By The Gypsy Nurse

January 21, 2019

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Treatment: Shift Work Disorder

If you feel that you or someone you know suffers from Shift Work Disorder, you probably want to know how to treat it.  Below you will find some interventions that have been successful for others in the treatment of SWD.

Treatments for Shift Work Disorder

“Prescribed sleep/wake scheduling”

Experts agree that there is no such thing as an “ideal” night work schedule, but some schedules may be better than others. For example, you can rotate shifts every two weeks in a forward (delaying) direction was found to be easier than rotation in a backward (advancing) direction. Some experts have advocated short runs (1 to 2 days) of night work with time for recovery; however, in the traditional heavy industries, longer (5 to 7 day) runs remain the rule.

Bright light treatment

The light-dark cycle is the most important environmental time cue for entraining circadian rhythms of most species, including humans, and bright artificial light exposure has been developed as a method to improve circadian adaptation in night workers. The timing of bright light exposure is critical for its phase shifting effects. To maximize a delay of the body clock, bright light exposure should occur in the evening or first part of the night, and bright light should be avoided in the morning

Melatonin Treatment

Melatonin is a hormone secreted by the pineal gland for about 12 hours at night. Taking melatonin resets the body clock in the opposite direction from light exposure; that is, taking melatonin in the afternoon or evening may cause the clock to reset to an earlier time, while taking melatonin in the morning may cause the clock to reset to a later time. Melatonin has been shown to accelerate the adaptation of the circadian system to a night work schedule

Medications that promote alertness

Caffeine is the most widely used alerting drug in the world and has been shown to improve alertness in simulated night work. Caffeine may or may not be recommended as a treatment for shift work disorder but it’s The Gypsy Nurses‘ go to drug of choice. Modafinil and armodafinil are non-amphetamine alerting drugs originally developed for the treatment narcolepsy that have been approved by the FDA (the US Food and Drug Administration) for excessive sleepiness associated with Sleep Work Disorder.

Medications that promote daytime sleep

Obtaining enough sleep during the day is a major problem for many night workers. Hypnotics given in the morning can lengthen daytime sleep; however, some studies have shown that nighttime sleepiness may be unaffected.

Other Interventions for Sleep Work Disorder

  • Minimize exposure to light on your way home from work if you are on the night shift to keep morning sunlight from activating your internal “daytime clock.”
  • Follow bedtime rituals and try to keep a regular sleep schedule – even on weekends.
  • Go to sleep as soon as possible after work. It is important to get at least 7 to 8 hours of sleep every day.At home, ask family and friends to help create a quiet and peaceful setting during your sleep time.
  • Have family members wear headphones to listen to music or watch TV. Encourage people in the household to avoid vacuuming, dish washing, and other noisy activities during your sleep time.
  • Put a “Do Not Disturb” sign on the front door so that delivery people and friends will not knock or ring the doorbell.

Head Nurse; A fellow blogger writes about how to deal with night shift in the post titled Beginners Guide to Working Nights.  I would encourage you to read this informative and somewhat comical entry for the new night shift worker.  The recommendations are excellent for sufferers of Shift Work Disorder.

That old saw about a fifteen-minute shower being equal to eight hours’ sleep? Is true. Don’t make any decisions about anything until you’ve poured a substantial quantity of hot water over your head. This goes whether you’re working that night or not. It’s amazing how far a little soap will go to make you feel Almost Human.

By The Gypsy Nurse

July 30, 2018

15889 Views

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Diagnosis: Shift Work Disorder

Shift Work Disorder (SWD)

Shift Work Disorder occurs when the body’s internal sleep-wake clock is out of sync with the work schedule.

Because of this disruption of the body’s natural rhythm, people with Shift Work Disorder often struggle to stay awake during their waking hours or have trouble sleeping during their sleeping hours.

Causes, incidence, and risk factors
According to the Bureau of Labor Statistics, approximately 15 million Americans work outside of the traditional 9 to 5 schedule. 1 in 4 of these workers may have Shift Work Disorder (SWD)

Risk Factors for SWD may include:

  • Work schedules that include night, early morning, or rotating shifts.
  • Work hours that overlap with the typical sleep period
  • Frequent Mandatory Overtime. Shift work is often combined with extended hours of duty, so fatigue can be a compounding factor.

Symptoms

  • Insomnia
  • Trouble focusing
  • Sleepiness-related accidents
  • Reduced work performance
  • Struggle to stay awake at work
  • Impaired functioning
  • Increased irritability
  • Worsening of heart and stomach disorders

Signs and tests
There are currently no definitive tests available for diagnosis of Shift Work Disorder.  If you think you may be suffering from SWD, please consult with your physician.

Treatment
There really is no cure for Shift Work Disorder other than changing your work hours to a ‘normal’ daytime work schedule. This may not be a possibility; especially in the nursing field.  Nursing is 24/7 and as long as there are sick people, there will be night shift workers in nursing.  Next week, we discuss some treatments that can help alleviate some of the symptoms of SWD.

Support Groups
Below you will find a couple of Support Groups for those suffering from SWD.  The Gypsy Nurse does not personally endorse these groups, they are only provided as a reference.

I would encourage you to post comments.  Tell me what you want to hear about, what you enjoyed, or how you combat some of the issues discussed.  You may also connect with us via Twitter or Facebook and together we can work on decreasing the symptoms together.

This information is provided by The Gypsy Nurse and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.