BACKGROUND: Shift work disorder (SWD) is characterized by symptoms of excessive 
sleepiness during work hours or insomnia during allotted daytime sleep hours, as 
well as by a disruption of the circadian rhythm. Many shift workers with SWD 
experience significant social, behavioral, and health problems as a result of 
this disorder. SWD is associated with a higher risk of occupational and motor 
vehicle accidents, and thus poses a public health risk.
METHODS: Currently there are both pharmacologic and non-pharmacologic treatments 
for this disorder that can be used to normalize the disruption of the circadian 
cycle or alleviate the symptoms of excessive sleepiness or insomnia. The 
American Academy of Sleep Medicine and the British Society of Psychopharmacology 
have developed guidelines for the diagnosis and treatment of patients with SWD.
RESULTS: Recommended therapies for altering the circadian cycle include 
chronobiotics such as melatonin or melatonin agonists and non-pharmacologic 
interventions such as timed light exposure. Other therapies, such as sedative 
hypnotics, target daytime insomnia, while pharmacologic agents such as 
modafinil, armodafinil, and caffeine and non-pharmacologic approaches such as 
napping promote nighttime alertness.
CONCLUSIONS: While no therapies (pharmacological or nonpharmacological) can 
restore altered circadian cycles to baseline levels, proper identification and 
management of SWD will likely reduce its co-morbidities and improve the quality 
of life for individuals with this disorder.