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Shift Work Sleep Disorder — SCE Neurology MCQ

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ModerateSleep DisordersShift Work Sleep DisorderSCE Neurology

A 31-year-old paramedic works rotating night shifts. For three months, she has severe sleepiness on night duty and fragmented daytime sleep after night shifts. A two-week diary and actigraphy show adequate sleep opportunity only when she is on days off; polysomnography excludes sleep apnoea. Which management plan is most appropriate initially?

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Correct answer: B — Optimise shift scheduling, protected daytime sleep, planned naps and timed light exposure with occupational-health support

The pattern supports shift-work sleep disorder. Initial management is behavioural, circadian and occupational: stabilising schedules where possible, planning protected sleep, strategic naps and light timing. Modafinil is not a blanket licensed UK treatment for this indication, sedative-hypnotics can impair safety and dependence risk, and CPAP is not indicated after obstructive sleep apnoea has been excluded.

Reference: British Association for Psychopharmacology sleep-disorder guideline: https://madeinheene.hee.nhs.uk/Portals/19/BAP_Guidelines-Sleep%202019.pdf