II. Epidemiology

  1. Hypersomnolence occurs in 20% of Night Shift Workers

III. Adverse Effects

  1. Decreased productivity
  2. Safety and injury risk
  3. Decreased quality of life
  4. Adverse health effects including decreased Life Expectancy

IV. Diagnosis: Excessive night shift Sleepiness

  1. Uses Daytime Sleepiness tools validated for night shift work
  2. Epworth Sleepiness Scale
  3. Multiple Sleep Latency Test

V. Management: Daytime Insomnia (sleeping during the day)

  1. Non-medication management
    1. See Sleep Hygiene
    2. Minimize light exposure while traveling home to bed (e.g. dark sun glasses)
    3. Keep bedroom dark
  2. Medication management
    1. Melatonin
      1. Dose: 3 mg before bed
      2. Consider prior to mid-afternoon nap
    2. Sedative-Hypnotics (e.g. Zolpidem)

VI. Management: Nighttime Hypersomnolence (staying awake overnight)

  1. Non-medication management
    1. Keep work area brightly lit
    2. Take a nap prior to overnight shift
    3. Maintain 8 hours sleep per 24 hours
    4. Exercise prior to work
  2. Caffeine
    1. Limit to 400 mg/day (e.g. maximum of 24 ounces coffee per day)
    2. Avoid within 4 hours of bed time
  3. Stimulants
    1. Preparations
      1. Modafinil (Provigil)
      2. Armodafinil (Nuvigil)
    2. Adverse effects
      1. Headaches, Nausea, daytime Insomnia
      2. Diminish efficacy of Oral Contraceptives
      3. Abuse potential (albeit lower than Methylphenidate and other stimulants)

VII. Resources

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Ontology: Night shift worker (C0555008)

Concepts Finding (T033)
SnomedCT 160916007, 138235007, 276066008
English night shift workers, night shift worker, Night shift worker, Night shift worker (finding)
Spanish trabajador de turno nocturno (hallazgo), trabajador de turno nocturno