Shift Work Sleep Disorder

[MomRN0913]

So, I went to a Dr i work closely with yesterday to get some prescriptions. He's a critical care pulmonologist and does sleep studies and treats sleep disorders. i told him I don't sleep well and use Xanax to sleep. I told him about the ridiculous pain I am having in my neck and shoulder. i have a small herniated disk which everyone blames the pain on. Well, knows i have work nights for almost 5 years and have been working days since Oct (fist bedside, now in management). He told me the pain and the insomnia and lack of energy is from Shift-work sleep disorder. Even though I work days now, it can take a long time to undo it's effects. He told me without proper sleep, i won't get better. he told me to take Melatonin which I will start tonight.I have also been told about another drug, Nuvigil(?) to give you more energy in the day then it wears off by night so you can sleep at night.

Anyone actually get diagnosed with this? I always blamed it on my stressful life (single mom to a 3 year old, having no help around the house and with her (except when she is with her dad) and trying to have a full time demanding career)which of course can make you tired..... but I think the Dr might me right! I thought I was hypothyroid for a while, because of the hair loss no energy, inability to lose weight..... but apparently this all has to do with this "disorder" Anyone take any meds for this?

I have always said if I actually got a good nights sleep I might feel great.

[classicdame, MSN, EdD]

not familiar with the diagnosis but you might find info online. I recommend you try the MD's suggestions before you do any other therapy, just to be sure that one works/does not work. Good luck. Lack of sleep is not healthy.

[heron, ASN, RN]

I've never been formally diagnosed, but I have it after years of night-shift. It's a severe derangement of circadian rhythms that manifests as a combination of insomnia and daytime drowsiness.

So far, the only way I've found for coping with it is setting strict limits with my schedule ... if working nights, trying to arrange to work the same nights every week. I avoid rotating like the plague. I just took a per diem job that had me rotating very rapidly (3 different shifts in 4 days) and it just about killed me. Had to resign the job.

Since you're working days now, the melatonin seems like a good place to start, since it tends to promote normal sleep. I'd be careful of getting into a pattern of meds to sleep and meds to wake up.

The trick for me has been to gently get my body back into a normal circadian cycle ... it takes time and is easily disrupted.

Can't say much more than that without giving medical advice. Just be patient and continue working with your doc, especially since he is experienced in sleep disorders. I feel your pain

[cb_rn]

NOT MEDICAL ADVICE but I have experience with a similar med.

I take provigil for shift work disorder. My doctor told me its a stimulant and when I looked it up in epocrates there was unknown mechanism of action. Its also used in MS, I believe, and narcolepsy. I have to go in for a written RX each month and its hideously expensive but I don't feel like I'm on an "upper" or get nervous and it keeps me awake the whole night (no more nodding off driving home). I've been warned that there is a risk of dependency so I don't use it for every shift.

[Ruby Vee, BSN]

i have shift work sleep disorder -- and obstructive sleep apnea. i wear my cpap and i take ambien to sleep. i have to rotate shifts and have more and more trouble switching as the years progress. my doctor told me she doesn't like to prescribe ambien unless it's for shift work sleep disorder.

[mentalhealthRN]

I was a mess after working crazy shifts. I now just plain won't do it. When I was at one job I would work all three shifts every week. I ended up with a disrhythmia, IBS and my migraines and Hypertension were crazy. I could not sleep during the day. My doc knows I am a nurse and said as long as I was working those crazy shifts she would not have me taking a pill to sleep, a pill to wake....she refused. She won't ever give me narcs for my chronic pain from headaches, and arthritis and DDD in my c-spine because she knows I am a nurse. How do you guys get your doc to write for all these meds!? I just had to start only applying for jobs that didn't require nights. Between my RLS and insomnia it was just no longer an option. Subsequently it has left me unemployed now since August but.....yeah never heard of this "shift work sleep disorder" but knowing what a mess shift work made me I totally think it is real.

[klone, MSN, RN]

I've also taken Ambien (when I get home from work) and Provigil (at around 11pm during my shift) for SWSD. I haven't taken Provigil in a few years, but it worked well at keeping me awake and safe during my shift and for the drive home.

I've gotten better over the years at functioning during the back and forth of working nights and then having several days off and being able to switch my body. Still take the Ambien, though.

To the poster who asked about why night shift workers get paid so much more than day shift workers for doing less work - this is a prime example! We all develop chemical dependencies in order to even function as a human. When I worked days, I didn't need uppers and downers in order to function.

[shiccy]

IIRC Nuvigil is what my coworker was placed on as well for this same disorder.

I have NO problems sleeping during the day, but my neighbor has three German Sheppard dogs they leave outside in their fenced in yard. This wouldn't be a problem, however the fence where they bark at passers by is right next to my bedroom window. It's one of the things that will wake me up when I sleep (one of the VERY *few* things, even with a fan on).

My problem is that I am never EVER able to get up enough energy to do anything until day two after working, and I rarely can get myself to do exercise because I feel so freaking "blah" after working like we do.

I *do* take melatonin, but not consistently. If it's time for you to go to bed, it works WONDERS. Be aware, though, you'll have the most VIVID dreams that it's ridiculous. I've actually had dreams that were so vivid that in the morning I couldn't tell if they were real. 99.9% of these dreams are not nightmares, although I do have them with the melatonin from time to time... Point in case, I had a dream that my dad passed away and my dream took place weeks after his death. My dad is very much alive, however it was so distressful that I woke up and called him immediately. I'm actually tearing up right now because of the whole thing.

In any case, I hope this works for you. I would be really interested in knowing whether the nuvigil works for you or not...

[CranberryMuffin]

Melatonin has done wonders for me as I am currently a night-shifter and trying to sleep during the day for me (when I first started on nights) was next to impossible.

The only thing I don't like about melatonin is that it can give you a sleep hangover - I tend to wake up feeling groggy and it can take awhile to wear off. HOWEVER, if you are looking to take something that will get you to sleep and help you stay asleep, melatonin is pretty great.

[RRTtoBSN, BSN]

I have SWSD as well and i have been on Ambien for 3 years. one of my doctors wants me off the Ambien but sometimes I seriously cannot sleep! I haven't had any negative effects from it (clothes have stayed on and no sleep driving/eating/sex/murder etc lol) so I am unsure as to why take it away? It habit forming, maybe. But if I haven't slept in 3 days and melatonin is like candy to me, then why not?