Associations Among Chronotype,Sleep Quality,and Neurocognitive Function in Shift-Working Nurses During Consecutive Morning Shifts: A Cross-Sectional Study

Abstract

Background:

Shift work, particularly rotating schedules, disrupt sleep and cognition, affecting worker health and patient safety. Understanding schedule–chronotype misalignment is essential. We examined whether chronotype was associated with sleep quality, neurocognitive function, and near-miss incidents during consecutive morning shifts in a rotating shift system.

Methods:

In this cross-sectional study at a South Korea tertiary hospital, 67 nurses completed the Morningness-Eveningness Questionnaire, wore actigraphy devices, underwent CNS Vital Signs testing, and near-miss incidents were recorded.

Findings:

Thirty-one participants (46.3%) had an intermediate chronotype and 36 (53.7%) an evening chronotype. Evening chronotypes reported significantly poorer subjective sleep quality and showed shorter total sleep duration, longer sleep onset latency, and lower sleep efficiency compared with intermediate chronotypes. They also performed worse on composite and visual memory. Near-miss incidents did not differ significantly between groups.

Conclusions/Application to Practice:

These findings suggest that aligning shift schedules with individual chronotypes could enhance sleep quality and workplace performance, potentially improving patient safety. The evidence suggests a need for adjustments in work schedules to align with individual circadian rhythms, which can lead to better patient safety by reducing cognitive errors and improving overall healthcare delivery.