Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers.
ABSTRACT Although there are considerable data demonstrating the impact of shift work on sleep and alertness, little research has examined the prevalence and consequences of shift work sleep disorder in comparison to the difficulties with insomnia and excessive sleepiness experienced by day workers. The present study was designed to determine the relative prevalence and negative consequences associated with shift work sleep disorder in a representative sample drawn from the working population of metropolitan Detroit.
Random-digit dialing techniques were used to assess individuals regarding their current work schedules and a variety of sleep- and non-sleep-related outcomes.
Detroit tricounty population.
A total of 2,570 individuals aged 18 to 65 years from a representative community-based sample including 360 people working rotating shifts, 174 people working nights, and 2036 working days.
Using standardized techniques, individuals were assessed for the presence of insomnia and excessive sleepiness, based on DSM-IV and ICSD criteria. Those individuals with either insomnia or excessive sleepiness and who were currently working rotating or night schedules were classified as having shift work sleep disorder. Occupational, behavioral, and health-related outcomes were also measured. Individuals who met criteria for shift work sleep disorder had significantly higher rates of ulcers (odds ratio = 4.18, 95% confidence interval = 2.00-8.72), sleepiness-related accidents, absenteeism, depression, and missed family and social activities more frequently compared to those shift workers who did not meet criteria (P < .05). Importantly, in most cases, the morbidity associated with shift work sleep disorder was significantly greater than that experienced by day workers with identical symptoms.
These findings suggest that individuals with shift work sleep disorder are at risk for significant behavioral and health-related morbidity associated with their sleep-wake symptomatology. Further, it suggests that the prevalence of shift work sleep disorder is approximately 10% of the night and rotating shift work population.
- European Journal of Work and Organizational Psychology 10/2013; 24(1):76-87. · 2.09 Impact Factor
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ABSTRACT: Excessive daytime sleepiness affects nearly 20% of the general population and is associated with many medical conditions, including shift work disorder (SWD), obstructive sleep apnea (OSA), and narcolepsy. Excessive sleepiness imposes a significant clinical, quality-of-life, safety, and economic burden on society. To compare healthcare costs for patients receiving initial therapy with armodafinil or with modafinil for the treatment of excessive sleepiness associated with OSA, SWD, or narcolepsy. A retrospective cohort analysis of medical and pharmacy claims was conducted using the IMS LifeLink Health Plan Claims Database. Patients aged ≥18 years who had a pharmacy claim for armodafinil or for modafinil between June 1, 2009, and February 28, 2012, and had 6 months of continuous eligibility before the index prescription date, as well as International Classification of Diseases, Ninth Revision diagnosis for either OSA (327.23), SWD (327.36), or narcolepsy (347.0x) were included in the study. Patients were placed into 1 of 2 treatment cohorts based on their index prescription and followed for 1 month minimum and 34 months maximum. The annualized all-cause costs were calculated by multiplying the average per-month medical and pharmacy costs for each patient by 12 months. The daily average consumption (DACON) for armodafinil or for modafinil was calculated by dividing the total units dispensed of either drug by the prescription days supply. A total of 5693 patients receiving armodafinil and 9212 patients receiving modafinil were included in this study. A lower DACON was observed for armodafinil (1.04) compared with modafinil (1.47). The postindex mean medical costs were significantly lower for the armodafinil cohort compared with the modafinil cohort after adjusting for baseline differences ($11,363 vs $13,775, respectively; P = .005). The mean monthly drug-specific pharmacy costs were lower for the armodafinil cohort compared with the modafinil cohort ($166 vs $326, respectively; P <.001). In addition, lower total healthcare costs were observed for the armodafinil cohort compared with the modafinil cohort after correcting for baseline differences ($18,309 vs $23,530, respectively; P <.001). As shown in this analysis, armodafinil may have real-world DACON advantages and may be associated with lower overall healthcare costs compared with modafinil.American Health and Drug Benefits 09/2014; 7(6):334-40.
Article: Circadian Rhythm Sleep Disorders.[Show abstract] [Hide abstract]
ABSTRACT: To review circadian rhythm sleep disorders, including underlying causes, diagnostic considerations, and typical treatments.Journal of clinical outcomes management: JCOM 11/2013; 20(11):513-528.