Are you a night worker? Or do you have to go to work early in the morning? Do you sometimes have to work at different times of the day? Such people may have some problems with sleep. That is the condition we are going to talk about today, called 'Shift Work Sleep Disorder' (SWSD) . Let's see what it is, why it happens, and what can be done about it.
What is this shift work sleep disorder (SWSD)?
Simply put, this is a sleep disorder caused by your shift. We all have a natural clock inside our bodies, called our circadian rhythm . This controls changes in our bodies, minds, and behaviors throughout the 24-hour day. This clock is often driven by light and darkness. When we work at a different time than our typical 9 a.m. to 5 p.m. shift—that is, at night, in the early morning, or at a different time—our natural clock gets thrown off balance.
Because of SWSD you can:
- You can fall asleep at any time.
- Even if you fall asleep, you may not be able to sleep properly and may keep waking up.
- Excessive sleepiness can occur at times when it is not needed, especially while working.
In the United States alone, about 20% of full-time workers work shifts like this. However, it's important to remember that not everyone who works shifts develops SWSD.
How common is this condition?
It's actually more common than you might think. SWSD may affect between 10% and 40% of people who work irregular hours.
What are the symptoms of shift work sleep disorder (SWSD)?
There are two main symptoms of this condition:
1. Insomnia: This means difficulty falling asleep and/or staying asleep even after falling asleep. This can also vary depending on the work schedule. For example, someone who works between 4 and 7 in the morning may have difficulty falling asleep. Similarly, someone who works in the evening may have difficulty staying asleep even after falling asleep.
2. Hypersomnia: This is excessive sleepiness that occurs at inappropriate times, especially when working at night or in the early hours of the morning. This can be very dangerous, as it can affect both work efficiency and safety.
In addition to these main symptoms, there may be several other symptoms:
- Difficulty concentrating. Like not being able to remember anything.
- Headache. Frequent headaches.
- Feeling lifeless and tired.
- Difficulty staying awake at work.
- Irritability, quick temper.
If you are a shift worker and have symptoms like these, definitely see a doctor.
Why does this SWSD occur?
Simply put, it's caused by a mismatch between your 'internal body clock' and the environment you're in. This causes your sleep schedule and duration to be disrupted.
Here's what usually happens: During the 24 hours of the day, light – especially sunlight – is what sets our body clock in motion. This light travels through our eyes and reaches a 'control center' in the brain. From there, a chain of processes and hormones in the body begins. This is what signals the body that 'it's time to wake up, it's time to start the day.'
Two other important things that affect our body clock are:
- Melatonin: This is a natural hormone that helps you sleep. It is produced by the pineal gland in our brain. Melatonin is secreted most at night (in the dark), and very little during the day (in the light).
- Cortisol: This is a hormone produced by our adrenal glands. Under normal circumstances, cortisol levels are low at night when we go to bed and peak in the morning when we are about to wake up. (In addition to this circadian rhythm, cortisol has other important functions.)
However, these signals in people who work irregular hours do not match their 'day', that is, the times they are awake and the times they go to bed. This negatively affects both sleep and wakefulness.
For example, people who work night shifts often sleep during the day. That is, at the same time that their bodies are signaling to 'wake up, stay awake.' As a result, their daytime sleep may be short and often interrupted. Also, they may feel sleepy when they work at night, because that is when melatonin levels are usually at their highest.
How is this SWSD condition diagnosed?
Keeping a sleep journal is a very important part of diagnosing SWSD. Your doctor will likely ask you to record the following for at least two weeks:
- The times you went to sleep and woke up.
- How many times did you wake up while sleeping?
- How relaxed you feel.
- Things that can affect your sleep or sleep patterns, for example, caffeine use like coffee, and noise pollution.
Doctors usually diagnose SWSD if you have had these symptoms for at least three months. They may also do a sleep study or other tests to make sure your symptoms aren't caused by another condition, such as sleep apnea , or a side effect of a medication.
What are the treatments for this?
There is no cure for shift work sleep disorder (SWSD). However, there are several treatments that target the core symptoms of the condition – namely, circadian rhythm dissonance, sleepiness, and sleep disruptions.
The main treatments are:
- Changes to your schedule or work schedule (if possible).
- Changes in your sleep habits at home.
- Bright light therapy.
- Melatonin supplement.
- Sleep medications.
- Wake promoting agents.
Let's look at each of these in a little more detail.
Changes to your schedule or routine
One way to treat SWSD is to make changes to your work habits and schedule. If possible, talk to your employer about scheduling changes or work-related changes that can help reduce the impact of SWSD. Your doctor will recommend specific strategies based on the shift you work and your work environment.
Here are some common things you can do:
- If you need to sleep during the day, avoid exposure to the sun in the morning. Wear sunglasses when you go home, and only if you have to go out.
- If possible, reduce the number of consecutive night shifts you work. Those who work night shifts should not work more than five consecutive night shifts, taking days off in between. Those who work 12-hour shifts should not work more than four consecutive days.
- After working several consecutive night shifts, take more than 48 hours off if possible.
- Avoid working long hours and excessive overtime.
- If possible, avoid jobs that require you to travel long distances to work, as this will also reduce the amount of time you have to sleep.
- Avoid frequent shifts. It is harder to get used to changing shifts than working the same shift for a long time.
- If possible, plan to take a nap before or during the night shift. These naps can improve alertness for night shift workers.
- Use moderate amounts of caffeine (e.g., coffee) to help you stay alert while working. However, stop consuming caffeine toward the end of your shift. Otherwise, it may interfere with your sleep at bedtime.
- Avoid driving while drowsy. If you are sleepy enough to drive home after your shift, take a power nap first, or drive home with someone else.
Changes in your sleep habits at home
It is said that shift workers sleep one to four hours less than non-shift workers. It is very important to get at least seven to nine hours of sleep every day.
If you're a shift worker, you need to prioritize sleep. Here are some tips to help you:
- Follow bedtime rituals. Try to maintain the same sleep schedule as much as possible, even on weekends and holidays.
- At home, ask family and friends to help you create a quiet, dark, and peaceful environment for bedtime.
- Tell your family that it's okay to listen to music or watch TV with headphones while you're sleeping.
- Encourage your family members not to do noisy tasks, such as vacuuming or washing dishes, while you are sleeping.
- Hang a 'Do Not Disturb' sign on your front door. This will reduce the number of delivery people and friends knocking on your door or ringing the doorbell.
- Get enough sleep during the holidays.
- Practice good sleep hygiene. That means setting a regular sleep schedule and avoiding caffeine, alcohol, and nicotine.
Bright light therapy
Bright light therapy involves exposing your body to a specific type of light to help it adjust to your new schedule. You use this light at a specific time, usually when you start your shift. Your doctor will tell you when and for how long to use this light therapy.
This light can be purchased as a lightbox, a desk lamp, or light goggles. These are similar to the lights used to treat Seasonal Affective Disorder (SAD) . This light therapy is especially useful for those who work night shifts.
Melatonin supplements
Melatonin supplements may help you better adjust to a shift work schedule. However, you should definitely talk to your doctor before taking a melatonin supplement.
Sleep medications
Your doctor may prescribe a sleeping pill to help you fall asleep at the right time. Sleeping pills can help you sleep better in the short term, but they can become addictive when used long-term. Sleeping pills can also have unpleasant or dangerous side effects.
Wake-promoting agents
Wake-promoting agents are a type of medication that helps you stay awake and increase your ability to stay awake. The US Food and Drug Administration (FDA) currently has two types of medications approved for SWSD:
- Modafinil (Modafinil - Provagil®).
- Armodafinil (Armodafinil - Nuvigil®).
While these medications can help reduce performance issues caused by sleepiness, they are not a substitute for adequate sleep. They also have side effects and can be addictive. Talk to your doctor to find out if these medications are right for you.
Can shift work sleep disorder be prevented?
In fact, there's no way to completely prevent shift work sleep disorder (SWSD) other than continuing to work traditional work hours. However, you can develop a set of habits that will help you manage your symptoms and get better quality sleep and stay alert during your waking hours . That means following the strategies discussed earlier.
What complications can occur due to SWSD?
If left untreated, shift work sleep disorder (SWSD) can lead to various complications. Here are some:
- Reduced work efficiency: People with SWSD often have difficulty concentrating and remembering things when they are awake and working. This can lead to reduced work efficiency. Imagine what would happen if you forgot something small while doing an important task.
- Increased risk of accidents: SWSD reduces alertness and reaction time. This increases the risk of making mistakes or getting into an accident while working. Also, the risk of getting into an accident while driving due to drowsiness increases.
- Psychological problems: SWSD can make you irritable and have difficulty dealing with conflict. People with SWSD are at a higher risk of developing depression than those without the condition.
- Alcohol and drug use: Many people with sleep problems, including SWSD, try to 'medicate' themselves by using alcohol or drugs. This can put them at risk for substance or alcohol use disorder.
Good quality sleep is essential for good health. SWSD and lack of sleep can worsen existing health conditions or create new problems.
Here are the long-term health risks that can arise from SWSD:
- Frequent illnesses, such as colds and flu.
- Increased blood cholesterol levels.
- Heart disease.
- Obesity.
- Gastrointestinal issues.
- Reproductive system problems and/or low testosterone levels.
- Several types of cancer.
How long will this SWSD situation last?
The symptoms of shift work sleep disorder usually last as long as you work irregular hours. The condition goes away when you start going to bed and waking up at regular times again. However, you may still have sleep problems after your shift work schedule ends.
When should I see a doctor about SWSD?
If you have symptoms of shift work sleep disorder, it's best to talk to a doctor to find a solution that works for you.
If you've been diagnosed with SWSD and your treatment plan isn't working after a few weeks, see your doctor again.
Remember, not everyone who works shifts develops shift work sleep disorder (SWSD). Many people find it difficult to adjust to a new shift at first. However, if you still have trouble falling or staying asleep after a few weeks, or if you still feel tired after seven to eight hours of sleep, you may have SWSD. The good news is that there are several ways to help reduce the symptoms of SWSD. A doctor can diagnose it and give you a treatment plan to manage SWSD.
Final Take-Home Message
Okay, so now you have a better understanding of what we've been talking about today, Shift Work Sleep Disorder (SWSD). If you're a shift worker, keep these things in mind:
- Prioritize your sleep. It's just as important as your job.
- If you have symptoms of SWSD (insomnia, excessive sleepiness, decreased attention), don't ignore them. Seek medical advice.
- You can control this condition to a great extent by making small changes to your work environment, home environment, and your daily routine.
- Things like bright light therapy, melatonin, and, if necessary, prescription medications can help.
- Never drive while drowsy. It is dangerous for you and others.
- You are not alone. There are many people who suffer from these problems, and there is help available.
So, take care of your sleep. Because good sleep is essential for a healthy, happy life!
` Shift Work Sleep Disorder, SWSD, Insomnia, Excessive Sleepiness, Circadian Rhythm, Melatonin, Shift Work Sleep
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