When it comes to sleeping against the clock or doing shift work day in and day out, no one does it quite like healthcare professionals. With patients needing round-the-clock care and supervision, healthcare workers must work in eight- or twelve-hour shifts to cover the entire 24-hour period.

Unfortunately, studies have shown that shift work can affect the health and quality of life of healthcare professionals because of circadian misalignment. It’s important for nurses and physicians, especially those working the night shift, to ensure that they get enough sleep and proper nutrition to function optimally at work. After all, when healthcare professionals are healthy and well-rested, they are less likely to make errors at work, and they can consistently provide high-quality patient care.

In this article, we discuss the common circadian rhythm challenges that night shift healthcare workers face, differentiate fatigue from shift work sleep disorder, and provide a circadian dysregulation self-assessment that healthcare professionals can use to improve their sleep duration and quality.

What are Circadian Rhythm Challenges?

Let’s start by defining what a circadian rhythm is. The circadian rhythm is the body’s internal clock, which dictates when you should sleep and wake up. Aside from sleeping and waking up, this biological process is also vital to body temperature regulation,  metabolic processes, and hormonal function.

Conditions or disorders that affect your sleep quality, sleep duration, and how well (or poorly) you function after you wake up are referred to as circadian rhythm disorders. There are various types of circadian rhythm disorders, such as jet lag, which happens when you travel to a place with a different time zone, and your body’s not used to the new day/night schedule. But the common circadian rhythm disorder that affects healthcare workers is the shift work sleep disorder (SWSD). SWSD arises when work shifts, like night duty for healthcare workers, disrupt normal sleep patterns.

Identifying Shift Work Sleep Disorder vs. Standard Fatigue

In this section, we’ll discuss the difference between shift work sleep disorder vs. night shift fatigue.

Standard fatigue refers to the body’s natural response to stressors such as physical activity, emotional stress, boredom, and lack of sleep. Fatigue can also be caused by health conditions, such as anemia, iron deficiency, and thyroid issues, as well as certain medicines and the use of alcohol or drugs.

Meanwhile, SWSD is a sleep disorder that typically affects professionals who work in unorthodox work hours, such as 12-hour shifts from 7 p.m. to 7 a.m. People living with SWSD often exhibit symptoms such as daytime sleepiness, insomnia (difficulty falling and staying asleep), irregular sleeping patterns, and even sleep apnea symptoms, including snoring and interrupted sleeping.

A large population of healthcare workers experiences SWSD. A 2021 study found that 48.5% of nurses experienced SWSD during the height of the COVID-19 pandemic. The healthcare professionals with SWSD experienced fatigue and psychological stress, and tend to use sleep medication and have irregular meals. Meanwhile, a separate 2026 study found that 49.5% — almost half of the global nursing population — of nurses are affected by SWSD. When left unaddressed, SWSD can lead to healthcare workers developing illnesses such as diabetes and cardiovascular diseases, as well as increasing the risks for occupational and safety challenges in the workplace.

Circadian Rhythm Dysregulation Self-Assessment: Important Indicators and Tools Nurses Should Know About

This self-assessment guide is designed to assist healthcare professionals in identifying symptoms of circadian rhythm dysregulation at an early stage, which can help reduce the risk of sleepiness, fatigue, potential workplace errors, and associated health hazards.

• Do you find it hard to fall asleep after working on the mid- or night shift?
• Do you feel drowsy or fatigued even after sleeping for more than seven hours?
• Do you have challenges staying focused or alert two to four hours into your shift?
• Do you often feel irritable or have poor motivation even on your days off?
• Have you noticed your reaction time slowing down, or have you experienced near-misses at work?
• Have you recently made any medication or treatment errors at work, or have you experienced communication lapses due to sleepiness or alertness-related challenges?

Nurses who are interested in tracking their sleep quality and levels can consider the following helpful strategies:

• Record key times: Document the ending time of your shift, the time you went to sleep, and the duration of your sleep. It’s also a good idea to note how often you experience sleep disturbances and for how long.
• Document your caffeine and alcohol intake. This can help you determine if you’re drinking too much caffeine and alcohol, which can affect the quality and duration of your sleep.
• Wear smart devices that measure your actigraphy, or your rest and activity cycles, as well as your body temperature levels.