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Sleep Disorder, Shift Work

Michael McShane, MD EdM Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Shift work disorder (SWD), classified as a circadian rhythm sleep-wake disorder, is characterized by symptoms of insomnia and/or excessive sleepiness when required to work during usu...

DIAGNOSIS

This is a clinical diagnosis. Criteria for circadian rhythm disorder per DSM-5 include all three of the following (1):       
  • A persistent or recurrent pattern of sleep disruption that is pr...

TREATMENT

  • The only standard recommendation by the American Academy of Sleep Medicine is planned (prescribed) sleep schedules (7)[C].

  • Other commonly used strategies include promoting wakefulness while ...

ONGOING CARE

PATIENT EDUCATION

  • Discuss sleep hygiene and optimizing the sleep environment.

  • Shift workers who sleep in the daytime should ensure a cool, dark, quiet sleep environment.

  • Reserve bedroom for ...

REFERENCES

1
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Association, 2013.
2
Wickwire EM, Geiger-Brown J, Scharf, ...

ADDITIONAL READING

HelpGuide. Sleep Diary. https://www.helpguide.org/wp-content/uploads/2018/12/sleep-diary.pdf. Accessed November 17, 2021.  

CODES

ICD10

G47.26 Circadian rhythm sleep disorder, shift work type 

SNOMED

  • 192000006 Work shift change (disorder)

  • 3745000 sleep-wake schedule disorder (disorder)

CLINICAL PEARLS

  • SWD has been associated with increased risk for metabolic disorders and mood disorders.

  • The first diagnostic step in SWD is to obtain a comprehensive sleep history and work history. Sle...

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