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Understanding and diagnosing shift work disorder.

Postgraduate medicine
September 1, 2011
Michael Thorpy
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the clinical benefits of melatonin and other therapies for treating shift work disorder (SWD).

Results Summary

The study suggests that melatonin, along with other treatments like caffeine, modafinil, and armodafinil, may improve wakefulness and sleep quality in SWD patients. However, the abstract does not provide specific data on melatonin's efficacy compared to other treatments.

Population

Shift workers, particularly those with shift work disorder (SWD).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
exercise
decrease
symptoms of SWD
patients with SWD
-
suggested for treatment
#1
exposure to light
decrease
symptoms of SWD
patients with SWD
-
suggested for treatment
#2
medications that contain melatonin
decrease
symptoms of SWD
some patients with SWD
-
may have clinical benefits
#3
medications that contain caffeine
decrease
symptoms of SWD
some patients with SWD
-
may have clinical benefits
#4
modafinil
decrease
excessive sleepiness associated with SWD
patients with SWD
-
approved to improve wakefulness
#5
armodafinil
decrease
excessive sleepiness associated with SWD
patients with SWD
-
approved to improve wakefulness
#6
modafinil and armodafinil
decrease
symptoms of SWD
patients with SWD
-
recent data suggest a clinical benefit
#7
use of these therapies
increase
sleep
patients with SWD
-
can significantly improve
#8
use of these therapies
increase
performance
patients with SWD
-
can significantly improve
#9
use of these therapies
increase
quality of life
patients with SWD
-
can significantly improve
#10
Abstract

A significant proportion of the workforce in industrialized countries (16%) are employed as shift workers. These workers may be susceptible to shift work disorder (SWD), a circadian rhythm sleep disorder, particularly those who work at night or on early-morning shifts. Shift work disorder remains an underdiagnosed and undertreated problem among this population. Patients with SWD have difficulty initiating sleep and waking up. Often, these patients have excessive sleepiness during their work shift. Shift work disorder has been associated with decreased productivity, impaired safety, diminished quality of life, and adverse effects on health. Several tools have been validated to assess excessive daytime sleepiness and are often used to assess excessive nighttime sleepiness, such as that experienced in patients with SWD, including the Epworth Sleepiness Scale and the Multiple Sleep Latency Test. The criteria for diagnosing SWD as established by the American Academy of Sleep Medicine (AASM) and published in the International Classification of Sleep Disorders-Second Edition (ICSD-2) were most recently updated in 2005 and thus do not contain newer agents approved for use in patients with SWD. The symptoms of SWD can be treated using behavioral, prescription, and nonprescription therapies. Current treatment guidelines suggest nonpharmacologic interventions, such as exercise and exposure to light. In addition, medications that contain melatonin or caffeine may have clinical benefits in some patients with SWD. However, modafinil and armodafinil are approved by the US Food and Drug Administration to improve wakefulness in patients with excessive sleepiness associated with SWD, and recent data suggest a clinical benefit. The use of these therapies can significantly improve sleep, performance, and quality of life for patients with SWD.

Medical Subject Headings (MeSH)
AdultAmphetaminesBenzhydryl CompoundsCentral Nervous System StimulantsCircadian RhythmDiagnosis, DifferentialFemaleHumansHypnotics and SedativesMaleModafinilSleep Disorders, Circadian RhythmWork Schedule Tolerance
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality60/10
Citation Metrics
Total Citations17
Citations/Year1.2
Relative Citation Ratio0.73
NIH Percentile38.9%
Research Impact Scores
APT Score0.75
Weight Score1.12
Normalized Score0.60
Related Supplements
Understanding and diagnosing shift work disorder. | Panacea Index