Running on Empty: Fatigue and Healthcare Professionals

Claire C. Caruso, PhD, RN


August 02, 2012

Editorial Collaboration

Medscape &

In This Article

Sleep Deprivation in Healthcare

A growing number of healthcare workers suffer from sleep deprivation and fatigue. From 1985 to 2007, the percentage of healthcare workers reporting 6 or fewer hours of sleep per day (a level considered by sleep experts to be too short) rose from 28% to 32%.[1]

This trend toward shorter sleep has several likely explanations. Healthcare workers typically work off-shifts and long hours to provide vital services to society around the clock. These demanding schedules can lead to difficulties with sleep because of the need to sleep at irregular times and at times that are out of phase with normal circadian rhythms. This misalignment of sleep with circadian rhythms leads to trouble with falling asleep, more arousals during sleep, and early awakenings leading to poorer sleep quality and shorter sleep duration. Furthermore, sleep duration may be shortened by insufficient time between work shifts and the competing demands of work and personal life. Economic pressures could force healthcare workers to seek second jobs, extra shifts, or longer hours, leaving even less time for them to sleep.

Healthcare workers often lack knowledge about the importance of sleep because the topic is rarely covered in their education programs.[2] Without this knowledge, healthcare workers may mistakenly curtail their sleep to fit other activities into their schedules. Short sleep duration is reported by 52% of night shift healthcare and social assistance workers.[3]

According to a 2011 American Nurses Association Health & Safety Survey, the top concerns of 74% of registered nurses were stress and overwork.[4] An alarming 10% of respondents had experienced a vehicle crash that was believed to be a consequence of shift work and fatigue.[4]


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