The Atlanta School of Sleep Medicine and Technology, Atlanta, GA 30342, USA.
Postgrad Med. 2011 Sep;123(5):106-15. doi: 10.3810/pgm.2011.09.2465.
"Shift work" is a term that applies to a wide array of nontraditional work schedules. Shift work disorder (SWD) is a circadian rhythm sleep disorder experienced by a subset of shift workers that is characterized by excessive sleepiness during work and/or insomnia during scheduled sleep times. It is estimated to affect up to 2 million Americans, and is associated with increased morbidity and mortality from metabolic risk factors, cardiovascular and gastrointestinal diseases, depression, accidents, and some kinds of cancers. Patient history is all that is needed to make a diagnosis with the International Classification of Sleep Disorders-Second Edition criteria as described herein. Circadian rhythm disorders, in which an underlying misalignment of circadian rhythm with the sleep-wake cycle occurs, may be treated by behavioral and pharmacologic approaches, including the use of hypnotics to improve the duration of sleep. However, evidence is limited with these approaches in patients diagnosed with SWD. Other treatment options may include pharmacologic interventions such as modafinil and armodafinil, which have shown efficacy in this population. Combined therapy can reduce insomnia and excessive sleepiness, and improve attention and alertness during work shifts and the subsequent commute home.
"轮班工作"是一个适用于广泛的非传统工作时间表的术语。轮班工作障碍（SWD）是一种昼夜节律睡眠障碍，发生在一部分轮班工作者中，其特征是在工作期间过度困倦和/或在预定睡眠时间失眠。据估计，它影响了多达 200 万美国人，并且与代谢风险因素、心血管和胃肠道疾病、抑郁、事故以及某些类型的癌症的发病率和死亡率增加有关。根据本文所述的国际睡眠障碍分类-第二版标准，仅通过患者病史即可做出诊断。昼夜节律紊乱是指昼夜节律与睡眠-觉醒周期之间发生的潜在不匹配，可能通过行为和药物治疗方法来治疗，包括使用催眠药来改善睡眠持续时间。然而，这些方法在被诊断为 SWD 的患者中的证据有限。其他治疗选择可能包括药物干预，如莫达非尼和阿莫达非尼，这些药物在该人群中显示出疗效。联合治疗可以减少失眠和过度嗜睡，并提高工作班次和随后回家途中的注意力和警觉性。
