Am J Psychiatry 1991; 148:1487-1493
Copyright © 1991 by American Psychiatric Association
Is the poor sleep of shift workers a disorder?
QR Regestein and TH Monk
Sleep Clinic, Brigham and Women's Hospital, Boston, MA 02115.
OBJECTIVE: The purpose of this article is to describe the impact of shift
work on sleep, as recently acknowledged in official nosologies of sleep
disorders, and to discuss whether sleep altered by shift work actually
constitutes a disorder. METHOD: The authors review subjective responses to
recent survey questions about sleep and polygraphic measurements of sleep
in shift workers and describe sleep clinic experiences with complaints
related to shift work. FINDINGS: Shift work entails wide variation in work
schedules, sleep quality, and worker tolerance and a high prevalence of
night-shift sleepiness. It probably affects rates of drug use, health
status, and family organization. Clinical presentations were rare, highly
varied, and empirically treated. The United States, unlike other countries,
has no legal restrictions on shift work. CONCLUSIONS: As a clinical
phenomenon, sleep altered by shift work is common and varied, probably
expresses nonphysiological sleep-wake scheduling, and is little treated.
Further study of its health effects and consideration of whether it is a
"disorder" or a "problem" seem warranted.
