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Shift Worker Syndrome

May 25, 2024

Shift Worker Syndrome

Shift Worker Syndrome, also known as Shift Work Sleep Disorder (SWSD), is a type of circadian rhythm sleep disorder that affects individuals who work non-traditional hours outside the regular 9 a.m. to 5 p.m. work schedule. Circadian rhythms are 24-hour cycles that regulate physical, mental, and behavioural changes in a human body, primarily responsive to light and darkness. 

SWSD is a common disorder affecting approximately 10% to 40% of individuals who work non-traditional shifts. It could involve those working overnight, early mornings, or rotating shifts.

Symptoms of Shift Worker Syndrome

The two primary symptoms of shift worker syndrome include insomnia and hypersomnia. 

Insomnia refers to the difficulty in falling asleep and/or maintaining sleep. People working between 4 a.m. and 7 a.m. often struggle with falling asleep, while those working evening shifts typically experience trouble staying asleep. Hypersomnia is characterized by excessive sleepiness at unwanted times, which often occurs during work hours in the night or early morning for a person with SWSD. This condition can be dangerous and impair work performance.

Other symptoms include:

  • Difficulty concentrating
  • Headaches
  • Lack of energy
  • Decreased alertness during work hours
  • Poor mood and irritability

Causes of Shift Worker Syndrome

Shift worker syndrome arises due to a mismatch between your internal body clock and the external environmental conditions impacting the timing and duration of your sleep. Normally, sunlight acts as a visual cue, triggering your internal clock throughout the day. This light gets transmitted through your eyes into your brain's control centre, leading to several bodily processes and hormonal changes that signal it's time for you to wake up.

Your internal clock also depends on the hormones melatonin and cortisol. Melatonin is released from the brain's pineal gland at higher levels during the night and at minimal amounts during the day. Cortisol is produced and released by your adrenal glands, with lower levels noted in the evening when you sleep and peak levels in the morning before you wake up. For individuals performing non-traditional shifts, these cues do not align with their active hours, affecting both sleep and wakefulness. 

Diagnosis of Shift Worker Syndrome

Diagnosing SWSD typically involves keeping a detailed sleep journal for at least two weeks. Your doctor will likely ask you to note down:

  • When you fall asleep and wake up.
  • How many times you wake up during your sleep
  • How rested you feel
  • Factors that might affect your sleep or sleep routine, such as caffeine consumption and noise disturbances

SWSD is generally diagnosed if you have experienced symptoms for at least three months. Your doctor may also recommend a sleep study or other tests to rule out other conditions, such as sleep apnea or the side effects of certain medications. 

Management and Treatment of Shift Worker Syndrome

While there isn't a cure-all, several treatments and management techniques target key features of SWSD, including:

  • Alterations to your work routine or schedule: If possible, try to adjust your shift timings or request a more regular schedule. Limiting evening and night shifts can help align your body clock with natural light-dark cycles. 
  • Changes to your sleep routine at home: Maintain a dark, quiet, and cool sleeping environment during daytime rest periods. Consider the use of sleep aids like eye masks or earplugs.
  • Bright light therapy: This therapy utilises exposure to bright light at specific times to reset your body's internal clock.
  • Melatonin supplements: These aid in re-synchronising your sleep-wake cycle.
  • Sleep medications: In some cases, the use of prescribed sleeping pills may be beneficial.
  • Wake-promoting agents: These medications can improve alertness and maintain wakefulness during working hours.
Prevention of Shift Worker Syndrome

Preventing SWSD may not be entirely possible unless you work traditional working hours consistently. However, taking steps towards managing your symptoms effectively can greatly enhance your quality of sleep and alertness during waking hours. These steps include making sleep a priority, following a regular sleep schedule, setting up a quiet and peaceful environment for sleep, and practicing good sleep hygiene.

Outlook of Shift Worker Syndrome

Without proper management, shift worker syndrome can lead to a range of complications. These include poor work performance, increased risk of accidents (both at work and while commuting), mood disorders such as irritability and depression, and substance use or alcohol abuse. Persistent sleep deprivation from SWSD may also worsen existing health conditions and increase the risk of developing new ones including obesity, heart disease, high cholesterol levels, gastrointestinal problems, and even cancer. 

However, the outlook for people with SWSD is generally positive if they seek appropriate treatment and make necessary lifestyle changes. Once a person stops working irregular hours, the symptoms of SWSD usually resolve.

Living With Shift Worker Syndrome

Living with shift worker syndrome can be challenging but it's not insurmountable. If you're experiencing symptoms of SWSD, it's important to consult a doctor to devise a management plan that's tailored to your needs. 

If you've already been diagnosed with SWSD and the existing treatment plan isn't yielding desired results, revisit your doctor to discuss other possible options. The key is to remain proactive about managing your health and well-being despite the challenges posed by irregular work schedules.

Home Remedies for Shift Worker Syndrome

Aside from medical interventions, there are several home remedies or lifestyle modifications that can help manage the symptoms of this disorder. These include:

  • Maintaining a healthy diet: Eating balanced meals at regular intervals can help keep your energy levels steady throughout your shift.
  • Regular exercise: Engaging in physical activity can enhance your sleep quality and boost energy levels.
  • Limiting light exposure: Use heavy curtains or sleep masks to block out light when you need to sleep during the day.
  • Reducing noise levels: Consider using earplugs or white noise machines to minimise disturbances during your sleep time.
  • Establishing a sleep routine: Try to go to bed and wake up at the same time every day, even on your days off, to regulate your body's internal clock.

Remember, SWSD is a manageable condition. If you're a shift worker experiencing sleep issues, don't hesitate to seek medical help. Your doctor can guide you through the various treatment options and preventive measures, helping you maintain a healthy work-life balance.

What are the consequences of untreated shift worker syndrome?

If shift worker syndrome remains untreated, it could lead to several long-term health issues. Insufficient sleep significantly increases the risks of cardiovascular disease, obesity, diabetes, and even certain types of cancer. Moreover, the condition can impact mental well-being, leading to mood disorders like depression and anxiety.

Can insurance cover the treatment for shift worker syndrome?

Usually, health insurance policies can cover treatment for recognised medical conditions such as shift worker syndrome. However, these depend on the specific terms and conditions of your policy. It's advisable to consult with your insurance provider to determine if your plan includes coverage for sleep disorders and their associated treatments.

Are there any age considerations for developing shift worker syndrome?

Shift worker syndrome can affect individuals of any age who are involved in shift work. However, people over the age of 40 seem to have a harder time adjusting to shift work and may be more susceptible to the condition. Age-related changes in sleep patterns and general health status may contribute to this increased vulnerability. It's essential for shift workers of all ages to pay attention to their sleep patterns and seek help if they notice any symptoms.

How effective are the treatments for shift worker syndrome?

Treatment for shift worker syndrome can be highly effective if followed properly. Medications, light therapy, and changes in sleep habits all contribute to managing the condition efficiently. In addition, lifestyle modifications like maintaining a healthy diet, regular exercise and reducing caffeine intake can significantly improve symptoms.

What is the recommended post-treatment care for shift worker syndrome?

Post-treatment care for shift worker syndrome involves consistent adherence to advised sleep schedules. Additionally, creating a sleep-conducive environment at home is important; this means dark, quiet and cool bedrooms. Regular check-ups with your doctor are also recommended to monitor progress and make any necessary adjustments to your treatment plan.

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