Shift sleep distraction ( SWSD ) is a circadian rhythm sleep disorder characterized by insomnia and excessive drowsiness that affects people whose hours overlap with typical sleep periods. There are many work schedules shifted, and they may be permanent, intermittent, or spinning; consequently, SWSD manifestations are quite varied.
Video Shift work sleep disorder
Diagnosis
The main symptoms of sleep shift work disorder are insomnia and excessive sleepiness associated with working (and sleeping) at a time that is not standardized. Shift sleep disturbances are also associated with falling asleep at work. The amount of daily sleep time is usually shortened and sleep quality is less on those who work night shift compared to those who work the afternoon shift. Drowsiness is manifested as a desire to nap, unwanted sleep, mental acuity disorder, irritability, reduced performance, and accident prone. Shift work is often combined with extended working hours, so fatigue can be a compounding factor. The symptoms coincide with the duration of shift work and usually transmit with the application of a conventional sleep-wake schedule. The boundary between "normal responses" to hard shift work and diagnosed disturbances is not sharp.
Maps Shift work sleep disorder
Causes and comorbidities
Insomnia and sleepiness when waking up are related to the misalignment between non-standard wake-up time and endogenous circadian tendencies to sleep and wake. In addition to circadian alignments, trying to sleep at unusual times can be disrupted by noise, social obligations, and other factors. Finally, there is an inevitable level of sleep deprivation associated with sudden transitions in sleep schedules.
Health risks
There are many studies that show the health risks associated with shift work. For example, a 2007 study led by IARC (International Agency for Research on Cancer) showed that a shift in work has been linked to cancer. Other studies have reported that night workers have an increased incidence of heart disease, digestive disorders and menstrual irregularities. Michael Lee, et al. shows that the night shift has a much higher risk of dangerous driving events when compared to a typical day shift schedule. Since the formal diagnosis of SWSD is not usually made in this study, it remains unclear whether the reported risks apply to a subset of shift workers who are eligible for SWSD diagnosis or apply to all shift workers.
Suprachiasmatic Core (SCN)
Brain stimulation is stimulated by the circadian system during the day and sleep is usually stimulated at night. Rhythm is maintained in the suprachiasmatic nucleus (SCN), located in the anterior hypothalamus in the brain, and synchronized with the day/night cycle. Transcontinental feedback loops in individual SCN cells form the molecular basis of biological timeliness. The shift in the circadian phase depends on the schedule of exposure to light, intensity, and previous light exposure. Variations in exposure can advance or delay this rhythm. For example, rhythm may be delayed due to exposure to light at night.
Photoreceptors located in the retina of the eye send information about environmental light through the retinohypothalamic ducts to the SCN. SCN regulates the pineal gland, which secretes the hormone melatonin. Usually, melatonin secretion begins two hours before bedtime and ends two hours before waking up. The decrease in neuronal firing on SCN is caused by the binding of melatonin to the melatonin receptors MT1 and MT2. It is believed that shooting reductions in SCN stimulate sleep. While active individuals a day produce melatonin at night, night shift workers produce melatonin suppressed at night due to exposure to light.
Treatment
Specified sleep/wake scheduling
Experts agree that there is no "ideal" nighttime schedule, but some schedules may be better than others. For example, rotating shifts every two weeks in the forward direction (delay) is found easier than rotation backwards (forward). The gradual delay ("nudging" of the circadian system about an hour per day) has been shown in laboratory settings to maintain synchrony between sleep and endogenous circadian rhythms, but this timetable is impractical for most real-world settings. Some experts advocate a short walk (1 to 2 days) of night work with time for recovery; However, in traditional heavy industries, longer (5 to 7 days) runs remain the rule. Ultimately, scheduling decisions usually involve maximizing leisure time, fairness in work relationships, etc. Rather than chronobiological considerations. Shift workers can benefit from following sleep hygiene practices related to sleep/wake scheduling. Symptoms usually only recover fully after normal sleep schedule is resumed.
Many night workers take a nap during their break, and in some industries, a planned nap in the workplace (with the facilities provided) begins to be accepted. Napping before starting the night shift is a logical prophylactic act. However, a long nap (more than 20-30 minutes) can produce sleep inertia, a nervous feeling after waking that can interfere with performance. Therefore, a short nap (10 to 30 minutes) is preferred for longer naps (more than 30 minutes). Also, a long nap can also disrupt the main bed.
In the transportation industry, safety is a major concern, and is mandated hours of service rules to enforce a break.
Brightness care
The light-dark cycle is the most important environmental time signal for practicing the circadian rhythm of most species, including humans, and bright artificial light exposure has been developed as a method of improving the circadian adaptation of night workers. Light exposure time is very important for the effect of phase shift. To maximize body clock delays, bright exposure should occur at night or the first part of the night, and bright light should be avoided in the morning. Wearing dark glasses (avoiding bright lights) or blue blocking goggles during commute from the morning can improve circadian adaptation. For workers who want to use bright light therapy, the appropriate equipment of the type used to treat winter depression is readily available but the patient needs to be educated about proper use, especially the matter of time. Bright lighting treatment is not recommended for patients with light sensitivity or eye diseases.
Melatonin treatment
Melatonin is a hormone secreted by the pineal gland in the dark, usually at night. Its production is suppressed by exposure to light, especially blue light around 460 to 480Ã, nm. Mild restrictions, or dark therapy, in the hours before sleep enable their production. Dark therapy does not require total darkness. The orange or orange goggles remove the blue light to the eye while allowing sight.
Melatonin is also available as an oral supplement. In the US and Canada, the hormone melatonin is not classified as a drug; it is sold as a dietary supplement. In other countries need a prescription or not available. Although not licensed by the FDA as a treatment for any disorder, no serious side effects or complications are reported to date.
Melatonin has been shown to accelerate the adaptation of the circadian system to the evening work schedule. Melatonin can help nap at night with a direct sleep enhancement mechanism. Melatonin treatment can increase sleep duration during naps and nighttime on night shift workers.
Drugs that promote vigilance
Caffeine is the most widely used warning drug in the world and has been shown to increase alertness in night work simulations. Caffeine and naps before night shift reduce sleepiness during shifts. Modafinil and armodafinil are non-amphetamine warning drugs originally developed for the treatment of narcolepsy that have been approved by the FDA (US Food and Drug Administration) for excessive drowsiness associated with SWSD.
Drugs that promote daytime sleep
Getting enough sleep during the day is a big deal for many night workers. Hypnotics given in the morning can lengthen daytime sleep; However, some studies show that sleepiness at night may not be affected. Zopiclone has been shown to be ineffective in improving sleep in shift workers.
See also
- Work shift
- Jet lag
- The human factor
- Human reliability
References
External links
- Shift Work Sleep Disorder (uni-marburg.de)
- (IARC/usnews)
Source of the article : Wikipedia
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