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Sleep loss and circadian disruption in shift work: health burden and management
Author(s) -
Rajaratnam Shantha M W,
Howard Mark E,
Grunstein Ronald R
Publication year - 2013
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja13.10561
Subject(s) - shift work , alertness , circadian rhythm , melatonin , medicine , modafinil , sleep inertia , insomnia , mood , psychology , psychiatry , sleep disorder , sleep debt
Summary Road and workplace accidents related to excessive sleepiness, to which shift work is a significant contributor, are estimated to cost $71–$93 billion per annum in the United States. There is growing evidence that understanding the interindividual variability in sleep–wake responses to shift work will help detect and manage workers vulnerable to the health consequences of shift work. A range of approaches can be used to enhance alertness in shift workers, including screening and treating sleep disorders, melatonin treatment to promote sleep during the daytime, and avoidance of inappropriate use of sedatives and wakefulness‐promoters such as modafinil and caffeine. Short naps, which minimise sleep inertia, are generally effective. Shifting the circadian pacemaker with appropriately timed melatonin and/or bright light may be used to facilitate adjustment to a shift work schedule in some situations, such as a long sequence of night work. It is important to manage the health risk of shift workers by minimising vascular risk factors through dietary and other lifestyle approaches.