Program Description

Do you work the night shift or rotating shifts? Do some of your patients struggle with sleep problems? If so, access our on-demand webinar on shiftwork sleep disorder (SWSD). More than 22 million Americans are shiftworkers, and nurses account for a large portion of them. Especially when they have long commutes and family responsibilities, shiftworking nurses are vulnerable to significant sleep loss and SWSD. According to the Centers for Disease Control and Prevention, SWSD poses serious health threats. Shiftwork, lost sleep, and SWSD can reduce your job performance, decrease quality of life, and jeopardize patient safety. And, the health threats your patients with SWSD suffer can lower their quality of life and put them at risk for injuries.

Unfortunately, many nurses and other healthcare professionals aren't familiar with SWSD. To learn more about this disorder that can affect you, your colleagues, and even patients, take advantage of an on-demand web course, "Shiftwork sleep disorder: The role of the nurse - Understanding the consequences of SWSD for you and your patients." This fast-paced, on-demand webinar features sleep disorder experts who discuss:

  • risks associated with shiftwork
  • physiologic and psychological effects of shiftwork and SWSD
  • impact of shiftwork on safety, performance, and productivity
  • nonpharmacologic and pharmacologic management
  • assessment tools

You'll leave the program feeling confident in your knowledge of SWSD and better able to recognize SWSD signs and symptoms in yourself, your patients, and your colleagues. As an added bonus, you'll have access to a special online toolkit to continue your education endeavor and the opportunity to earn continuing nursing education (CNE) credit (see CNE Credit tab).

This program is supported by an unrestricted educational grant from Teva Pharmaceuticals to the American Nurses Foundation. All content underwent peer review by experts in the field.




Cathy Rick, RN, PhD (h), NEA-BC, FAAN, FACHE

Chief Nursing Officer
Department of Veterans Affairs






Michael Decker, PhD, RN, RRTMichael Decker, PhD, RN, RRT, D.ABSM
Program Chair
Diplomate, American Board of Sleep Medicine
Byrdine F. Lewis Chair in Nursing
Georgia State University

Role of the Nurse: Integrating SWSD interventions for you and your patient

Michael Decker,
a Diplomate of the American Board of Sleep Medicine, holds the Byrdine F. Lewis Endowed Chair in Nursing at Georgia State University, Atlanta. Dr. Decker's research focusing upon sleep-related disorders, their etiology, and subsequent neurochemical, cognitive, and behavioral sequelae has been funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). His clinical research focuses on characterizing the incidence and prevalence of sleep-related disorders within the population and understanding the association between those disorders and such chronic diseases as diabetes, high blood pressure, and stroke. He has published more than 40 peer-reviewed papers, six book chapters, and multiple clinical guidelines, and is routinely invited to present his research throughout the United States and abroad.


Jeanne Geiger-Brown, PhD, RNJeanne Geiger-Brown, PhD, RN
Associate Professor
Assistant Dean for Research
University of Maryland School of Nursing

SWSD in safety, performance, productivity

Jeanne Geiger-Brown is an associate professor at the University of Maryland School of Nursing, Baltimore, where she is also the Assistant Dean for Research. She is a nurse scientist whose research is at the intersection of occupational epidemiology, cognitive science, and sleep medicine. She studies work schedules and sleep deficiency, occupational sleep disorders, and screening for sleep disorders in occupational settings. Dr. Geiger Brown also conducts intervention research to assist individuals and organizations to improve the quantity and quality of sleep achieved by workers. Her research has informed changes in scheduling practices and policy in several healthcare settings. Her research also contributed to portions of the National Occupational Research Agenda for the Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health (NIOSH), and assisted NIOSH to modify an educational product for nurses engaged in shiftwork and extended work hours.


Kathryn Lee, PhD, FAAN, CBSMKathryn Lee, PhD, FAAN, CBSM
Associate Dean for Research
Professor and James and Marjorie Livingston Endowed Chair
University of California, San Francisco School of Nursing

SWSD: Understanding its symptoms and risk factors

Kathryn Lee
is a professor of nursing at the University of California, San Francisco. She holds the James and Marjorie Livingston Endowed Chair in Nursing and is the Associate Dean for Research in the School of Nursing. Dr. Lee completed her PhD training at the University of Washington and was a Robert Wood Johnson Clinical Nurse Scholar. She is board certified in Behavioral Sleep Medicine (CBSM). Dr. Lee is a past member of the Sleep Research Advisory Board in the National Heart Lung and Blood Institute at the National Institutes of Health. She is currently an associate editor for the journal Behavioral Sleep Medicine, and serves on the editorial board of Sleep Medicine Reviews. She has written over 150 publications related to sleep and women's health.


James Wyatt, PhD, DABSM, CBSMJames Wyatt, PhD, D.ABSM, CBSM
Director, Sleep Disorders Service and Research Center
Rush University Medical Center
Associate Professor of Behavioral Sciences
Rush Medical College

Health consequences and comorbidities of shiftwork and SWSD

James Wyatt is the Director of the Sleep Disorders Service and Research Center at Rush University Medical Center and is an associate professor of Behavioral Sciences at Rush Medical College, Chicago, Illinois. He is a Fellow of the American Academy of Sleep Medicine (AASM), and was the chair of the circadian rhythms section of AASM from 2009 to 2012. Dr. Wyatt is board-certified in clinical sleep disorders by the American Board of Sleep Medicine, and certified in behavioral sleep medicine by the AASM. His current research concentrates on the homeostatic and circadian modulation of sleep and wakefulness, circadian rhythm sleep disorders, wrist actigraphy, and insomnia. Dr. Wyatt lectures at national courses and conferences on circadian rhythm sleep disorders.

This program is supported by an unrestricted educational grant from Teva Pharmaceuticals to the American Nurses Foundation. All content underwent peer review by experts in the field.

American Nurses Association
Center for Continuing Education and Professional Development
Disclosures to Learners
Shiftwork Sleep Disorder: The Role of The Nurse
Understanding SWSD for You and Your Patients

Learning Objectives

  • Recognize shiftwork sleep disorder (SWSD) and its risk factors.
  • Translate the detrimental health and social consequences of SWSD into a need for self and patient intervention.
  • Translate the impact of SWSD on safety, performance, and productivity into a need for self and patient intervention.
  • Apply nursing strategies for early diagnosis and management of SWSD for self and patient education and intervention.

Successful Completion of this Continuing Nursing Education Activity
In order to receive full contact-hour credit for this CNE activity, you must:

  • Be registered for this activity
  • Complete the entire webinar
  • Download the PDF of the toolkit
  • Complete and submit the online Evaluation Form after the webinar.

1.25 contact hour (60 minute contact hour) will be awarded to attendees who successfully complete this CNE activity.

The American Nurses Association Center for Continuing Education and Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

ANCC Provider Number 0023.
ANA is approved by the California Board of Registered Nursing, Provider Number CEP6178 for 1.5
contact hours (50 minute contact hour).

Certificate of Successful Completion
Once you have finished completing the online evaluation, you will be able to print or save your certificate. 

Conflicts of Interest
A conflict of interest occurs when an individual has an opportunity to affect educational content about
health-care products or services of a commercial interest with which she/he has a financial relationship.
The speakers and planners of this CNE activity have disclosed no relevant financial relationships with any
commercial interests pertaining to this activity.

Commercial/Noncommercial Company Support
This program is supported by an unrestricted educational grant from Teva Pharmaceuticals to the American
Nurses Foundation. All content underwent peer review by experts in the field.

Non-Endorsement of Products
The Center for Continuing Education and Professional Development's accredited provider status
refers only to continuing nursing education activities and does not imply that there is real or implied
endorsement by of any product, service, or company referred to in this activity nor of any company
subsidizing costs related to the activity.

Off-label Product Use
This CNE activity does not include any unannounced information about off-label use of a product for a
purpose other than that for which it was approved by the Food and Drug Administration (FDA).

Shiftwork Sleep Disorder: The Role of the Nurse
Understanding the Consequences of SWSD for You and Your Patients


The American Nurses Association, American Nurses Foundation, and American Nurse Today--in collaboration with the CORE Medical Education, LLC--are pleased to present this online toolkit on shiftwork, sleep, and patient health. The toolkit was designed to provide evidence-based tools to nurses and patients, in order to improve patient-provider communication and diagnosis and treatment of shiftwork sleep disorder (SWSD). It features practical resources previously developed under the auspices of societies and associations associated with sleep and shiftwork, as well as peer-reviewed literature on the topic.   

DIAGNOSTIC TOOLS:This section contains online links to access and download diagnostic tools designed to explore basic diagnosis and treatment recommendations and patient-care methods.

  • The American Academy of Sleep Medicine created a sleep diary that can track patients' sleep patterns over a 2-week period. This tool is useful for identifying a sleep disorder by capturing a patient's time in bed, sleep latency, total sleep time, awakenings, wake after sleep onset, overall sleep quality, and morning sleepiness.

  • The Epworth Sleepiness Scale (ESS), a self-administered questionnaire with eight questions, provides a measure of a person's general level of daytime sleepiness, or average sleep propensity in daily life. It has become the most widely used method for making an in-office assessment of sleepiness and excessive sleepiness.

PATIENT GROUPS AND ONLINE DISCUSSION FORUMS: This section contains links to patient education resources and support websites.

  • American Academy of Sleep Medicine, patient education portal: This website is useful for anyone interested in sleep disorders, including their signs, symptoms, and treatment. It also provides a discussion forum where users can interact with other potential sleep disorder sufferers.

  • National Sleep Foundation, patient education portal: This website provides useful general information on sleep topics and sleep disorders. Its "Ask the Expert" tool lets users ask experts about sleep conditions. Users also can find a sleep professional through this site.

  • Sleep and Health Education program, Harvard Medical School, Division of Sleep Medicine website: This website helps users understand circadian and homeostatic sleep drives and how they interact in shiftworkers. Its three major sections are Healthy sleep, Get sleep, and Sleep apnea.  

  • American Board of Sleep Medicine: Click on "Verification of Diplomates" for names of board-certified sleep specialists.

  • Sleep Center Locations: This website lists accredited sleep disorder centers and sleep-related breathing laboratories from the American Academy of Sleep Medicine.

  • American Academy of Dental Sleep Medicine: Here you'll find a searchable directory of dentists who specialize in treating certain sleep problems.


FEDERAL GOVERNMENT RESOURCES: This section contains links to federal government resources.

  • Agency for Health Care Research and Quality (Department of Health and Human Services). Patient Safety and Quality: An Evidence-Based Handbook for Nurses:  In this detailed handbook, chapter 40 addresses the effects of fatigue and sleepiness on nurse performance and patient safety. (For chapter 40, see

  • Centers for Disease Control and Prevention website: Insufficient Sleep Is a Public Health Epidemic: and This website presents the magnitude of the problem of insufficient sleep and provides links to other websites from the CDC, National Sleep Foundation, and the media. It was created to raise awareness of sleep insufficiency and sleep disorders and the importance of sleep health for the nation's overall health. It provides links to useful podcasts on the topic as well.

  • National Institute for Occupational Safety and Health (NIOSH): and   NIOSH recently launched the information series "Total Worker Health."  Its inaugural issue includes "Can Enough Zzzz's Prevent Disease?" by Claire C. Caruso, PhD, RN, a NIOSH research health scientist. The site also offers "Work schedules: Shiftwork and long work hours" at

  • National Heart, Lung, and Blood Institute: Your Guide to Healthy Sleep ( This resource provides sleeping tips, information on sleep disorders, and guidance on seeking help from sleep professionals.

  • Healthy People 2020 This resource provides science-based, 10-year national objectives for promoting health and preventing disease. Since 1979, Healthy People has established and monitored national health objectives to meet a broad range of health needs, encourage collaboration across sectors, guide individuals toward making informed health decisions, and measure the impact of prevention activities. Currently, Healthy People 2020 is leading the way to achieve increased quality and years of healthy life and the elimination of health disparities. 

  • Plain Language About Shiftwork: A publication of NIOSH, the Department of Health and Human Services, and the CDC, this document provides basic facts about shiftwork and offers ways to make shiftwork life easier. Itís organized into six sections: basic background information, how to examine work schedules, health and safety effects of shiftwork, improving shiftwork through the organization, coping strategies for the individual, and recommended reading.


REFERENCES AND PUBLICATIONS: This section contains links to additional references and publications for further reading.

Shiftwork and general health

  • Buxton OM, Cain SW, O'Connor SP, et al. Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Sci Transl Med. 2012 Apr 11;4(129):129ra43.
  • Flo E, Pallesen S, Mageroy N, et al. Shiftwork disorder in nurses--assessment, prevalence and related health problems. PLoS One. 2012;7(4):e33981.
  • Ijoha S, Weir ID, Rennert NJ. Relationship between sleep disorders and the risk for developing type 2 diabetes mellitus. Postgrad Med. 2012 Jul;124(4):119-29.
  • Krystal AD, Roth T, Simon RD. Shiftwork disorder case studies: applying management principles in clinical practice. J Clin Psychiatry. 2012 Aug;73(8):e25.

Shiftwork and performance

Shiftwork and fatigue/patient safety

  • Nurse Fatigue and Patient Safety.  This research report summarizes the literature on this topic by the Canadian Nurses Association and Registered Nurses' Association of Ontario. It represents a call to action to the healthcare system overall, healthcare organizations, governments, nursing associations, unions, regulatory bodies--and nurses themselves--to address the rising levels and significant impact of nurse fatigue.
  • Geiger-Brown J, Rogers VE, Trinkoff AM, et al. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int. 2012 Mar;29(2):211-9.
  • Scott LD, Hofmeister N, Rogness N, et al. An interventional approach for patient and nurse safety: a fatigue countermeasures feasibility study. Nurse Res. 2010 Jul-Aug;59(4):250-8.


Shiftwork and sleep (general)

  • Sleep Disorders and Sleep Promotion in Nursing Practice. Redeker N, McEnany GP, eds. New York: Springer; 2011. This textbook presents the latest scientific evidence on health promotion and prevention and treatment of sleep disorders. It helps readers understand strategies for promoting normal sleep, caring for those with sleep problems, and how to support sleep in various settings. Chapter 16: Sleep disorders and sleep promotion in nursing practice. Lee KA, pp. 261-276 and Chapter 22: Sleep promotion in occupational settings. Geiger-Brown J. and McPhaul K, pp. 355-69 are the contributions of our expert faculty. 
    Excerpt is available at
  • Venkateshiah SB, Collop NA. Sleep and sleep disorders in the hospital. Chest 2012 May;141(5):1337-45.
  • Wright KP Jr, Bogan RK, Wyatt JK. Shiftwork and the assessment and management of shiftwork disorder (SWD). Sleep Med Rev. 2012 May 3.
  • Lee KA, Lipscomb J. Sleep among shiftworkers--a priority for clinical practice and research in occupational health nursing. AAOHN J. Oct;51(10):418-20.
  • Lee KA. Is sleep a priority for yourself or your research? Int J Occup Environ Health. 2004 Jan-Mar;10(1):106-7.
  • Roth T. Shiftwork disorder: overview and diagnosis. J Clin Psychiatry. 2012 Mar;73(3):e09. 
  • Gamble KL, Motsinger-Reif AA, Hida A, et al. Shiftwork in nurses: contribution of phenotypes and genotypes to adaptation. PLoS One. 2011 Apr 13;6(4):e18395.

Circadian rhythms

  • Krystal AD. How the circadian rhythm affects sleep, wakefulness, and overall health: background for understanding shiftwork disorder. J Clin Psychiatry. 2012 Feb;73(2):e05.
  • Gumenyuk V, Roth T, Drake CL. Circadian phase, sleepiness, and light exposure assessment in night workers with and without shiftwork disorder. Chronobiol Int. 2012 Aug;29(7):928-36.

American Nurses Association's Healthy Nurse website: This website provides a section on work environments, which includes information about nursing work hours and working when fatigued.

This program is supported by an unrestricted educational grant from Teva Pharmaceuticals to the American Nurses Foundation. All content underwent peer review by experts in the field.

Shiftwork Sleep Disorder: The Role of the Nurse
Understanding the Consequences of SWSD for You and Your Patients

You are invited to take part in a follow up survey . . .

Thank you for your interest in shift work sleep disorder (SWSD). We will be continuing our efforts to enhance nursesí knowledge in this area. To that end, we plan to follow up with participants who complete the web course to ascertain how they use this information in their personal and professional perceptions of SWSD; specifically, how the web course and the toolkit improved their knowledge and competence.

You will be receiving an email that contains a link to a survey approximately 45 to 60 days after your completion of the course. We invite you to respond to the survey questions online. Your answers will be confidential, and we will not ask for your name. The data will be analyzed for the entire group of respondents, and the results will be published in a future issue of American Nurse Today, the official journal of the American Nurses Association.

Your email address will be kept strictly confidential and not shared with any other entity.

We hope you enjoy the web course and participate in the follow-up survey.

This program is supported by an unrestricted educational grant from Teva Pharmaceuticals to the American Nurses Foundation. All content underwent peer review by experts in the field.

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