WordNet

provoke or excite; "The rock musician worked the crowd of young girls into a frenzy"
(physics) a manifestation of energy; the transfer of energy from one physical system to another expressed as the product of a force and the distance through which it moves a body in the direction of that force; "work equals force times distance"
arrive at a certain condition through repeated motion; "The stitches of the hem worked loose after she wore the skirt many times"
a product produced or accomplished through the effort or activity or agency of a person or thing; "it is not regarded as one of his more memorable works"; "the symphony was hailed as an ingenious work"; "he was indebted to the pioneering work of John Dewey"; "the work of an active imagination"; "erosion is the work of wind or water over time" (同)piece of work
activity directed toward making or doing something; "she checked several points needing further work"
have an effect or outcome; often the one desired or expected; "The voting process doesnt work as well as people thought"; "How does your idea work in practice?"; "This method doesnt work"; "The breaks of my new car act quickly"; "The medicine works only if you take it with a lot of water" (同)act
be employed; "Is your husband working again?"; "My wife never worked"; "Do you want to work after the age of 60?"; "She never did any work because she inherited a lot of money"; "She works as a waitress to put herself through college" (同)do work
cause to work; "he is working his servants hard" (同)put to work
shape, form, or improve a material; "work stone into tools"; "process iron"; "work the metal" (同)work on, process
behave in a certain way when handled; "This dough does not work easily"; "The soft metal works well"
cause to operate or function; "This pilot works the controls"; "Can you work an electric drill?"
exert oneself by doing mental or physical work for a purpose or out of necessity; "I will work hard to improve my grades"; "she worked hard for better living conditions for the poor"
gratify and charm, usually in order to influence; "the political candidate worked the crowds"
move in an agitated manner; "His fingers worked with tension"
move into or onto; "work the raisins into the dough"; "the student worked a few jokes into his presentation"; "work the body onto the flatbed truck"
operate in a certain place, area, or specialty; "She works the night clubs"; "The salesman works the Midwest"; "This artist works mostly in acrylics"
operate in or through; "Work the phones"
proceed towards a goal or along a path or through an activity; "work your way through every problem or task"; "She was working on her second martini when the guests arrived"; "Start from the bottom and work towards the top"
use a shift key on a keyboard; "She could not shift so all her letters are written in lower case"
the time period during which you are at work (同)work shift, duty period
the act of moving from one place to another; "his constant shifting disrupted the class" (同)shifting
an event in which something is displaced without rotation (同)displacement
a crew of workers who work for a specific period of time
change place or direction; "Shift ones position" (同)dislodge, reposition
change gears; "you have to shift when you go down a steep hill"
change in quality; "His tone shifted"
change phonetically as part of a systematic historical change; "Grimm showed how the consonants shifted"
move and exchange for another; "shift the date for our class reunion"
move from one setting or context to another; "shift the emphasis"; "shift ones attention"
serving to permit or facilitate further work or activity; "discussed the working draft of a peace treaty"; "they need working agreements with their neighbor states on interstate projects"
a mine or quarry that is being or has been worked (同)workings
actively engaged in paid work; "the working population"; "the ratio of working men to unemployed"; "a working mother"; "robots can be on the job day and night" (同)on the job
adequate for practical use; especially sufficient in strength or numbers to accomplish something; "the party has a working majority in the House"; "a working knowledge of Spanish"
adopted as a temporary basis for further work; "a working draft"; "a working hypothesis"
be able to accommodate for sleeping; "This tent sleeps six people"
be asleep (同)kip, slumber, log Z''s, catch some Z''s
a period of time spent sleeping; "he felt better after a little sleep"; "there wasnt time for a nap" (同)nap
a natural and periodic state of rest during which consciousness of the world is suspended; "he didnt get enough sleep last night"; "calm as a child in dreamless slumber" (同)slumber
a torpid state resembling deep sleep (同)sopor
bring disorder to (同)disarray
a physical condition in which there is a disturbance of normal functioning; "the doctor prescribed some medicine for the disorder"; "everyone gets stomach upsets from time to time" (同)upset
a disturbance of the peace or of public order

PrepTutorEJDIC

〈U〉(一般的な)『仕事,』労働;努力,勉強 / 〈U〉(実際にやっている具体的な)『仕事』,作業,勉強 / 〈U〉《定冠詞なしで》『仕事の口,』職[業],(工場・会社などの)勤め先 / 〈U〉制作,細工;《比喩(ひゆ)的に》しわざ / 〈C〉《しばしば複数形で》(文学・芸術の)『作品,』著作,(ある人の)作品 / 〈U〉《集合的に》(材料・道具などを含めて)作っているもの(今しているもの)全部 / 《複数形で》(機械の)動く部分,仕掛け / 《複数形で》《単数・複数扱い》《しばしば複合語を作って》『工場』 / 《複数形で》(宗教・道徳的な)行為,行い / 〈U〉(物理学で)仕事量 / 『働く』,仕事をする;(…に)取り組む,(…を)勉強する《+『at』(『on』)+『名』》 / (…に)『勤める』,勤務する《+『at』(『on, for』)+『名』》 / 《しばしば副詞[句]を伴って》〈機械・道具などが〉『ぐあいよく動く,』作動する,〈計画などが〉うまくいく,〈薬などが〉効く / 《副詞[句]を伴って》(ある方向に)少しずつ進む / 〈顔などが〉ぴくぴく動く,〈波などが〉揺れる / 《通例副詞を伴って》細工される,こねられる / 発酵する / 〈機械・道具など〉‘を'『動かす』,運転する / 〈人・牛馬など〉‘を'『働かせる』 / 〈工場・鉱山・農場など〉‘を'操業(経営)する,〈土地〉‘を'耕作する / 〈ある地域〉‘を'活動場所にする,受け持つ / 〈結果・効果など〉‘を'もたらす,生じさせる / (手で)…‘を'細工する,加工する;…‘に'手を加えて(…を)作る《+名+into+名》 / 《副詞[句]を伴って》(苦労して)…‘を'進む,(努力して)…‘を'得る / 〈人・物〉‘を'動かして(…に)する《+名+to(into)+名》 / …‘を'刺しゅうする,縫い付ける
〈人・場所・位置など〉‘を'『移し替える』,置き換える / …‘を'変える,取り替える / 〈自動車のギヤ〉‘を'入れ変える / (…へ)『変わる』,移る《+『to』+『名』》 / 車のギヤを変える;〈車が〉ギヤが入れ変わる・『変換』,転換;移動 / (仕事、作業の)『交替』,交替製;交替の組(人);交替時間 / (特に,自動車)変速装置 / やりくり[算段],一時しのぎの手段,便法;ずるい手段,策略 / シフトドレス(肩から腰までまっすぐした線のゆったりしたワンピース);スリップ
(機械・器具などが)『動く』,使える / (特に生活にために)『働く』,[肉体]労働に従事する / (知識などが)『実際に役立つ』,実用的な / 『労働(仕事)上の』,労働(仕事)用の / (機械などの)動き方,動かし方《+of+名》 / (鉱山などの)作業場,現場
〈U〉『眠り』,『睡眠』[『状態』] / 〈C〉《a sleep》一眠り[の時間] / 〈U〉永眠,死 / 〈U〉(一時的な手足などの)無感覚,しびれ;冬眠(hibernation) / 〈U〉目やに / 『眠る』 / 『文眠なる』,(死んで)葬られている / 〈人〉‘を'泊める[設備がある] / 《a+形容詞+sleepを目的語にして》…‘を'眠る
〈U〉『無秩序』,混乱,乱雑(confusion) / 《しばしば複数形で》(社会的・政治的な)粉争,騒動 / 〈C〉(肉体的・精神的な)不調,異常,障害 / …‘の'秩序を乱す / 〈心身〉‘に'異常を起こさせる

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/05/19 13:18:49」(JST)

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[Wiki en表示]

Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia and excessive sleepiness affecting people whose work hours overlap with the typical sleep period. There are numerous shift work schedules, and they may be permanent, intermittent, or rotating; consequently, the manifestations of SWSD are quite variable.

1 Diagnosis
2 Causes and comorbidities
3 Health risks
4 Suprachiasmatic nucleus (SCN)
5 Treatment
- 5.1 Prescribed sleep/wake scheduling
- 5.2 Bright light treatment
- 5.3 Melatonin treatment
- 5.4 Medications that promote alertness
- 5.5 Medications that promote daytime sleep
6 See also
7 References
8 External links

Diagnosis

The primary symptoms of shift work sleep disorder are insomnia and excessive sleepiness associated with working (and sleeping) at non-standard times. Shift work sleep disorder is also associated with falling asleep at work. Total daily sleep time is usually shortened and sleep quality is less in those who work night shifts compared to those who work day shifts.^[1] Sleepiness is manifested as a desire to nap, unintended dozing, impaired mental acuity, irritability, reduced performance, and accident proneness. Shift work is often combined with extended hours of duty, so fatigue can be a compounding factor.^[2] The symptoms coincide with the duration of shift work and usually remit with the adoption of a conventional sleep-wake schedule.^[2] The boundary between a "normal response" to the rigors of shift work and a diagnosable disorder is not sharp.

Causes and comorbidities

Insomnia and wake-time sleepiness are related to misalignment between the timing of the non-standard wake–sleep schedule and the endogenous circadian propensity for sleep and wake. In addition to circadian misalignment, attempted sleep at unusual times can be interrupted by noise, social obligations, and other factors. Finally, there is an inevitable degree of sleep deprivation associated with sudden transitions in sleep schedule.^[1]

Health risks

There have been many studies suggesting health risks associated with shift work. For example, a 2007 study led by the IARC (International Agency for Research on Cancer) showed that shiftwork has been associated with cancer.^[1]^[3] Other studies have reported that night workers have an increased incidence of heart disease, digestive disorders and menstrual irregularities.^[4] Because a formal diagnosis of SWSD was not typically made in these studies, it remains unclear whether the reported risks apply to the subset of shiftworkers who qualify for a diagnosis of SWSD or apply to all shiftworkers.

Suprachiasmatic nucleus (SCN)

Brain arousal is stimulated by the circadian system during the day and sleep is usually stimulated at night.^[5] The rhythms are maintained in the suprachiasmatic nucleus (SCN), located in the anterior hypothalamus in the brain, and synchronized with the day/night cycle.^[5] Gene-transcription feedback loops in individual SCN cells form the molecular basis of biological timekeeping.^[5] Circadian phase shifts are dependent on the schedule of light exposure, the intensity, and previous exposure to light.^[6] Variations in exposure can advance or delay these rhythms. For example, the rhythms can be delayed due to light exposure at night.^[6]

Photoreceptors located in the retina of the eye send information about environmental light through the retinohypothalamic tract to the SCN.^[5]^[6] The SCN regulates the pineal gland, which secretes the hormone melatonin.^[6] Typically, the secretion of melatonin begins two hours before bedtime and ends two hours prior to waking up.^[6] A decline in neuronal firing in the SCN is caused by the binding of melatonin to the MT1 and MT2 melatonin receptors. It is believed that the reduction in firing in the SCN stimulates sleep.^[5] While day-active individuals produce melatonin at night, night shift workers' production of melatonin is suppressed at night due to light exposure.^[6]

Treatment

Prescribed sleep/wake scheduling

Experts agree that there is no such thing as an "ideal" night work schedule, but some schedules may be better than others. For example, rotating shifts every two weeks in a forward (delaying) direction was found to be easier than rotation in a backward (advancing) direction.^[7] Gradual delays (“nudging” the circadian system about an hour per day) has been shown in a laboratory setting to maintain synchrony between sleep and the endogenous circadian rhythms,^[8] but this schedule is impractical for most real world settings. Some experts have advocated short runs (1 to 2 days) of night work with time for recovery; however, in the traditional heavy industries, longer (5 to 7 day) runs remain the rule. In the end, scheduling decisions usually involve maximizing leisure time, fairness in labor relations, etc. rather than chronobiological considerations. Shift workers can benefit from adhering to sleep hygiene practices related to sleep/wake scheduling.^{[citation needed]} Symptoms typically only fully resolve once a normal sleep schedule is resumed.^[2]

Many night workers take naps during their breaks, and in some industries, planned napping at work (with facilities provided) is beginning to be accepted. A nap before starting a night shift is a logical prophylactic measure. However, naps that are too long (over 20–30 minutes) may generate sleep inertia, a groggy feeling after awakening that can impair performance. Therefore, brief naps (10 to 30 minutes) are preferred to longer naps (over 30 minutes). Also, long naps may also interfere with the main sleep bout^{[citation needed]}.

In the transportation industry, safety is a major concern, and mandated hours of service rules attempt to enforce rest times.

Bright light treatment

The light-dark cycle is the most important environmental time cue for entraining circadian rhythms of most species, including humans, and bright artificial light exposure has been developed as a method to improve circadian adaptation in night workers. The timing of bright light exposure is critical for its phase shifting effects. To maximize a delay of the body clock, bright light exposure should occur in the evening or first part of the night, and bright light should be avoided in the morning. Wearing dark goggles^[9] (avoiding bright light) or blue-blocking goggles during the morning commute home from work can improve circadian adaptation. For workers who want to use bright light therapy, appropriate fixtures of the type used to treat winter depression are readily available^[10] but patients need to be educated regarding their appropriate use, especially the issue of timing. Bright light treatment is not recommended for patients with light sensitivity or ocular disease.

Melatonin treatment

Melatonin is a hormone secreted by the pineal gland in darkness, normally at night. Its production is suppressed by light exposure,^[11] principally blue light around 460 to 480 nm. Light restriction, or dark therapy, in the hours before bedtime allows its production. Dark therapy does not require total darkness. Amber or orange colored goggles eliminate blue light to the eyes while allowing vision.

Melatonin is also available as an oral supplement. In the US and Canada, the hormone melatonin is not classified as a drug; it is sold as a dietary supplement. In other countries it requires a prescription or is unavailable. Although it is not licensed by the FDA as a treatment for any disorder, there have been no serious side effects or complications reported to date.

Melatonin has been shown to accelerate the adaptation of the circadian system to a nighttime work schedule.^[12] Melatonin may benefit daytime sleep in night workers by an additional direct sleep promoting mechanism. Melatonin treatment may increase sleep length during both daytime and nighttime sleep in night shift workers.^[1]

Medications that promote alertness

Caffeine is the most widely used alerting drug in the world and has been shown to improve alertness in simulated night work.^[13] Caffeine and naps before a night shift reduces sleepiness during the shift.^[1] Modafinil and armodafinil are non-amphetamine alerting drugs originally developed for the treatment of narcolepsy that have been approved by the FDA (the US Food and Drug Administration) for excessive sleepiness associated with SWSD.^[14]

Medications that promote daytime sleep

Obtaining enough sleep during the day is a major problem for many night workers. Hypnotics given in the morning can lengthen daytime sleep; however, some studies have shown that nighttime sleepiness may be unaffected.^[15] Zopiclone has been shown to be ineffective in increasing sleep in shift workers.^[1]

References

^ ^a ^b ^c ^d ^e ^f Liira, Juha; Verbeek, Jos H.; Costa, Giovanni; Driscoll, Tim R.; Sallinen, Mikael; Isotalo, Leena K.; Ruotsalainen, Jani H. (2014). "Pharmacological interventions for sleepiness and sleep disturbances caused by shift work". The Cochrane Database of Systematic Reviews. 8: CD009776. doi:10.1002/14651858.CD009776.pub2. ISSN 1469-493X. PMID 25113164.
^ ^a ^b ^c Ker, Katharine; Edwards, Philip James; Felix, Lambert M.; Blackhall, Karen; Roberts, Ian (2010). "Caffeine for the prevention of injuries and errors in shift workers". The Cochrane Database of Systematic Reviews (5): CD008508. doi:10.1002/14651858.CD008508. ISSN 1469-493X. PMC 4160007 . PMID 20464765.
^ Kurt, Straif (December 2007). "IARC Monographs Programme finds cancer hazards associated with shiftwork, painting and firefighting" (Press release). International Agency for Research on Cancer. Retrieved 2010-06-08.
^ Nicholson PJ, D'Auria DA (April 1999). "Shift work, health, the working time regulations and health assessments". Occup Med (Lond). 49 (3): 127–37. doi:10.1093/occmed/49.3.127. PMID 10451593.
^ ^a ^b ^c ^d ^e Wright, K., Bogan, R., & Wyatt, J. (2012). Shift work and the assessment and management of shift work disorder (SWD). Sleep Medicine Reviews, 41-54. Retrieved December 8, 2014.
^ ^a ^b ^c ^d ^e ^f Boivin, D., & Boudreau, P. (2014). Impacts of shift work on sleep and circadian rhythms. Pathologie Biologie, 292-301. Retrieved December 8, 2014
^ Czeisler CA, Moore-Ede MC, Coleman RH (July 1982). "Rotating shift work schedules that disrupt sleep are improved by applying circadian principles". Science. 217 (4558): 460–3. doi:10.1126/science.7089576. PMID 7089576.
^ Gallo LC, Eastman CI (January 1993). "Circadian rhythms during gradually delaying and advancing sleep and light schedules". Physiol. Behav. 53 (1): 119–26. doi:10.1016/0031-9384(93)90019-C. PMID 8434051.
^ Eastman CI, Stewart KT, Mahoney MP, Liu L, Fogg LF (September 1994). "Dark goggles and bright light improve circadian rhythm adaptation to night-shift work". Sleep. 17 (6): 535–43. PMID 7809567.
^ "Seasonal affective disorder treatment: Choosing a light box". MayoClinic.com. Retrieved 2010-12-30.
^ deHaro D, Kines KJ, Sokolowski M, Dauchy RT, Streva VA, Hill SM, Hanifin JP, Brainard GC, Blask DE, Belancio VP (2014). "Regulation of L1 expression and retrotransposition by melatonin and its receptor: implications for cancer risk associated with light exposure at night". Nucleic Acids Research. 42 (12): 7694–7707. doi:10.1093/nar/gku503. PMC 4081101 . PMID 24914052.
^ Sack RL, Lewy AJ (December 1997). "Melatonin as a chronobiotic: treatment of circadian desynchrony in night workers and the blind". J. Biol. Rhythms. 12 (6): 595–603. doi:10.1177/074873049701200615. PMID 9406035.
^ Muehlbach MJ, Walsh JK (January 1995). "The effects of caffeine on simulated night-shift work and subsequent daytime sleep". Sleep. 18 (1): 22–9. PMID 7761739.
^ Czeisler CA, Walsh JK, Roth T, et al. (August 2005). "Modafinil for excessive sleepiness associated with shift-work sleep disorder". N. Engl. J. Med. 353 (5): 476–86. doi:10.1056/NEJMoa041292. PMID 16079371.
^ Walsh JK, Schweitzer PK, Anch AM, Muehlbach MJ, Jenkins NA, Dickins QS (April 1991). "Sleepiness/alertness on a simulated night shift following sleep at home with triazolam". Sleep. 14 (2): 140–6. PMID 1866527.

External links

Shift Work Sleep Disorder (uni-marburg.de)
(IARC/usnews)

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