1. Diagnosis and management of sleep disorders in shift workers, with patient informed solutions to improve health services research and practice.
- Author
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Reynolds AC, Loffler KA, Grivell N, Brown BW, and Adams RJ
- Subjects
- Humans, Australia, Health Services Research, Sleep Wake Disorders diagnosis, Sleep Wake Disorders therapy
- Abstract
Background: The combination of shift work and an unmanaged sleep disorder carries health and safety risks. Yet, diagnosis rates for sleep disorders are low in shift workers. The aim of this study was to understand the experience of sleep disorder diagnosis and treatment in shift workers, and consider patient informed solutions to improve access to health services., Methods: Semi-structured interviews were conducted with 16 Australian shift workers with a diagnosed sleep disorder. Patient journey mapping and reflexive thematic analysis were used to understand diagnosis and management experiences., Results: There were highly variable experiences with diagnosis and management, often taking >5 years to seek help from a health care provider (HCP) after noticing symptoms of a sleep disorder. Three themes were constructed, including 'the cause of the problem', 'prioritising work', and '(dis)satisfaction and (dis)connection'. Extent of patient and HCP awareness of sleep disorders, and a prevailing attitude of shift work being 'the problem' impacted diagnosis, as did organisational needs (including rostering, which had both positive and negative influences on help seeking). Relationships with HCPs were important, and living on non-standard time was both a barrier and an enabler to sleep disorder care. Participants identified the need for education and awareness, prompts and easy access to screening and referral pathways, and tailored models of care., Conclusion: Education and awareness initiatives for shift workers, their employers and HCPs, together with development of a model of care for shift workers with sleep disorders may address some of the unique barriers to diagnosis and management., Competing Interests: Declaration of competing interest ACR reports research funding from the Lifetime Support Authority, Sydney Trains, Flinders Foundation, Hospital Research Foundation, Medical Research Future Fund, Vanda Pharmaceuticals, Safework SA, research consulting fees from Compumedics, and honoraria for presentation of education materials related to shift work from Teva Pharmaceuticals. RJA reports funding from the NHMRC, MRFF, ResMed Foundation, Hospital Research Foundation, Philips, Commonwealth of Australia and Sydney Trains, and equipment support from Neuroflex. For both authors, this support was outside the scope of the present manuscript., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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