SWD is defined as sleep disturbances due to working at night or rotating shifts between night and day. It involves a problem with the 24-hour internal clock (circadian rhythm) regulating the light and dark circle for the individual. It is usually seen in people who work night shifts.
The diagnosis is based on the history obtain from the patient and at times the patient is given a sleep diary to write down sleep and wake times. It is essential to diagnose and treat this disorder since it is associated with increase risks of infections, breast and prostate cancer, high cholesterol, heart attacks, and obesity.
The approach and the treatment for this disorder can be difficult since the ultimate treatment is to switch to a regular work schedule, which will improve the sleep hygiene and sleep cycle and therefore eliminate the problem. Other modalities that can be helpful are controlling the light, the sound, and the temperature. Light therapy can be used and the patient’s education and counseling is helpful. At times pharmacotherapy can be used also including Ambien, Sonata, Lunesta, Rozerem and at times the stimulants such as modafinil and rmodafinil can be used during the wakefulness to maintain wakefulness.