Understanding and Managing Shift Work Sleep Disorder

Understanding Shift Work Sleep Disorder

Shift work sleep disorder (SWSD) is a serious condition that occurs when a person's work schedule overlaps with the typical time for sleep. This causes issues with getting good quality and adequate sleep and leads to excessive sleepiness when the person needs to be awake. SWSD has been a known issue for individuals working night and rotating shifts for many years. Recently, it has gained more widespread recognition and understanding as a legitimate medical disorder.

Causes of Shift Work Sleep Disorder

SWSD is caused by a misalignment between a person's internal circadian rhythm, the body's internal 24 hour clock, and their sleep/wake schedule. Humans are biologically programmed to be awake during daylight hours and sleep at night. But people with shifting work schedules are trying to sleep when their bodies expect them to be awake. This conflict leads to various problems including:

• Difficulty falling and staying asleep during scheduled sleep periods
• Excessive sleepiness and difficulty staying awake when needing to be alert at work
• Decreased work performance and productivity
• Mood issues such as irritability and depression

Symptoms of Shift Work Sleep Disorder

Individuals with SWSD typically struggle with many of the following symptoms:

• Chronic sleep deprivation characterized by not getting enough sleep on a regular basis
• Difficulty initiating or maintaining sleep during scheduled sleep times
• Frequently falling asleep unintentionally at work
• Irritability, anxiety, depression
• Gastrointestinal issues
• Increased risk of accidents or errors at work related to excessive sleepiness
• Poor concentration, focus and memory

Diagnosing Shift Work Sleep Disorder

Diagnosing SWSD begins with an evaluation by a sleep specialist. The doctor will gather information about sleep habits, medical history, and work schedule. This helps them assess sleep duration, timing, behaviors, and sleep environment.

They will also often order an overnight polysomnography test. This test involves monitoring brain waves, breathing, heart rate, and movement overnight to assess sleep quality and diagnose conditions like sleep apnea. Multiple Sleep Latency Tests during scheduled sleep times may also be used to evaluate sleepiness.

ICD-10 Code for Shift Work Sleep Disorder

The ICD-10 code used to designate shift work sleep disorder is G47.26. This code falls under the category of sleep disorders under the ICD-10 system for medical coding and billing.

Treating Shift Work Sleep Disorder

Treatment focuses on improving sleep duration and timing to match work schedules when possible. Good sleep hygiene practices are important like limiting light and noise exposure when sleeping. Strategic napping may also help counteract sleepiness. Other treatment options include:

Sleep Medications

Medications promote sleepiness at scheduled sleep times or help the individual remain awake when needed. Commonly prescribed medications include stimulants and wakefulness agents like modafinil as well as hypnotics and sedatives to induce sleep.

Light Exposure Therapy

Timing exposure properly to light and darkness helps realign the bodys internal clock. Increased light exposure when needing to stay awake along with limited light during scheduled sleep times can help manage SWSD symptoms.

Cognitive Behavioral Therapy (CBT)

CBT provides tools to improve coping ability, sleep behaviors, decision making regarding sleep needs, and address symptoms impacting work performance or well-being. It may help reduce distress associated with SWSD.

Preventing Shift Work Sleep Disorder

The most effective way to prevent SWSD is avoiding shift work altogether. But for many professions, that isnt an option. Other preventative tips include:

• Choosing a set shift schedule when possible instead of rotating shifts
• Keeping shifts shorter with plenty off-duty breaks for sleeping
• Napping before shifts or during breaks
• Improving sleep environments to limit noise/light and ensure comfort
• Careful timing of meals, activity, light exposure to promote better sleep

Educating shift workers on proper sleep hygiene and the importance of sleep can empower them to prioritize sleep whenever possible around shifts. Providing screening or testing for common sleep disorders can also allow early treatment options before SWSD occurs.

The Outlook for Shift Work Sleep Disorder

SWSD can have major implications for some shift workers if left unmanaged. The cumulative effects of poor sleep can take a major toll both physically and mentally. This also significantly increases safety risks in many occupations. But diagnosis and effective treatment targeted at optimizing sleep can help minimize symptoms.

Many employers now recognize the substantial risks of shift work and implement improved schedules, sleep facilities, and wellness programs. Advancements in lighting technologies that better control melatonin and other hormones tied to sleep provide options for treatment too. With proper management and prevention approaches, the negative impacts of SWSD can be reduced.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.