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Night Shifts

Updated: Jul 25, 2021

Working night shift is an inevitable part of medical training, whether you love it or hate it. If night shifts are a part of your career in medicine, it is important to be educated on their impact. Dr. Kim Fredericksen joins the blog today to talk about her experiences as an emergency medicine physician and share her knowledge on the effects of working night shifts.

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As someone with lots of experience, I decided to compose a piece on working night shifts. I studied biological rhythms for my honor’s thesis in college and I have worked as an emergency medicine attending on nights for many years. According to an editorial published in NEJM, up to 20% of workers are scheduled either night or rotating shifts in industrialized nations. The human endogenous circadian rhythm is 24.1 hours which makes switching shifts easier to adjust to if following a sequential forward day to evening to night pattern.

Working nights has been shown to have deleterious implications on many aspects of personal health. Working nights can impact mood and energy including contributing to sleeping disorders and depression. According to the National Sleep Foundation (NSF), working nights has been shown to increase risk for high blood pressure, heart disease, metabolic disease (with a 29% increased risk of becoming overweight), gastrointestinal problems, and stroke. Working night shift can also increase fertility problems, contribute to irregular menstrual cycles, and increase risk for breast cancer. Work performance and overall mental acuity can also be affected by night shifts. Night shifts longer than eight hours have been associated with increased medical errors. Working overnight can impair driving like alcohol resulting in slower reaction times and puts drivers at increased risk for accidents.

People experienced in working night shifts often have personal preferences in what works for them. There are lots of resources online including through national organizations such as the CDC, NSF, and NIOSH. A recent article in Emerge Med J 2020 by Wallace and Huber suggests ideas overall to improve quality of life while working night shifts. Some of these suggestions include naps, optimizing sleeping environments, and pointers on caffeine intake, diet, and possibly melatonin.

As a physician, part of training will inevitably include working night shifts. Medicine has come a long way in improving medical training working conditions even since the days a couple of decades ago when I was in training. Employing evidence-based strategies as well as individualized techniques can make this part of the job less painful and help in combating the negative effects of night shift.

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