In a small study of emergency medicine physicians, an alternative overnight schedule was associated with more deep sleep, less post-shift sleepiness, and lower levels of certain inflammatory biomarkers.¹

The study examined whether changing the timing of overnight shifts could reduce circadian disruption among physicians working rotating schedules.

The alternative model used a 4 a.m. shift turnover, giving physicians more opportunity to sleep during dark hours. Researchers followed 12 emergency medicine physicians over six months and compared outcomes during traditional overnight shifts, the modified schedule, and periods without overnight work.

During traditional overnight shifts, participants experienced increases in certain inflammatory markers and losses in deep sleep. Under the modified schedule, white blood cell counts returned closer to baseline, participants retained more deep sleep, and they reported less sleepiness after their shifts.

Shift work remains essential to around-the-clock health care delivery, but circadian disruption has been associated with sleep, cardiovascular, metabolic and cognitive risks. Although the findings are preliminary, the study suggests that scheduling practices may be one consideration for organizations exploring ways to support clinician well-being.

“Provider well-being is influenced by many factors, including opportunities for rest and recovery,” said Dipul Patadia, Associate Chief Medical Officer, Client Growth and Innovation, Cigna Healthcare. “While additional research is needed, studies like this contribute to a growing body of evidence highlighting the connection between clinician health, workplace practices, and long-term workforce sustainability.”

What providers should know

• Sleep remains a critical component of clinician well-being. Researchers found that physicians working traditional overnight shifts experienced poorer sleep outcomes and higher levels of certain inflammatory markers.
• Workplace practices can influence provider health. A modified overnight scheduling approach was associated with improvements in sleep quality and reduced sleepiness among participating physicians.
• Supporting physician well-being may require operational solutions. The findings suggest that scheduling practices may be one factor organizations can evaluate when exploring strategies to reduce fatigue and support workforce resilience.
• More research is needed.  While the findings are promising, researchers described the study as preliminary and called for larger studies to better understand the long-term effects of the scheduling approach across different provider populations and care settings.

As provider well-being continues to be a focus across health care, studies like this may help inform future conversations about workplace practices that support clinician health and resilience.

Read the study in the American Journal of Emergency Medicine

To learn more about provider wellness and the drivers of overall provider physical and mental health, read highlights from new research by The Cigna Group in Health Care Providers Show Strong Vitality Amid Workplace Pressures.

1. Elizabeth Kendrick, et al. “Casino schedules reduce inflammatory biomarkers and improve sleep in emergency medicine physicians during shift work.” The American Journal of Emergency Medicine. September 2026. Retrieved from https://www.sciencedirect.com/science/article/pii/S0735675726002305.