Is the poor sleep of shift workers a disorder?
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.


METHODS
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.


RESULTS
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.
Sleep Clinic, Brigham and Women's Hospital, Boston, MA 02115.
Q R
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Regestein
T H
TH
Monk
D000328:Adult; D005190:Family; D005260:Female; D006291:Health Policy; D006304:Health Status; D006801:Humans; D008297:Male; D016272:Occupational Health / Q000331:legislation & jurisprudence; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014940:Work Schedule Tolerance / Q000523:psychology