Simple scheduling change can improve health and well-being of night-shift physicians

University of Missouri researchers have found that a simple scheduling change can improve the health and well-being of physicians working overnight shifts.

In a recent study, Matthew Robinson, chair of the Department of Emergency Medicine in the School of Medicine, examined emergency medicine physicians who regularly rotate between shifts. Rather than working their usual 10 p.m. to 6 a.m. shift during night rotations, physicians worked from 8 p.m. to 4 a.m.

Robinson found that the earlier schedule led to measurable improvements in sleep quality and biomarkers associated with inflammation. The schedule allowed physicians to sleep more during traditional nighttime hours, helping align their sleep with the body's natural circadian rhythm.

Previous studies have linked disruptions to that internal rhythm to higher rates of inflammation and higher risks of heart disease, diabetes and burnout. Robinson wanted to determine whether a relatively small scheduling change could improve the health of physicians working overnight in a demanding hospital environment.

What sparked my interest in this work was reading a lot of previous research that shows night-shift workers are at higher risk for cardiovascular disease, cancer and earlier death, so the disruption to our circadian rhythm is an important topic from a wellness perspective. If we can collect data that shows changing the night-shift schedule actually makes our physicians healthier, perhaps this change in scheduling can be implemented more widely throughout health care and other industries with night-shift workers."

Matthew Robinson, chair of the Department of Emergency Medicine, School of Medicine, University of Missouri

In the study, Robinson measured biomarkers associated with inflammation, including white blood cell count and platelet count, before and after switching to the new schedule. Higher levels of these markers can signal increased inflammation, which has been connected to chronic health problems. Both markers decreased after physicians adopted the earlier schedule, suggesting that the schedule change can reduce inflammation.

Study participants also wore Fitbit devices that tracked their sleep patterns. After switching schedules, the physicians experienced more restorative sleep, helping them feel more refreshed and well-rested.

Physicians who participated in the study have reported meaningful improvements in their overall quality of life, Robinson said.

"Changing the schedule allowed them more time to be awake during the day, and that gave them more time for social engagements and time with family, which is really meaningful in terms of having a fulfilling life," he said. "While the initial experiment ended, we voted to keep the new schedule in place and have been using it ever since. This work reflects Mizzou's commitment to improving the health and well-being of its health care employees, and that ultimately translates to better patient care."

Going forward, he hopes to conduct larger studies to see whether the health benefits of the scheduling change would extend to nurses, who often work 12-hour shifts, as well as other health care employees working overnight.

The study, "Casino schedules reduce inflammatory biomarkers and improve sleep in emergency medicine physicians during shift work," was published in The American Journal of Emergency Medicine.