National Sleep Foundation

Chapter 5: Circadian Rhythm Sleep Disorders

Treatment

How is shift work disorder treated?

Strategies to improve sleep for those with shift work disorder include:

Treatment is designed to help synchronize shift workers to their required schedules.

Avoiding natural bright light when the individual is preparing for sleep may be the most important consideration for treating Shift Work Disorder. Bright light exposure regimens have proven to be effective in helping to synchronize shift workers to their schedules.102 103   

Additional strategies to improve sleep for those with shift work disorder include the following (also see Chapter 2 for more information on sleep habits):104 105   

• Adjusting the bedroom environment (e.g., sound- and/or light-proofing)
• Optimizing the sleep schedule based on the patient’s unique circumstances (e.g., obligation to see children off to school)
• Reinforcing proper sleep habits
• Practicing relaxation techniques

• Educating family and friends about the shift worker’s the need for uninterrupted daytime sleep.

Patients who do not respond adequately to behavioral and environmental approaches may need pharmacotherapy. Sedative hypnotics may temporarily improve daytime sleep, especially during rotating or short, irregular shift work.
Wake-enhancing medications are used to increase alertness during working hours.106 The Food and Drug Administration has approved modafinil and armodafinil to treat the excessive daytime sleepiness that is associated with shift work sleep disorder.107 108

References

104.  Drake CL, Wright KP, “Shift Work, Shift-Work Disorder, and Jet Lag,” in In Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 784-798

105.  National Sleep Foundation (NSF), Shift Work Disorder: Medical Treatments for Shift Work, Arlington, VA: NSF, 2014. Available online at: http://sleepfoundation.org/shift-work/content/medical-treatments-shift-work-disorder

106. Hart CL, Ward AS, Haney M, Nasser J, Foltin RW. Methamphetamine attenuates disruptions in performance and mood during simulated night-shift work. Psychopharmacology (Berl). 2003;169:42-51

107. Czeisler CA, Walsh JK, Roth T, et al. US Modafinil in Shift Work Sleep Disorder Study Group. Modafinil for excessive sleepiness associated with shift-work sleep disorder. N Engl J Med. 2005;353:476-486.

108. National Sleep Foundation (NSF), Shift Work Disorder: Medical Treatments for Shift Work, Arlington, VA: NSF, 2014. Available online at: http://sleepfoundation.org/shift-work/content/medical-treatments-shift-work-disorder