Circadian Rhythms in Night Shift Medical Staff
CLINICAL QUESTION: Night shift work exposes medical personnel to a range of physiological and psycho-cognitive health risks. Are there evidence-based strategies that can help mitigate these risks?
BACKGROUND: Night shift work is an unavoidable reality of modern healthcare. However, humans are not nocturnal creatures, and this type of work confers long-term health risks to our bodies. This systematic review synthesizes current evidence on the risks of night shift work and suggests potential interventions to reduce harm.
STUDY DESIGN: Systematic review
SETTING: A search of MEDLINE databases was conducted for articles published between 2019 and 2024 using keywords such as “night shift,” “shift work,” and “sleep disorder.” Out of 403 articles identified, 38 met the inclusion criteria for final analysis.
SYNOPSIS: The selected studies largely support a consensus: night shift work increases the risk of biological, physiological, and psychological health issues. Several actionable strategies to mitigate these risks emerged from the review. For shift scheduling, a three-night-shift-per-week schedule was associated with poorer sleep quality compared to other scheduling patterns. Individuals with a morning chronotype experienced worse sleep quality on days off than those with evening chronotypes, indicating a mismatch between biological predisposition and work demands. On average, night shift workers gained 8 kg of body weight, largely due to increased snacking and hyperphagia, leading to central obesity. This could potentially be mitigated by consuming a high-protein meal before shifts. Moreover, post-shift sleep quality can be improved with a high-protein meal immediately after the shift.
To address these findings, solutions were proposed. Night shift workers should undergo regular screening for hypertension, insulin resistance, weight gain, and mental health disorders. Shift schedules should consider individual chronotypes to optimize alignment with circadian biology. Nutritional interventions, particularly high-protein dietary strategies, may help mitigate weight gain and improve sleep quality. Certain shift patterns are more disruptive to sleep and should be reevaluated in scheduling practices.
BOTTOM LINE: Healthcare institutions should consider adopting tailored wellness and screening programs to support the unique needs of their night shift workforce.
CITATION: Czyż-Szypenbejl K, Mędrzycka-Dąbrowska W. The impact of night work on the sleep and health of medical staff–a review of the latest scientific reports. J Clin Med. 2024;13(15):4505. doi: 10.3390/jcm13154505.
Dr. Moazzam
Dr. Moazzam is a hospitalist and an assistant clinical professor of medicine at UC San Diego Health in San Diego.