When lifestyle changes, such as good sleep hygiene, do not effectively reduce the effects of shift work change and irregular work hours cannot be avoided, treatment for shift work sleep disorder (SWSD) may be necessary. Treatment options include bright light therapy, also called chronotherapy, and medications.
In light therapy, shift workers are exposed to artificial lighting, for example, to simulate daytime during the night. Bright light therapy can help people with shift work disorder and other circadian rhythm disorders adjust their sleep-wake cycle and get better sleep.
This treatment involves exposure to bright lighting at regular times of the day, for a certain length of time. Light boxes, special lamps, and devices that can be regulated to gradually dim or brighten lights in a sleeping area (e.g., to simulate sunrise or sunset) can be used in light therapy.
Shift work sleep disorder treatment also may involve medications. Types of medications that may be used include the following:
- Benzodiazepines (e.g., temazepam [Restoril])
- Benzodiazepine agonists (e.g., zolpidem [Ambien], [Ambien CR], [Sonata], eszopidone [Lunesta])
- Stimulants (e.g., modafinil [Provigil], armodafinil [Nuvigil])
These medications should be used only as directed. Side effects include headache, nausea, dizziness, and nervousness. Serious side effects, such as psychiatric symptoms (e.g., hallucinations, suicidal thoughts) and severe skin rash (e.g., Stevens-Johnson syndrome), also may occur with some medications used to treat shift work sleep disorder.
Temazepam, zolpidem, and eszopidone, which also may be used to treat other sleep disorders, such as insomnia, are taken before bed to induce sleep.
Modafinil and armodafinil are used to reduce excessive sleepiness (ES) and promote wakefulness in people with shift work sleep disorder. These medications are taken once per day, usually about 1 hour prior to the start of the person's shift.