Recognition of shift-work disorder in primary care

Area of Science:

• Sleep Medicine
• Primary Care

Background:

• Shift-work disorder (SWD) affects numerous individuals working non-traditional hours.
• Persistent excessive sleepiness (ES) and insomnia are key symptoms of SWD.
• These symptoms can be indicative of other underlying sleep or medical conditions.

Purpose of the Study:

• To outline a practical approach for primary care physicians to recognize SWD.
• To emphasize the importance of differential diagnosis in patients presenting with ES and insomnia.
• To highlight tools for evaluating excessive sleepiness.

Main Methods:

• Screening patients working night or rotating shifts for ES and insomnia.
• Generating a differential diagnosis for ES and insomnia.
• Inquiring about symptoms of other common sleep/wake disorders like obstructive sleep apnea and periodic limb movement disorder.
• Utilizing the Epworth Sleepiness Scale for subjective ES evaluation.

Main Results:

• Persistent ES and insomnia in shift workers suggest potential SWD.
• Differential diagnosis is essential to rule out other conditions.
• The Epworth Sleepiness Scale aids in assessing subjective sleepiness.

Conclusions:

• Primary care physicians can effectively screen for SWD by assessing ES and insomnia in relevant patient populations.
• A thorough differential diagnosis is critical for accurate SWD recognition.
• Standardized tools like the Epworth Sleepiness Scale can assist in clinical evaluation.