About 20% of the population performs shift work, meaning they work hours outside of the normal 9–5 schedule. However, the prevalence of this reversed sched¬ule—and its side effects—is not well recognized.
One of the most challenging side effects of shift work is shift work sleep disorder (SWSD), in which you have difficulty getting enough sleep because your schedule doesn’t align with the natural day and night rhythm. You are, in a sense, fighting against nature by working at night and sleeping during the day.
The incidence of SWSD is “about 32% of night workers, 10% of daily workers and 8–26% of workers in rotating shifts. “It is higher in a hospital setting among nurses, medical interns, and doctors since hospitals are open 24/7. In addition, there is a shortage of healthcare workers to cover the shifts, stretching shift workers even further. SWSD is also common in factories and food-production plants that run around the clock.
The common symptoms of SWSD are daytime drowsiness (somnolence), fatigue, insomnia, and even depression. These symptoms are due to the non-synchronization of the circadian rhythm because of work schedule demands.
In the hospital setting, most shifts vary between 12 and 24 hours. Lack of sleep for such a long time, plus the absence of natural light, shifts the internal clock forward and backward, resulting in symptoms of insomnia and sleepiness.
The treatment for shift work disorder is to avoid bright light at the end of the shift, have a fixed sleep time, and if indicated, to use FDA-approved stimulant medi¬cations like modafinil and armodafinil to combat sleepiness. That being said, this is a difficult disorder to treat as the shifts vary regularly, thus placing the circadian clock under constant turmoil.