Do you know the signs of shift work disorder?
Are you one of the 30 percent of nurses who work the night shift? If you are, are you frequently tired or do you often find yourself fighting off sleep? Do you have difficulty falling or staying asleep? Do these sleep problems disrupt your social, family or work life? Have these sleep difficulties been present for at least one month?
If you answered yes to any of these questions, then read on, because you may have shift work disorder, a type of circadian-rhythm sleep disorder that can adversely impact not only your job performance, but also the quality and even duration of your life. The good news is that by following a few simple recommendations, you can improve your health and well being and get your life back on track again.
What is shift work disorder? The human body naturally follows a “circadian” or approximately 24-hour period of wakefulness and sleepiness, with the desire to sleep strongest between midnight and 6 a.m., and between 2 p.m. and 4 p.m. Your circadian sleep-wake rhythm, which is linked to nature’s cycle of light and darkness, is regulated by an internal biologic clock located in the suprachiasmatic nuclei of the hypothalamus. Shift work disorder and its consequences occur when you try to stay awake when your internal biologic clock is telling you to sleep, or when you try to sleep when your internal clock wants you to be awake.
What are the major symptoms of shift work disorder?
It should come as no surprise that during the night shift, when your internal clock is saying you should be asleep, you would feel excessively tired, fatigued and less alert. It should be just as easy to understand why you would also have difficulty falling and staying asleep when your body’s sleep-wake rhythm demands you be awake. Thus, the major symptoms of shift work disorder are hypersomnia, or excessive sleepiness, and insomnia.
What are the consequences of shift work disorder?
- Shift work disorder typically results in a decrease in total sleep time of one to four hours and an “unsatisfactory” or non-restorative sleep quality.
- Excessive sleepiness, a consequence of both cumulative sleep loss and decreased circadian alertness, can result in difficulty staying alert, concentrating, remembering things and making decisions, as well as problems with eye-hand coordination, headaches, decreased attention span and increased reaction times.
- In 2005, Kenshu Suzuki, MD, and colleagues reported in their sleep study of nurses that those who were excessively sleepy during the night shift were more likely to make drug administration errors, have needle stick injuries and operate medical equipment incorrectly—mistakes that can impact both patient and nurse. Surveys of medical workers have demonstrated that 41 percent admit to making fatigue-related errors; 19 percent reported that their error worsened a patient’s condition. These findings are consistent with studies demonstrating that experiencing only two hours of sleep loss has the same effect on performance as drinking three alcoholic beverages.
- Individuals with shift work disorder also have increased absenteeism; gastrointestinal and digestive problems such as heartburn and indigestion; heart problems, including an increased risk of heart attacks and hypertension; carcinoma of the breast, uterus and colon; menstrual irregularities; colds and flu; and weight gain.
- Shift workers have more automobile accidents, especially driving to and from work, probably because they’re more likely to drive while fatigued and almost twice as likely to fall asleep at the wheel. In fact, two-thirds of shift workers report driving drowsy after a shift. In addition, associated irritability, impatience and mood disorders such as anxiety and depression can ruin job and family relationships and spoil social activities.
Do you have Shift Work Disorder? Take our quiz. To learn more about shift work disorder and get some tips on how to trick your body into sleeping (when the rest of the world is awake), read all of our Shift Work Disorder Articles series!
Terry Cralle is Co-founder and Corporate Vice President of the Keswick Sleep Institute in Charlottesville, Virginia. She holds a B.A. in Sociology from Randolph-Macon College and received her Bachelors of Science in Nursing at the Virginia Commonwealth University and completed a Masters of Science in Healthcare Management with an Emphasis in Healthcare Risk Management from the Finch University of Health Sciences at the Chicago Medical School. Terry is a Certified Professional in Healthcare Quality as well as a Certified Quality Auditor. Terry has had over 20 years experience as a healthcare consultant. She has published on clinical research topics as well as serving as Lecturer at Piedmont Virginia Community College in Charlottesville, Virginia.
By Terry Cralle