Shift Work Sleep Disorder (SWSD)
Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder that commonly affects people who work non-traditional hours that involve overnight, early morning, or rotating shifts.
SWSD affects our circadian rhythms, which are physical, mental, and behavioural rhythms that follow a 24-hour cycle. Interruption in our circadian rhythm leads to disruption in the timing of sleep. When this occurs, there is difficulty adjusting to different sleep/wake schedules. One common problem is that insomnia symptoms in SWSD can arise from circadian misalignment. Other symptoms include excessive sleepiness and at unwanted times, difficulty concentrating, headaches, low mood, irritability a lack of energy, and a higher risk of errors or accidents. Long-term effects can lead to cardiovascular diseases, diabetes & metabolic syndromes, obesity, gastrointestinal problems, difficulties with fertility & pregnancy, and an increased risk of cancer.
CBT-I can help with the assessment of SWSD using a detailed sleep diary looking at the reduction in total sleep time (usually 1-4 hours loss of sleep per schedule) and how much excessive sleepiness affects the client when awake. Education on sleep hygiene and how best to sleep on the days outside of shifts helps to manage insomnia. An indication of SWSD requires a referral to the clients Doctor for a physical examination to rule out any other illnesses or conditions that could be causing these symptoms with a possible referral to a sleep clinic for further analysis.
If the symptoms persist after changing to a traditional working schedule, then CBT-I is a robust treatment pathway.
How can I sleep better with shift work?
Here are 5 Key tips for better sleep for shift workers
Plan ahead for your sleep by:
Try not to rely on caffeinated drinks to help you stay awake. Coffee has a half-life of up to 8hrs, so it is better to avoid caffeine six to eight hours before your intended sleep time.
Be careful with what you eat. High-protein foods such as steak and chicken can disrupt sleep as they will take longer to breakdown and our digestion system is 50% slower whilst we sleep. So, eat ‘complex’ carbohydrates like whole-wheat toast or oatmeal before bed. These foods help with the release of serotonin, a chemical precursor to melatonin.
Alcohol as a ‘sleep aid’? No, just No!! Alcohol is anything but an aid for sleep. Alcohol disrupts the normal deep sleep and rapid eye movement (REM) sleep which leads to shorter sleep time and more fragmented and lighter sleep. As alcohol levels drop, your brain kicks into overdrive. You may toss and turn as your body undergoes a rebound arousal. It takes about an hour for our bodies to process 1 unit of alcohol. A glass of wine will reduce our sleep quality by about 10%, 2 glasses of wine by 25% and 3 glasses of wine by 50%.
Try to limit sunlight before sleep, sunlight will wake our brains up. If it is safe to do so, wear sunglasses on your journey home from work. You can also try some light exercise just before your journey home to help overcome tiredness.
Your bedroom is a ‘sleep room’, ensure it is conducive to sleep. Your sleep room needs to be as dark as possible, try using an eye mask, keep it quiet, consider white noise such as a standing fan and/or use ear plugs, keep it cool at about 18 degrees and comfortable. How old is your mattress? It is recommended to change your mattress every 6-8 years.