The Hazards of Shift Work Sleep Disorder (SWSD)

Allen Blaivas, M.D. Health Pro
  • The New York Times reported on August 31 that the air traffic controller involved in the tragic Comair flight, which killed 49 people, was working on only two hours of sleep. This brings to mind an important, but little recognized sleep disorder known as shift work sleep disorder.

    With the invention of electricity, modern society has become a 24/7 world. The problem is that our biology makes this difficult. We have a circadian pacemaker, running on a 24-hour schedule, which makes us more awake during the day and sleepy at night. When this physiology is altered, the sleep period tends to be less refreshing and the fatigue that occurs during the work period can lead to reduced alertness and efficiency. This may translate into major public safety issues as some the primary industries that require shift work are healthcare, transportation, and safety (police, fire, air traffic controllers, etc.). Unfortunately, this was not the only tragedy that has been related to fatigue. Other major catastrophes include the Exxon Valdez oil spill, the Three Mile Island nuclear accident, and the Challenger space shuttle crash.
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    Shift Work Sleep Disorder (SWSD) is defined as a complaint of insomnia or excessive sleepiness that is associated with a work period (usually at night) that occurs during the normal sleep hours. It is estimated that as many as 20% of workers in industrialized countries are shift workers, either in the form of rotating shifts or permanent shifts.

    The primary complaint is that sleep is not refreshing and is difficult to maintain in the post-shift period (especially when the major sleep period begins in the morning, between 6 a.m. and 8 a.m.). Due to social obligations, shift workers often try to revert back to a “normal” schedule when off, which further worsens their sleep quality. This combination of decreased quality and quantity of sleep may be associated with medical and social problems. Shift workers appear to be at an increased risk for gastrointestinal diseases, heart disease, type 2 diabetes mellitus, as well as for sleep deprivation, depression, sleepiness-related accidents, and social stresses.

    If shift work is a necessary part of your work life, there are some suggestions that might make your sleep better and your alertness at work greater. I explore these possibilities in another blog post.

    Have a question about sleeping or sleep disorders? Send it to and check back soon to see if it has been answered.
Published On: October 23, 2006