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Featured Article: Shift work and inter-individual differences in sleep and sleepiness
Transcript of Additional Q&A
 | Guest Host: Thomas Roth, PhD Chief, Division Head Sleep Disorders and Research Center Henry Ford Hospital Detroit, MI |
 | Featured Author: Hans P. A. Van Dongen, PhD Associate Research Professor Assistant Director Sleep and Performance Research Center Washington State University, Spokane Spokane, WA |
1. Could you comment on the role of exercise in sleep-wake regulation and excessive sleepiness? What effect does regular exercise have on mitigating the impact of shift work, and how can exercise be used to manage excessive sleepiness and other effects of shift work?
While exercise is a healthy habit and benefits shift workers in general, the role it may have for sleep and sleepiness is not clear. Since exercise generally increases overall fitness, it may contribute to improved coping with shift work. However, there is little evidence to suggest that exercise alone is effective in overcoming excessive sleepiness.
2. Are there any gender differences in tolerance to shift work, or influences of gender hormones resulting in excessive sleepiness due to shift work?
There is some evidence for relatively small group-average differences between women and men in tolerance for shift work, but the individual differences that exist among women and among men are much bigger than these group differences. Just knowing whether a person is a man or a women says very little about the person's ability to tolerate shift work.
3. Are there any tests or lab-based challenges that might predict a person's vulnerability to develop shift work sleep disorder? For example, if these symptoms emerge with short-term sleep deprivation or changes in the timing of sleep and waking, does this indicate vulnerability for shift work disorder?
The research needed to resolve this question has not yet been done. I would expect that interactions among various biological and environmental factors will make it difficult to come up with a single reasonably predictive factor. However, if a person is known to be biologically vulnerable to short-term sleep deprivation, for instance, then following up with this individual to track their shift work experiences and objectively measure their sleepiness levels would be advisable.
4. A recent paper (Haupt et al., 2008) showed that exposure to shift work was associated with atherosclerosis and myocardial infarction, depending on the duration of the exposure and the age of the participants. How should I advise patients who are shift workers, but without shift work disorder, on the potential health consequences of shift work?
There is other emerging evidence of a relationship between shift work and adverse health consequences, but it is perhaps too early to know for sure that the relationship is causal. My advice to shift workers at this time would be to make sure they have regular health check-ups, so that if a health problem emerges, it is caught early on. Also, I would emphasize the importance of maintaining the best possible sleep hygiene, and of seeking medical advice if this doesn't work out (e.g., due to vulnerability to circadian displacement).
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JC-001-031008-05
