Do you have Shift Work Disorder (SWD)?
Sleepfoundation.org 1 says if you experience any of these symptoms, talk to your doctor.
- I feel drowsy when at work or on my "off time" during family or social engagements.
- I have fallen asleep at work.
- I'm not productive at work. I often can't think quickly or make good decisions while i'm on the job.
- I have trouble falling asleep when its time to sleep (when my shift ends or when I'm supposed to sleep).
- I wake up too soon. I cannot sleep seven to nine hours continuously.
- My sleep is "broken" and I wake up frequently during the time I should be sleeping.
- I feel irritable or moody.
- My shift work schedule has created trouble in my personal life (with my partner, family or friends).
Can we see a show of hands?
The consensus of our unscientific, ad hoc focus group (consisting of whoever was in the break room) is "I've got that" on almost 100% of the listed observations.
Drowsy Driving... or Worse
Your disturbed sleep may make itself noticeable with the occurrence of microsleep events. Microsleeps are involuntary losses of awareness, lasting a few seconds.
The relative danger increases with the relative importance of vigilance -- while operating a vehicle, machinery or providing medical care. One microsleep can be one too many.
Take immediate safety action if you have a microsleep while driving. A car nap beats a dirt nap, an day.
Non-Medical Management
Options which may be considered to manage the impact of Shift Work Disorder (SWD) include employing good sleep hygiene, adjusting one's schedule and managing the sleep environment.
Good sleep hygiene can be a great first step to restore a more normal Circadian Rhythm -- the body's natural wake-sleep cycle.
Consider:
- Installing and using blackout shades or curtains in the bedroom.
- Adjusting the bedroom temperature to a comfortable setting.
- Using a "white noise" machine, running a fan or playing a recording of nature sounds or relaxing music.
- Going to your mental "happy place".
- Relaxation exercises.
- Having a sleep ritual
- Remove clocks from view.
- Avoid caffeine use before bedtime (even if you are proficient in the caffeine bolus rebound sedation technique).
- Take supplemental Melatonin before sleep, as directed.
- Resist computer and smartphone use before sleep
- Your pets may have to sleep elsewhere, or at least respect your sleep time.
- Light therapy. Wear orange or amber glasses for the commute home after night shift to keep the body from suppressing natural melatonin.
You may need exposure to blue light to reset your wake cycle.
Diagnosis
The route to diagnosis may include your keeping a sleep diary, undergoing home sleep testing or in-lab polysomnography (PSG) and seeing a sleep medicine specialist.
Treatment
Your doctor can help you with treatment options, taking into account your symptoms and health history.
Treatment may include some of the non-medical methods (noted above), but may also include prescription medications.
Some medications are aimed at enhancing alertness:
Modafinil Brand Duvigil
Armodafil Brand Nuvigil
Others, such as, supplemental melatonin, benzodiapines, non-benzodiapine hypnotics and certain antidepressants, may make it possible to have more, uninterrupted sleep.
A sleep study may reveal the presence of Obstructive Sleep Apnea, which might be addressed by use of a CPAP or BiPAP machine.
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References
1. sleepfoundation.org, accessed 2/28/2015
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