Biological and practical considerations regarding circadian rhythm and mental health relationships among nurses working night shifts: a narrative review and recommendations

Abstract

Summary. Background. Sleep is a vital physiological process regulated by the circadian clock and homeostatic mechanisms. Shift work is necessary to ensure continuity of healthcare provision. Worldwide, nurses work night shifts on a rotational or permanent basis. Objective. To analyse the impact of circadian rhythm disruption due to night shift work on the mental wellbeing of nurses. Methods. The literature search was conducted using PubMed and Scopus electronic databases. Selection criteria include studies published in English between 1997 and 2021 that examined the impact of night-shift work on the mental health of nurses. Results. The searches generated a total of 22 records on the PubMed database, and 9 records on the Scopus database, and a total of 31 studies. 29 papers were identified after removal of duplicates. However, 29 articles were screened based on the review of titles and abstracts. 19 articles were identified for full-test review. Seven papers were included in this review. Conclusions. Disrupted circadian rhythms and poor sleep quality and quantity have been identified as two of the most significant elements in the long-term effects of night-shift work on nurses’ mental health. Strategies and policies to promote workplace health may reduce the occurrence of mental health disorders among night-shift nurses, whether the shifts are rotational or permanent. Nursing supervisors and hospital administrators should consider developing new guidelines to minimize the negative impact of night shift rotations on mental health and the quality of life among nurses.