What is Shift Work Sleep Disorder and Why Does it Matter?

shift work sleep disorder

Do you work night or graveyard shifts? Do you get enough spare time to engage in activities other than work and sleep?

Due to perks like extra pay and a flexible schedule, a lot of people are choosing to work at night. The labor law does not necessitate employers to compensate the night workers additionally, but considering the profits, some employers are willing to do so. They are prepared to hire willing workers who are ready to burn the midnight oil. 

According to a report by PBS, young Americans don’t mind working jobs at night that traditionally carried out during the daytime. 

Think of it: Working at night might have a few pros, but for the most part, it is mentally and physically taxing. In most cases, night work is more relaxed and low-stress compared to a 9-to-5 job. 

Generally, night workers do not worry about their bosses breathing down their necks. Nighttime bosses — in general — are informal and have a laid back attitude. Which is good news for an employee, but it comes at a cost.

Most nighttime workers do not enjoy their profession. They feel like work and sleep are the only two things they get to do in the entire week. Sleep deprivation and loneliness are the two problems a night shift worker has come up against almost every day. 

But how long can a person continue to compromise on sleep and social life? As a matter of fact, shift-work is the leading cause of a condition known as shift work sleep disorder (SWSD).

What is Shift Work Sleep Disorder (SWSD)? How Many People in the US Suffer from this Condition?

Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder observed commonly amongst people who work through the early morning hours, typically covering the period between midnight and 8 a.m. 

Insomnia and excessive sleepiness are the two main symptoms of this condition. Usually, a person suffering from shift work sleep disorder (SWSD) feels drowsy during his/her work hours and fails to fall asleep during the off hours.

According to a stat by NationalSleepFoundation, in the US, almost 10 percent of night and rotating shift workers are troubled by shift work disorder. Plus, 25-30 percent of night workers have agreed to experience symptoms of excessive sleepiness or insomnia. There is another stat that says 15 percent of the US workforce work either at night or on rotating shifts. 

Keeping in mind the Population of the United States in 2019, we calculated the number of people showing symptoms of shift work sleep disorder (SWSD). It comes to 14 million (out of a total of 329.06 million), the number is shocking. Also, the fact that shift work sleep disorder (SWSD) is, for the most part, not often formally diagnosed makes the estimated number seem meager.

Diagnosis of Shift Work Sleep Disorder (SWSD)

It is common for someone who works at unusual hours to feel a bit uneasy and apprehensive sometimes. This does not indicate shift work sleep disorder (SWSD). 70-80 percent of the population who work at night or on rotating shifts do not complain of experiencing insomnia in off-hours or feeling excessively sleepy during work hours.

There are plenty who thrive as night-shift workers and prefer to work at night despite given the option to change work hours. 

So how do you self diagnose shift work sleep disorder (SWSD)? 

International Classification of Sleep Disorder – Third Edition (ICSD-3) and International Classification of Diseases (ICD-10), two major sleep science organizations, have set criteria to identify shift work sleep disorder (SWSD) in night shift workers.  

Here are the four diagnostic guidelines by ICSD-3 and ICD-10 :

1) There is a report of insomnia or/and excessive sleepiness with a reduction of total sleep time, work which is associated with a recurring work schedule that overlaps that usual time for sleep.

2) The symptoms have been present and associated with the shift work schedule for at least three months.

3) Sleep log or actigraphy monitoring for more than 14 days shows a disturbed sleep and wake pattern.

4) The sleep and/or wake disturbances are not better explained by another current sleep disorder, medical or neurological disorder, mental disorder, medication use, poor sleep hygiene, or substance use disorder.

We have taken the four points mentioned above directly from the International Classification of Sleep Disorders (ICSD-3) document.  

It can be challenging to get actigraphy (mentioned in the third point) monitoring done without prescription. Also, you will have to learn how to read those charts. So, unless you wish to consult a physician, do not bother with it. Just watch yourself and note if you meet the first, second, and fourth criteria. 

Treatment Options for Shift Work Sleep Disorder (SWSD)

1) Bright light therapy

Bright light therapy is one of the most effective treatments for circadian rhythm sleep disorders. The idea behind bright light therapy is to rewire your internal biological clock to its default position. Due to working sleepless nights, your internal clock is not working the way it should. Its only purpose is to notify you when to sleep and when to wake up. 

With bright light therapy, your internal clock can be reset at the right time. This is how bright light therapy works: A patient with circadian rhythm disorder is exposed to bright light at a luminance of around 10,000 lux. 

A regular light bulb gives luminance of 200 lux, which is not good enough. A particular light bulb is used for the therapy. For instance, if you wish to delay sleep in the evening, expose yourself to bright light for the moment sleep kicks in.

2) Melatonin treatment

Just like bright light therapy delays the secretion of melatonin after exposure, you can also inject (or orally supplement) melatonin in your bloodstream to compensate for its deficiency. 

Melatonin is a hormone released by the pineal gland (located in the brain). This hormone is gradually released in the bloodstream as the sun goes down. At bedtime, the level of melatonin in the body is the highest.

Moreover, the pineal gland is triggered by the internal clock. A circadian rhythm disorder is developed when the clock fails to recognize the right time to sleep or wake up. In countries like the US and Canada, melatonin supplements are available over-the-counter, and you can purchase them without a prescription. 

3) Sleep in a pitch-black room

Shift Work Sleep Disorder

As we already stated, melatonin secretion increases when the prefrontal cortex (region above your eye sockets) stops sensing the presence of light in the surrounding environment. 

For a night shift worker, the best way to trick the pineal gland into releasing melatonin is by simulating nighttime in your room. We recommend you to dedicate a place just for daytime sleeping. Use cardboard, aluminum foils, or dark-colored curtains to plug every hole in your room from which there is a possibility of sunlight seeping in. 

Over-The-Counter Medication for Shift Work Sleep Disorder (SWSD)

Shift Work Sleep Disorder

If the above-mentioned natural remedies do not help you deal with your sleep disorder, then it would be wise to try out some over-the-counter side effects of free drugs. Sleep deprivation is one of the biggest causes of lack of productivity at work. You don’t want to slack or appear sluggish at work. 

To reiterate, insomnia or/and excessive sleepiness are two main issues night workers face. So, to deal with insomnia, you can take hypnotic or soporific drugs like Zopiclone (Imovane, Zimovane, and Dopareel). Take the recommended dosage in the morning, and it will help you stay asleep for 6-8 hours.

On the other hand, if excessive sleepiness is your problem, then have a cup of freshly brewed coffee before heading out to work. You can also carry caffeinated drinks to work. They can help you stay alert and focused at night. As for the medication, you can go for non-amphetamine alerting drugs like Provigil (Modafinil). 

Even patients with sleep apnea and narcolepsy take Provigil pills to fight with drowsiness during the day. Compounds contained in Provigil are meant to alter the state of neurotransmitters in the brain. It should take 30-60 minutes for the effects of Provigil to kick in. It works similarly to Adderall (a popular over-the-counter drug to treat ADHD) but is not as powerful. 

Conclusion

Sometimes a night, rotational, or a graveyard shift is difficult to deal with. Even with benefits like more pay, low stress, laid back environment, etc., some people break down after a few months and have to quit their jobs. 

If you are thinking about accepting that enticing job offer involving night shifts, you will likely end up unemployed and sleep-deprived after a few months. Hence, it is crucial to prepare yourself well beforehand.