Healthcare professionals routinely counsel patients on the importance of sleep; however, their working patterns often undermine sleep. Research presented at The Sleep Congress 2025 in Strasbourg, France, linked night work, on-call duties, and extended shifts to disrupted sleep, higher error rates, and increased risks to clinician well-being and patient safety.

Speaking during the session Sleeping, a Dream for Healthcare Workers, Laure Peter-Derex, MD, PhD, neurologist and professor at the Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Lyon, France, highlighted this central contradiction: Clinicians understand the vital role of sleep in health yet remain among those most exposed to circadian rhythm disorders and chronic sleep deprivation.

Night Shifts

Mathieu Berger, PhD, associate professor and researcher at Jean Monnet University in Saint-Étienne, France, focused on the effects of night shifts, on-call duties, and extended rotations on sleep among healthcare professionals. “I am going to present an overview of recent studies on healthcare workers’ sleep and its impact on the risk of accidents and health,” he said.

Berger first cited a study conducted by Maurice M. Ohayon, MD, PhD, professor of psychiatry and behavioral sciences (sleep medicine) and director of the Stanford Sleep Epidemiology Research Center, Stanford Medicine, Stanford, California, involving 817 employees of Centre Hospitalier Le Vinatier in Lyon, France. The study analysed the impact of different work schedules on sleep. Staff working rotating or night shifts slept an average of 1 hour less than those on fixed daytime schedules and reported higher rates of sleep disorders, particularly insomnia and circadian rhythm disorders. No differences were observed in sleep apnoea. The study also reported a 30% higher rate of sick leave over 1 year among staff working rotating daytime shifts.

Building on these findings, Berger presented more recent data from his research group in Saint-Étienne. After returning from postdoctoral training, the team launched an observational survey of healthcare staff within the Loire Hospital Territorial Groups (GHT Loire), which included four university hospitals in France. Approximately 300 healthcare professionals, nurses, and nursing assistants, were surveyed for this study.

“Even on fixed workdays, workers sleep on average 1 hour and 30 minutes less in 24 hours than on their rest days, a gap that is even greater among night workers,” Berger said. Although night workers take more naps, they do not compensate for nocturnal sleep debt, and recovery never reaches the level observed in staff who do not work night shifts. The survey also revealed a high prevalence of sleep disorders among healthcare workers.

Errors Rise

As Berger noted, sleep debt has a direct effect on the quality of care provided. He highlighted a study published in BMJ Quality & Safety approximately a decade ago, in which 28 clinicians were observed for a total of 120 hours. An observer recorded each medical prescription during that period. Of the 239 prescriptions, 208 contained errors.

Further analysis showed that most errors were linked to interruptions during the act of prescribing. Another key determinant was sleep quality the previous night. Poor sleep was associated with a higher number of prescription errors.

Additional data were presented from a doctoral thesis conducted by Laura Schmitt, PhD, and discussed at the Congress by Stéphanie Mazza, PhD, professor of neuropsychology at the Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Bron, France. The thesis examined nurses and physicians working in emergency departments and found that “reducing shift duration to a maximum of 16 hours led to a 36.6% reduction in adverse events and a 57% reduction in un-intercepted errors.”

Training Impact

Mazza also presented findings from an interventional study conducted in two emergency departments in Lyon, involving 50 healthcare professionals, including physicians and nurses. Both departments operated on 12-hour shifts from 7 AM to 7 PM and from 7 PM to 7 Am, respectively.

Participants were randomly assigned to two groups. Half of the participants received a 2-hour training session focused on fatigue management based on their own sleep and work data. The programme also introduced cardio feedback and mental imagery techniques, offering relaxation tools aimed at reducing physiological and cognitive arousal at the bedtime. The second group did not receive any initial training.

After the participants were advised to follow the recommendations for 15 days, divergent outcomes were observed. Healthcare professionals who had not received the training experienced a deterioration in sleep, whereas those who completed the programme increased their time in bed by 37 minutes and their total sleep time by 27 minutes, Mazza reported.

Multifactorial Approach

Mounir Chennaoui, MD, senior researcher at the French Armed Forces Biomedical Research Institute in Brétigny-sur-Orge, France, reviewed available “countermeasures to the effects of shiftwork.”

According to Chennaoui, “Effective approaches are multifactorial: They combine physiology, ergonomics, [and] organisation and must be personalised.” He emphasised that studies of physiological interventions show probable or possible benefits, but the current evidence base remains insufficient to support definitive conclusions.

Naps provide a recognised benefit by reducing sleepiness and improving performance, although they do not replace nighttime sleep. Techniques such as optimised napping — which incorporates mental preparation, breathing, and relaxation, as well as exposure to intense light at the start of a shift — may help some individuals, although responses vary among individuals. Regular physical activity also improves recovery and nocturnal sleep quality of the individual.

Among organisational strategies, Chennaoui cited rapid shift rotation or fixed schedules aligned with individual chronotypes, strategic breaks, and integrated programmes combining sleep management, light exposure, and working-time adaptation. He concluded that melatonin should be used as a last resort.

This story was translated from Univadis France, part of the Medscape Professional Network.