Shift work sleep disorder (SWSD) refers to a condition seen in some workers who work nights or who have frequent changes in their work shifts.


Manifestations - one or both of the following:

(1) excessive sleepiness during work period

(2) disordered sleep during major sleep period (insomnia, short duration, delayed onset), with sleep of poor quality


People at risk - one or both of the following:

(1) working night shift

(2) having frequent changes in times for work shift (variable work schedule)


Diagnosis requires:

(1) Moderate to marked impairment as a result of disordered sleep.

(2) The patient's sleep disorder disappears if the inciting cause is changed (no longer works nights or stable work schedule).

(3) Exclusion of other causes


Impairments and consequences associated with shift work sleep disorder:

(1) increased need for napping

(2) decreased alertness and clarity of thought

(3) higher rate of peptic ulceration and other gastrointestinal complaints

(4) higher rate of serious work injury

(5) higher rate of work absenteeism

(6) higher rate of commuting accidents

(7) impaired participation in social and family activities, with tendency towards social isolation

(8) higher rate of drug and alcohol misuse

(9) higher rate of clinical depression

(10) impaired interpersonal relationships


Differential diagnosis:

(1) depression

(2) sleep apnea syndrome

(3) other sleep disorders


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