The healthcare industry doesn’t operate on a traditional 9-to-5 schedule. Physicians, nurses, residents, respiratory therapists, EMTs, and other healthcare professionals may work overnight, early morning, extended, or rotating shifts to care for patients. These irregular shifts can disrupt the body’s natural biological clock and potentially affect performance.
Shift work sleep disorder (SWSD) is a circadian rhythm disorder that can occur when work schedules conflict with the body’s natural sleep-wake cycle. SWSD doesn’t just leave a clinician feeling tired. It can also affect attention, concentration, reaction time, judgment, and other aspects of functioning.
BlackDoctor Pro spoke with Carleara Weiss, Ph.D., MS, RN, Sleep Science Advisor for Aeroflow Sleep, to discuss why SWSD can affect clinicians and strategies for supporting healthier sleep.
As mentioned, shift work sleep disorder is a circadian rhythm disorder that occurs when a person’s work schedule clashes with their body’s natural 24-hour internal clock. It can cause difficulty falling asleep, trouble staying asleep, and unwanted sleepiness.
“However, it is critical to remember that the negative consequences go beyond sleep and may lead to other problems such as difficulty with attention and concentration, poor judgment, and weight gain,” Dr. Weiss said.
The two main symptoms associated with shift work sleep disorder are insomnia and excessive sleepiness, or hypersomnia.
About 20 percent of full-time employees in the United States work shifts, but not everyone who works shifts develops SWSD.
Clinicians experiencing persistent SWSD symptoms should discuss them with a qualified healthcare professional rather than assuming that fatigue is an unavoidable part of shift work.
Healthcare requires around-the-clock staffing to support patients, making overnight and rotating schedules unavoidable for many workers.
Working during the body’s biological sleep window requires people to remain awake against internal signals promoting sleep, creating a mismatch between the central circadian clock and behavioral routines.
Healthcare workers can face additional challenges that may contribute to shift work sleep disorder, including:
But SWSD shouldn’t be seen as an individual failure or lack of resilience on the healthcare worker’s behalf. Scheduling practices and workplace design can also contribute to sleep disruption, making this a broader healthcare workforce issue.
While shift work sleep disorder can ultimately impact a clinician’s sleep and overall well-being, sleep disruption may also affect how they deliver patient care.
“Sleep disturbances negatively impact cognitive function, attention, concentration, and reaction times, and may impact clinical decision-making when identifying patients’ symptoms,” Dr. Weiss said. “It may also damage problem-solving skills and memory, creating more irritability and anxiety. Combined, these problems may impact a clinician’s ability to perform high-quality care.”
The concern isn’t simply whether a clinician feels fatigued, but whether sleep disruption can affect the cognitive functions required for safe, effective care.
While demanding schedules in healthcare are unavoidable for many roles, practical strategies may help workers protect their sleep and manage the challenges of shift work.
Dr. Weiss shared the following recommendations:
Clinicians cannot always “sleep better” their way out of schedules that continuously disrupt circadian rhythms. Healthcare organizations also have a role in creating a work environment that supports healthy sleep and adequate recovery in a 24-hour care industry.
Dr. Weiss recommended several organizational approaches, including:
Additional strategies that Dr. Weiss said may be more difficult to implement but could support worker safety and well-being include:
Reducing the burden of shift work sleep disorder requires both individual strategies and systems-level changes.
When healthcare workers don’t get adequate sleep, the effects can significantly impact healthcare organizations. Sleep and fatigue are workforce and patient safety considerations, not solely personal wellness issues.
Healthcare leaders should examine scheduling practices, consecutive shifts, turnaround time between shifts, and opportunities for recovery.
Some healthcare organizations are also exploring ways to reduce sleepiness and fatigue among healthcare workers. Mount Sinai’s Center for Light and Health Research develops specialized lighting interventions designed to support sleep, alertness, and overall well-being, including among workers with demanding schedules.
The CDC’s National Institute for Occupational Safety and Health (NIOSH) has a dedicated Center for Work and Fatigue Research focused on the health and safety risks of nonstandard schedules and workplace fatigue. NIOSH offers free training for nurses on shift work and long hours.
On September 1st, 2026, the American Nurses Association (ANA) released an updated position statement on nurse fatigue. The statement frames fatigue as a workplace and patient safety issue and addresses areas including intershift recovery, excessive and consecutive hours, predictable scheduling, and nonpunitive reporting environments.
Healthcare workers often must work against their biological clocks to keep patients cared for around the clock. Individual strategies can help address sleep disruption, but organizational practices can also determine whether workers can have a realistic opportunity to recover.
Supporting clinician sleep ultimately benefits both healthcare workers and the patients they serve.
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