This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Educational Activity

Shift Work Disorder Case Studies: Applying Management Principles in Clinical Practice

Andrew D. Krystal, MD, MS; Thomas Roth, PhD; and Richard D. Simon, Jr, MD

Published: August 15, 2012

Article Abstract

Shift work disorder (SWD) is a circadian rhythm sleep disorder characterized by insomnia and excessive sleepiness. SWD, which is estimated to affect 10% of people who work night or rotating shifts, can have serious consequences such as accidents, loss of productivity, and depression. By enlisting the support of family, identifying and treating comorbid sleep disorders, and appropriately timing light and dark exposure (supplemented by melatonin), clinicians can help many shift workers improve their ability to sleep, maintain wakefulness, and possibly decrease other adverse effects of shift work. More aggressive treatment strategies and referral to a sleep specialist should be considered for patients who do not respond to these simple measures.


This CME activity is expired. For more CME activities, visit
Find more articles on this and other psychiatry and CNS topics:
The Journal of Clinical Psychiatry
The Primary Care Companion for CNS Disorders

Volume: 73

Quick Links: