Napping on the Night Shift: What Research Says for Nurses and Shift Workers

Why the night shift is so hard

During a night shift, you work against your body clock. In the early morning hours, the clock is pushing hard for sleep, and the pressure to sleep has been building since you woke up the day before. Many night workers know the moment when their eyes get heavy and their reactions slow down.

This is not only uncomfortable; it can affect safety. That is why researchers in nursing, emergency medicine and aviation have studied whether short planned naps during the shift help. [1] [5]

What the research reviews found

A systematic review by Ruggiero and Redeker looked at 13 studies of naps taken during real or simulated night shifts. Most found that, despite short periods of grogginess right after waking, night-shift napping reduced sleepiness and improved performance. The studies were mostly small, and none examined actual workplace safety outcomes such as errors or accidents. [1]

A later meta-analysis by Martin-Gill and colleagues, focused on emergency medical services and similar shift workers, also included 13 studies. Naps clearly reduced sleepiness at the end of the shift. The effect on reaction time was small and not statistically significant. The authors conclude that scheduled naps improved performance and reduced fatigue overall, but that the best timing and length are still unclear. [2]

A study with nurses and physicians

One of the most relevant studies for hospital staff comes from an emergency department in the US. Smith-Coggins and colleagues studied 49 physicians and nurses working three consecutive 12-hour night shifts. Half of them were given a 40-minute nap opportunity at 3 AM; the other half worked as usual. [3]

90% of the nap group actually fell asleep, on average for about 25 minutes. At 7:30 AM, at the end of the shift, they had fewer attention lapses, reported more vigour and less fatigue and sleepiness than the no-nap group. They also tended to complete a simulated IV insertion faster. [3]

But there were two important limits. Right after the nap, at 4 AM, their memory was temporarily worse. And in a simulated drive home after the shift, the nap group did not perform better than the others. [3]

A 20-minute nap in 12-hour shifts

In another workplace study, Purnell and colleagues gave 24 aircraft maintenance engineers on 12-hour night shifts the chance to take a 20-minute nap between 1 and 3 AM. On the first night shift, the nap improved reaction speed at the end of the shift. On the second night, there was no measurable effect. The nap also did not change how sleepy the workers felt while driving home, or how well they slept afterwards. [4]

The message: a short nap can help, especially at the start of a series of night shifts, but it is not a complete solution.

How long and when?

There is no proven ideal length for night-shift naps. Studies used anything from 20 to 40 minutes of nap opportunity. [4] [3] A review by Hilditch and colleagues warns that the common advice to keep naps under 30 minutes is based mainly on daytime studies. At night, and after a long time awake, even short naps can include deep sleep and be followed by marked grogginess. [6]

Practical considerations:

• Many studies placed the nap between about 1 and 4 AM.
• A longer nap may give more relief, but requires a longer wake-up period.
• A nap before the shift is another option. Rosekind and colleagues describe both preventive naps before duty and operational naps during duty. [5]

A nap before your shift

Napping during the shift is only one option. Many people also try to sleep before a night shift, sometimes called a preventive or prophylactic nap. Rosekind and colleagues describe preventive naps before duty and operational naps during duty as two parts of an alertness-management strategy. [5]

One small laboratory study tested the idea. Twelve young men worked two simulated 12-hour night shifts. After a regular night’s sleep, they took a one-hour afternoon nap before the first shift, and had seven hours of daytime sleep between the shifts. Performance and sleepiness on the first night did not differ significantly from the second night, so the first-night dip that is often seen was not observed. [9] With 12 participants, all young men, in a laboratory, this shows that the idea is plausible, not what is best for you.

The study does not show that 60 to 90 minutes is an ideal length. Waking abruptly from deep sleep produces more sleep inertia than waking from lighter stages. [10] If you nap for an hour or more before a shift, leave a generous margin between waking up and the start of work: time to get up, get some light, drink something and arrive.

Handling grogginess before patient care

The biggest practical risk of a night-shift nap is sleep inertia. In the emergency department study, memory was worse immediately after the 3 AM nap. [3] A review of countermeasures found no reliable way to remove grogginess after waking, and recommends avoiding safety-critical tasks immediately after a nap. [7]

For practice, that means:

1. Agree on coverage so that someone else handles alarms and calls during the nap and the first minutes afterwards.
2. Plan about 15 minutes after waking before returning to critical tasks such as medication preparation.
3. Use bright light, cold water and movement to support the transition, without assuming they remove grogginess.
4. If caffeine fits your shift, take it before the nap rather than after. [7]

The drive home

Many night workers drive home after the shift. In the emergency department study, the nap did not improve performance in a simulated drive home. [3] In the engineering study, the nap did not change how sleepy people felt on the road. [4]

NHTSA treats coffee and a short nap as short-term measures, not a replacement for sufficient sleep. If you feel drowsy, do not drive; take a nap before leaving, use public transport or arrange a lift. [8]

Day-night rhythm for patients

Night shifts are not only about our own sleep. In intensive care, patients’ sleep is often disturbed by light, noise and procedures. In a pilot study in a neurological intensive care unit, many recordings could not be scored at all; where they could, sleep was fragmented with notably less deep and REM sleep. Sleep-promoting measures, noise-cancelling headphones, eye masks and melatonin, were feasible, but this small study found no difference in clinical outcomes. [12]

In a simulation with healthy volunteers, recorded intensive care noise and light made sleep lighter, and earplugs and eye masks improved it. [11] The 2018 international guideline for adult intensive care patients covers sleep disruption as one of five core topics, alongside pain, agitation, delirium and immobility. [13]

These studies do not prove that any single measure works for every patient. But the basic ideas, darkness at night, less noise and a recognisable day and night, are the same ones that make your own nap easier. See a better nap environment.

Making night-shift naps work in a team

• Talk to your manager and team about a clear nap policy, including who covers whom.
• Find a quiet, dark place with a reclining chair or bed.
• Use an eye mask, earplugs and a reliable alarm, ideally with vibration. See a better nap environment.
• Plan nap times in advance instead of waiting for a quiet moment that may never come.

A nap does not replace adequate staffing or sufficient sleep between shifts. But as part of a fatigue plan, research suggests it can help. [1] For daytime work, see napping at work.

From my practice

I work as an intensive care nurse and I like to nap myself. When I am off and have the time, I usually nap for 20 to 30 minutes, and my favourite is the 26-minute NASA nap. Before a night shift I try to sleep for 60 to 90 minutes.

That is my personal habit, not a recommendation. People differ a lot, and a longer nap needs more time to wake up, so I plan it so that I can get up calmly before my shift starts. On the unit, I care about giving patients a day-night rhythm as far as an intensive care unit allows. I am not a sleep physician, which is why I link the studies behind everything in this guide.

Common questions about night-shift naps

Will a nap make me more tired afterwards?

Right after waking you may feel groggy for a while. In the studies, the benefits showed up later in the shift. [3]

Is a 20-minute nap enough?

It can help, especially early in a series of night shifts, but the effect may be smaller on later nights. [4]

Can I nap during my break if my employer has no policy?

Clarify it first. A nap should be agreed and covered, so that patient care and safety are not affected.