What is Shift Work Sleep Disorder?
Shortened as SWSD, this is a disorder affecting the normal sleep-wake cycle, normally manifested as constant sleepiness during the daytime and inability to sleep when you would normally want to sleep(at night).
As the name implies, this disorder normally arises as a result on unpredictable work schedules, and takes a few weeks before manifesting itself fully.
Indeed, shift work does possess certain advantages, especially to the hiring organization, since from their view point, they may be able to increase production, or make available 24 hour services. However, this is not the case for the workers; they actually face the risk of developing a variety of health conditions, including cardiovascular, stomach and intestinal as well as sleep and behavioral disorders.
Symptoms of SWSD
Although down the line the symptoms of SWSD may worsen or become more, initial symptoms that aid diagnosis are all sleep related in appearance. These may include;
- Somnolence- this is a syndrome characterized by excessive daytime drowsiness and sleepiness, sometimes triggered without warning. May be a particular problem for persons working in the transportation or aviation industries, or drivers in general
- Reduced productivity- again, a byproduct of acute sleep deprivation, workers are unable to function efficiently and may also display mental cloudiness.
- Mood Changes- part of the psychological aspect of SWSD relates to changes in mood and temperament. Individuals become easily agitated, depressed at failures and have a harder time coping with everyday stresses.
Causes of SWSD
- Work- the single largest contributing factor to the development of SWSD is the hours of work. Many individuals afflicted with it will confess to working long hours, for days at a time and without supplementary sleep. These persons who frequently disrupt their natural circadian rhythm are the most likely to develop SWSD.
- Co-Morbidities- co-morbidities are other conditions that occur with the disorder in question, with a potential for making it worse. For example, in the case of SWSD, insomnia or narcolepsy can possibly worsen the outcome of SWSD, or make an individual more prone to develop it if at risk.
Associated Health Risks of SWSD
Shift work by itself can result in an array of health related problems, which when complicated with a sleep disorder, negatively impacts many aspects of that individual’s life. Effects can be seen on;
- Weakened Immune System- recovery occurs naturally during sleep and to a much lesser extent during daytime sleep. This lack of recuperative ability can lead to frequent colds and infections.
- Cancers- research has shown an increase in the rate of oxidative reactions in the body directly contribute to the development of cancers, especially of the breast and prostate.
- Cardiovascular Issues- increased blood pressure, higher risk of heart attacks and even strokes are all an eventuality over time when the ill effects from sleep deprivation accumulate.
- Obesity- during sleep, a key fat liberating hormone, called growth hormone, is released with promotes fat metabolism and lean muscle growth. Irregular sleep patterns cause inhibited release patterns of this vital hormone curbing metabolic rate significantly. Thyroid hormone secretion is also affected by shifts in circadian rhythm.
Management of SWSD
Effective management of SWSD involves both a degree of drug treatment as well as lifestyle/ behavioral changes and sometimes light therapy treatment.
- Melatonin- in normal individuals, melatonin is the hormone that promotes sleepiness at night for about 12 hours straight. However, persons working shifts interrupt the normal secretion of melatonin since melatonin is secreted in the dark. Light quickly breaks down this hormone, so as you can see, daytime sleeping is much more difficult and less restorative that nocturnal sleep. One way melatonin may be used to promote sleep would be to take it at hours different than the evening, in an attempt to change the circadian clock. For example, taking it in the afternoon can lead to an earlier clock, while taking it in the morning can have the opposite effect. It can be useful for speeding up adjustment to a new work schedule.
- Stimulants- these are drugs that send signals to the brain to continue working, or rather stimulate the adrenal glands to produce adrenalin and keep the body awake. There are a wide range of stimulants available today, many over the counter, some by prescription, but to the same effect ultimately. The most popular and readily available stimulant the world over is caffeine, consumed by millions on a daily basis as part of their morning ritual to give them that necessary boost for the day. Caffeine is very effective at promoting alertness, regardless of when taken, but caution needs to be taken when considering dose and tolerance to its effects since it does occur often. Armodafinil and Modafinil are also popular prescription stimulants, originally used for narcolepsy but beneficial for SWSD also.
- Hypnotics- this is the broad name to represent all drugs whose purpose is to cause sleep. There are many different classes of hypnotics; the most widely used being the benzodiazepines, such as diazepam and alprazolam. These drugs may be useful in promoting daytime sleep, but show no real effect on nocturnal sleep in comparison with natural melatonin.
A major governing force of the body’s circadian rhythm is the effect of light on it. Well timed exposure to light can help to delay the body’s clock for several hours, while exposure to bright light early in the morning having the opposite effect. It may be difficult to avoid the bright light on the way home, but wearing heavily tinted glasses may aid this and help speed up adaptation to the new cycle.
Category: Sleep Disorders