Impact of Shift Work and Long Working Hours on Sleep Quality and Clinical Performance Among Health Professionals
Keywords:
shift work, sleep quality, clinical performance, circadian rhythms, occupational health, patient safetyAbstract
Background:
Shift work and prolonged working hours are integral to modern healthcare; they maintain 24-hour service but disrupt circadian rhythms. These nonstandard schedules impair sleep quality and cognitive performance, potentially increasing clinical errors among health professionals. Understanding these effects is critical for workforce management and patient safety.
Methods:
A systematic search of PubMed from database inception through 2024 was conducted, adhering to PRISMA guidelines. Clinical-trial and cohort studies examining the impact of shift work or extended-hour schedules on sleep quality and clinical performance were eligible.
Results:
Across 14 included studies, night-shift or extended-hour conditions were associated with markedly increased error rates, including a 44 % relative increase in crossover trials and a 1.8-fold rise in error odds (95 % CI 1.3–2.5) in cohort analyses. Sleep metrics deteriorated under nonstandard schedules, with Pittsburgh Sleep Quality Index scores rising by approximately 3 points and average sleep time declining below 5 h, while task completion and dispatch times slowed by 12 % and 9 %, respectively, and simulated triage times increased by 18 %. Intervention studies demonstrated that planned 40-minute naps reduced psychomotor vigilance lapses by 37 % and that a telehealth-delivered sleep program improved PSQI scores by 2.4 points and reduced self-reported errors by 15 %.
Conclusions:
Nonstandard work schedules and extended shifts substantially compromise sleep health and elevate clinical error risk among healthcare professionals. Adoption of evidence-based countermeasures is imperative to mitigate fatigue, enhance practitioner well-being, and improve patient safety.
