Sleep Disorder, Shift Work

Jennifer W. Caceres, M.D. Reviewed 05/2023

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:

A persistent or recurrent pattern of sleep disruption that is primari...

TREATMENT

The only standard recommendation by the American Academy of Sleep Medicine is planned (prescribed) sleep schedules [C].
Other commonly used strategies include promoting wakefulness while at w...

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 fo...

REFERENCES

Wickwire EM, Geiger-Brown J, Scharf SM, et al. Shift work and shift work sleep disorder: clinical and organizational perspectives. Chest. 2017;151(5):1156–1172.

Cheng P, Drake C. Shift Wor...

ADDITIONAL READING

HelpGuide. Sleep Diary. https://www.helpguide.org/wp-content/uploads/2018/12/sleep-diary.pdf. Accessed November 6, 2022.

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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