3, 6 Studies comparing night shift workers with day workers estimate that 44.8% of night workers score greater than 10 on the Epworth Sleepiness Scale (compared to 32.7% of day workers), and 24.7% score greater than 13 (compared to 15.5% of day workers). Many shift workers meeting diagnostic criteria for SWD report sleep difficulties consistent with those reported by patients with an insomnia disorder, while others report excessive sleepiness (either alone or in combination with insomnia symptoms). Diagnostic criteria for SWD require the presence of one or both of these symptoms, temporally related to a shift work schedule for at least three months, and not better explained by another medical, psychiatric, or sleep disorder. 1 – 5 Clinically, this mismatch manifests in insomnia and/or excessive sleepiness. Shift work disorder (SWD) is a circadian rhythm disorder characterized by a chronic mismatch between a shift worker's sleep-wake schedule and his or her circadian clock.
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