American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the first step in managing shift work sleep disorder?

1. Medication adjustment

2. Addressing sleep-related behaviors and environment

3. Implementing a strict sleep schedule

4. Using bright light therapy

The correct answer is: Addressing sleep-related behaviors and environment

The management of shift work sleep disorder typically begins with addressing sleep-related behaviors and environmental factors. This initial step is crucial because it sets the foundation for better sleep hygiene and creates a conducive environment for rest. By educating patients on healthy sleep practices, such as avoiding stimulants before bedtime, optimizing the sleep environment (like reducing noise and controlling light), and establishing a wind-down routine, patients can potentially improve their sleep quality and overall well-being. Focusing on behavioral modifications and creating an environment that fosters sleep allows individuals to identify patterns and triggers that disrupt sleep, which can be more beneficial than other interventions at the outset. Once these foundational changes are in place, other strategies, such as medication adjustments, structured sleep schedules, or light therapy, can be incorporated in a more targeted manner based on the individual’s response and specific needs.