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shift work sleep disorder

Excessive sleepiness due to changes in work shift, i.e. night shift. Pathology: - disruption of circadian rhythms Complications: - obesity, metabolic syndrome - diabetes mellitus type 2 - hyperlipidemia - hypertension - increased risk of cardiovascular events - nursing night shift rotations (>= 3 night shifts monthly, in addition to day & evening shifts for > 5 years associated with increased risk of cardiovascular events (RR=1.2) [6] - psychosocial stress - increased risk of cognitive impairment [3] - driving performance of anesthesiology residents impaired after 6 consecutive night shifts [7] - increased risk of automobile accidents [4] Management: - education & counseling - sleep hygiene is 1st line [5] - avoidance of direct sunlight in the early morning - avoidance of exertion, eating, alcohol before morning sleep - caffeine during daytime work - consider eliminating shift work [5] - modafinil 200 mg at start of each night shift [1]

Related

modafinil (Provigil, Sparlon)

General

sleep disorder

References

  1. Czeisler CA et al U.S. Modafinil in Shift Work Sleep Disorder Study Group. Modafinil for excessive sleepiness associated with shift-work sleep disorder. N Engl J Med. 2005 Aug 4;353(5):476-86. Erratum in: N Engl J Med. 2005 Sep 8;353(10):1078. PMID: 16079371 - Basner RC. Shift-work sleep disorder--the glass is more than half empty. N Engl J Med. 2005 Aug 4;353(5):519-21. No abstract available. PMID: 16079378
  2. Journal Watch, August 31, 2012 Massachusetts Medical Society www.jwatch.org - Vyas MV et al. Shift work and vascular events: Systematic review and meta- analysis. BMJ 2012 Jul 26; 345:e4800 PMID: 22835925
  3. Devore EE et al. Shift work and cognition in the Nurses' Health Study. Am J Epidemiol 2013 Oct 15; 178:1296 PMID: 24076971 http://aje.oxfordjournals.org/content/178/8/1296
  4. Lee ML et al. High risk of near-crash driving events following night-shift work. Proc Natl Acad Sci U S 5 2016 Jan 5; 113:176 PMID: 26699470 http://www.pnas.org/content/113/1/176
  5. Medical Knowledge Self Assessment Program (MKSAP) 17, 19 American College of Physicians, Philadelphia 2015, 2022
  6. Vetter C, Devore EE, Wegrzyn LR et al. Association between rotating night shift work and risk of coronary heart disease among women. JAMA 2016 Apr 26; 315:1726 PMID: 27115377
  7. Huffmyer JL, Moncrief M, Tashjian JA Driving Performance of Residents after Six Consecutive Overnight Work Shifts. Anesthesiology. 2016 Jun;124(6):1396-403. PMID: 27028468
  8. Reis C, Staats R, Pellegrino P et a; The prevalence of excessive sleepiness is higher in shift workers than in patients with obstructive sleep apnea. J Sleep Res. 2020 Aug;29(4):e13073. PMID: 32395904 Free article