She Works Hard for Her Sleep

Shift work and long work hours, such as 12-hour shifts, can disturb sleep and circadian rhythms. Shift work disorder is a circadian rhythm disorder in which excessive sleepiness and/or insomnia due to work schedule occur. There is a circadian misalignment between the timing of the sleep/wake schedule and the circadian pressures for sleep and wakefulness. Between 10% and 38% of nightshift and rotating shift workers experience shift work disorder. There can be interruptions during sleep caused by light, noise, and social obligations when sleep occurs at unusual times, resulting in a short sleep duration/inadequate sleep and poor sleep quality. Sleep logs provide valuable information. To improve the quantity and quality of sleep, the sleep environment and timing of light exposure need to be optimized, and limiting interruptions during sleep is recommended. Wake-promoting agents such as armodafinil prior to work may be needed for fatigue management. Validated tools can aid in diagnosis, and there may be an underutilization of sleep specialists in these patients.