Sleep medicineMay 7, 2013

Nurses on fast rotating shifts overestimate their thinking skills and ability to stay awake during the day after a shift change

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 21, 2026

Abstract

Nurses working fast rotating shifts showed higher levels of thyrotropin (TSH) and poorer performance on visual attention tasks compared to off-duty peers.

Off-duty nurses demonstrated a greater ability to maintain wakefulness than those working night shifts.
No significant differences were found in total sleep time or sleep latency between the two groups.
Night-shift nurses had poorer performance on tasks requiring high attention compared to the off-duty group.
Higher TSH levels in the night-shift group were associated with decreased attention performance.
Nurses on rotating shifts may overestimate their cognitive abilities after daytime sleep restriction.

Simplified

OBJECTIVES: The objective of our study was to explore changes in cognitive functions, sleep propensity, and sleep-related hormones (growth hormone [GH], cortisol, prolactin [PRL], thyrotropin [TSH]) in the daytime of nurses working on fast rotating shifts.

METHODS: Twenty nurses who worked two consecutive night shifts and 23 off-duty nurses were recruited from an acute psychiatric ward. The maintenance of wakefulness test (MWT), Stanford sleepiness scale (SSS), visual attention tasks, Wisconsin card sorting test (WCST), multiple sleep latency test (MSLT), and measuring hormones were administered four times throughout the daytime at 2-hour intervals.

RESULTS: The subjects in the off-duty group were more able to maintain wakefulness than those in the night-shift group; however, there were no differences in self-reported total sleep time or sleep latency on the MSLT and SSS scores between the two groups. The subjects in the night-shift group had poorer performances on visual attentive tasks and higher levels of TSH than those in the off-duty group, and this resulted in a lack of a learning effect on the tasks that required a high attentive load.

CONCLUSIONS: Nurses working on fast rotating shifts overestimate the cognitive functions and capacity of maintaining wakefulness following daytime sleep restriction. Attention performance depended on the attentive load requirement and was possibly related to TSH level.

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Nurses on fast rotating shifts overestimate their thinking skills and ability to stay awake during the day after a shift change

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