of cardiovascular disease, or aggravate any existing cardiovascular conditions.

Drug and/or alcohol dependency may occur as the individual attempts to compensate for the shifting sleep schedules and attempts to force sleep, or force wakefulness, or both.

How is it diagnosed?

Shift Work Sleep Disorder is usually diagnosed by inquiries into the individual's shift schedule and medical history. Sleep studies are only required if the source of the sleep disorder is in question, and if needed, should be done during the shifted sleep period and during the work period, with a 24hr monitoring system.

The primary diagnostic criteria are:

  • The patient has a primary complaint of insomnia or excessive sleepiness.
  • The primary complaint is temporally associated with a work period (usually night work) that occurs during the habitual sleep phase.
  • Polysomnography and the MSLT demonstrate loss of a normal sleep-wake pattern (i.e., disturbed chronobiologic rhythmicity).
  • No medical or mental disorder accounts for the symptoms.
  • The symptoms do not meet criteria for any other sleep disorder producing insomnia or
  • Minimal criteria: A plus B
  • Severity Criteria: Severity is graded on the amount of sleep deficit, with mild being 1-2 hours of deficit, moderate being 2-3 hours, and severe being over 3 hours.

How is it treated?

There is no specific treatment for Shift Work Sleep Disorder, but there are guidelines to minimize the effects:

  • Avoid frequently changing shifts
  • Avoid long commutes (cuts into sleeping time)
  • Avoid prolonged shifts or excess overtime
  • Get enough sleep on the days off
  • Have 48 hours or more off inbetween work stretches
  • Lighting: Use bright light / blue light therapy before work
  • Lighting: Keep the lights dim after work to promote sleep.
  • Work 5 days or less in a row (if doing 8 hour shifts)
  • Work 4 days or less in a row (if doing 12hr shift)

Some or all of these are listed on many sites that suggest options to deal with Shift Work Sleep Disorder - however, I do recognize that not all of these listed are practical or easily obtainable - you don't normally have control over your work schedule, for example, or where a job is located. You may be forced to take a long distance job if you've had zero luck finding anything local, or you may be stuck with a boss who believes in abusing the workers.

Notes

Medically, this is interpreted as any person who is working an evening or overnight shift, or who works rotating shifts, AND who's normal sleep pattern is to sleep at night - and thus goes back to normal sleep habits on their days off.

While this is technically true, "shift work" issues can happen for anyone who's working (or in school, etc.) regularly during hours their body prefers to sleep. This means that someone with Delayed Sleep Phase, forced to be awake days, especially early days, will experience the same issues. Someone with Advanced Sleep Phase, forced to work an evening or overnight shift, will suffer the same issues.

Credits/References