Diagnosis and Treatment of Shift Work Disorder

Shift work refers to any job that falls outside of a "traditional" 9:00-5:00 work schedule, affecting most people who start work before 6:30 a.m. or after 4:30 p.m. Approximately 16% of the workforce are employed as shift workers, with many susceptible to shift work disorder (SWD). Often unrecognized and undertreated, SWD is a circadian rhythm sleep disorder that can cause excessive sleepiness during the work shift combined with insomnia during desired sleep times. Other symptoms may include headaches, weight gain, gastrointestinal issues, fatigue, attention/concentration issues, irritability, and depression. Although a cure does not exist for SWD, symptoms can be managed using a combination of behavioral and pharmacological methods. Behavioral interventions include sleep scheduling, exercise, and light exposure. Melatonin and caffeine-containing agents may provide relief, with U.S. Food and Drug Administration-approved modafinil and armodafinil improving wakefulness. Treatment can greatly improve performance, sleep, and quality of life for these patients.