Is Shift work Making Your Patient Sick? Emerging Theories and Therapies for Treating Shift Work Disorder

Sep 10, 2011Postgraduate medicine

New ideas and treatments for health problems caused by shift work

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Shift work disorder (SWD) affects up to 2 million Americans and is associated with various health risks.

SWD is characterized by excessive sleepiness during work and insomnia during scheduled sleep times.
It is linked to increased morbidity and mortality from metabolic risk factors, cardiovascular and gastrointestinal diseases, depression, accidents, and certain cancers.
Diagnosis can be made solely based on patient history using established criteria.
Treatment options are limited, yet may include behavioral strategies and pharmacologic interventions.
Medications like modafinil and armodafinil have shown effectiveness in reducing symptoms of SWD.
Combined therapy may improve sleep duration, reduce insomnia and excessive sleepiness, and enhance attention and alertness during shifts.

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"Shift work" is a term that applies to a wide array of nontraditional work schedules. Shift work disorder (SWD) is a circadian rhythm sleep disorder experienced by a subset of shift workers that is characterized by excessive sleepiness during work and/or insomnia during scheduled sleep times. It is estimated to affect up to 2 million Americans, and is associated with increased morbidity and mortality from metabolic risk factors, cardiovascular and gastrointestinal diseases, depression, accidents, and some kinds of cancers. Patient history is all that is needed to make a diagnosis with the International Classification of Sleep Disorders-Second Edition criteria as described herein. Circadian rhythm disorders, in which an underlying misalignment of circadian rhythm with the sleep-wake cycle occurs, may be treated by behavioral and pharmacologic approaches, including the use of hypnotics to improve the duration of sleep. However, evidence is limited with these approaches in patients diagnosed with SWD. Other treatment options may include pharmacologic interventions such as modafinil and armodafinil, which have shown efficacy in this population. Combined therapy can reduce insomnia and excessive sleepiness, and improve attention and alertness during work shifts and the subsequent commute home.

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Is Shift work Making Your Patient Sick? Emerging Theories and Therapies for Treating Shift Work Disorder

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