Over time, this eventually leads to weight gain. Frequently, nurses rely on excessive levels of caffeine to remain awake, which can further compound sleep deprivation. Increased appetite associated with cortisol disruption can lead to poor dietary choices that are higher in fat and carbohydrates. Abnormal cortisol levels also can increase the body’s inflammatory responses, increasing the risk for chronic conditions, such as diabetes, certain cancers, and cardiovascular diseases (specifically, atherosclerosis and hypertension). Difficulty sleeping leads to further disruption of the body’s cortisol levels, creating a pattern of sleep deprivation and cortisol disruption. Long-term circadian rhythm disruption results in cortisol secretion pathway hyperactivity and chronic cortisol elevation. Nurses who work at night and sleep during the day frequently see the opposite effect-their cortisol levels remain elevated throughout the evening and decrease in morning. Typically, cortisol levels peak around 8 am and are at their lowest around 3 am. Normally, cortisol levels are higher in the morning, rising in the early morning to help with awakening and then slowly decreasing throughout the day. It also helps regulate your body’s internal clock. It helps reduce inflammation, increase blood sugar, regulate blood pressure, and manage how your body uses carbohydrates, proteins, and fats. Your circadian rhythm (sleep–wake cycle) is regulated by cortisol, the fight-or-flight hormone, which jumps into action when you feel stressed. In addition, these nurses may miss out on meetings, most of which are held during the day when they’re sleeping, or think that day staff don’t value or understand their work. The National Academy of Medicine recognizes that nurses working night shifts or rotating shifts experience performance deficits, such as medication errors, associated with sleepiness. Additionally, nurses who work night shifts report more work-related injuries and drowsy driving incidents than their counterparts on day shifts. Staying awake during these hours disturbs the body’s circadian rhythm, resulting in poor sleep quality and an increased risk for cardiovascular disease, diabetes, and depression compared with nurses who work day shifts. For most nurses, that means working between 7 pm and 7 am or 11 pm and 7 am. Bureau of Labor Statistics defines night shift as the hours between 9:00 pm and 8:00 am. Incorporating exercise into their routine can improve night shift nurses’ overall health. The result can include detrimental effects on their physical and mental health and an increased risk for many chronic conditions. Exactly how many nurses work the night shift is unknown, but we do know that working at night disrupts nurses’ diurnal circadian rhythms. Work, sleep, eat, repeat is a common routine for nurses who work at night while others sleep. Exercising with others can help improve motivation.Nurses who work night shifts or rotating shifts should adopt evidence-based strategies to increase exercise and subsequently improve their health and well-being.Working at night disrupts nurses’ circadian rhythms and impacts their physical and mental health. How regular activity can increase sleep quality and quantity.
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