Kulkarni K, Schow M, Shubrook JH. Shift Workers at Risk for Metabolic Syndrome. J Am Osteopath Assoc 2020;120(2):107–117. doi: https://doi.org/10.7556/jaoa.2020.020.
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In this highly digitalized era, sleep disorders are becoming more common and are associated with an increased burden of chronic disease. Shift workers are at an increased risk for both sleep disorders and metabolic syndrome. In this article, the authors outline the connection between circadian discordance, hormonal imbalance, and the development of metabolic syndrome in shift workers. Based on a literature review of animal model studies, observational studies, and clinical trials conducted between August and October of 2018, the authors offer several clinical interventions, including work schedules, light therapy, medications, and dietary habits to improve the circadian synchronicity of shift workers and reduce their risk of morbidity and mortality. It is important for physicians to be familiar with the consequences of shift work and ways to mitigate the risks for this patient population.
a These proposed schedules are examples for patients working a 10:30 pm to 7 am shift with 2 days off per week, a schedule in which patients will most likely prefer to be awake during the daytime. Patients should be encouraged to find a sleep schedule that fits with their personal routine while minimizing adjustments between off days and on days of shift work.
Abbreviations: GABA, γ-aminobutyric acid; NA, not applicable; NREM, non–rapid eye movement; REM, rapid eye movement; SNRI, serotonin-norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor.
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