Shift Work Disorder (SWD) is among the most commonly undiagnosed and undertreated sleep/wake disorders. About 22 million Americans perform some type of nonstandard shift work and are at risk for SWD—the presence of excessive sleepiness and/or insomnia for at least 1 month, in association with a shift work schedule, provided other sleep/wake disorders can be excluded.
SWD can increase the risk of gastrointestinal disorders, cardiovascular disease, cancer, diabetes, other metabolic disturbances, irritability, or depressed mood. Persons with SWD may also have higher rates of ulcers, accidents related to drowsiness, absenteeism, missed family and social activities, and poorer job performance. Attempts to improve sleep may lead to drug and alcohol dependency.
SWD may develop when the physical environment requires a sleep schedule that is different from the individual’s internal circadian rhythms. SWD diagnosis is based on the patient history and may include use of a sleep diary/log. The differential diagnosis should exclude other potentially causative conditions, such as mood disorders, especially depression, and other sleep/wake disorders.
Managing SWD symptoms includes using bright lights during awake hours to help combat drowsiness, medication to treat excessive sleepiness or insomnia, and proper sleep/wake hygiene measures. Patient education about quality-of-life improvement with SWD management can help raise patient awareness and facilitate treatment success.
In this course: Recognize the role of circadian rhythms in sleep/wake function. Identify the risks and comorbid conditions associated with shift work disorder. Utilize screening questions and diagnostic tools to improve the identification and diagnosis of shift work disorder. Implement management strategies for patients with shift work disorder that optimize sleep, alertness, and circadian rhythm alignment. Utilize techniques to provide patient education about improving quality of life with effective management.
1.0 Free AMA Pra CAT 1 CME
Expires 9/29/12