Empowering the Night Shift: The Circadian Home™

Thank you for stopping by my WE CARE Nursing Conference poster. The Circadian Home™ is a nurse-led educational framework exploring practical ways to work with circadian biology during night shift. I’m continuing to refine this work, and I appreciate your interest.

The Poster at a Glance

A Nurse-Led Framework for Circadian Alignment

Karen Sanderson, LPN · 24 years in nursing, including night shift · UAB Hospital, Spinal Cord Injury Unit · a planning-stage project

The Circadian Home Framework · Five Practical Levers Across One Night

Clock diagram of one night shift, 7 PM to 7 AM, with the circadian low at 3 to 5 AM and daytime sleep from 8:30 AM to 4:30 PM. Five levers sit around it: caffeine, meals, light, recovery and sleep.
Clock diagram of one night shift, 7 PM to 7 AM. The circadian low is 3 to 5 AM. Daytime sleep is 8:30 AM to 4:30 PM.
CAFFEINEUse early if neededEarlier in the shift, not close to planned sleep
MEALSPlan overnight foodA meal before work, and again around 1–2 AM
LIGHTAlertness + sleep cuesWorkplace light through the shift, dim light on the way home
SLEEPProtect sleep opportunityDark, cool and quiet, around 8:30 AM
RECOVERYPrepare + recoverProtect the transition home after the last night

1 · Background / Purpose

My mother was an LPN who also worked nights. She developed type 2 diabetes at 36 and died of metastatic breast cancer at 49. I cannot say shift work caused her illnesses. However, current research shows that long-term circadian disruption and persistent night-shift work are associated with increased health risks.

I can't change the past, but I can educate the future.

At UAB, night shift workers report more distress and burnout

63%of night shift workers reported distress, compared with 51% on day shift

55%reported burnout, compared with 45% of day shift workers

WE CARE's own evaluation. Survey of 878 UAB Hospital shift workers (ref. 3).

WHO / IARC 2020: night shift work is “probably carcinogenic to humans” (Group 2A).

That is a hazard classification. It does not mean every night worker will get cancer.

2 · Methods / Implementation

I read the research on circadian rhythms and shift work, then put it into plain language nurses can use.

  • Built from peer-reviewed research and the World Health Organization report on night shift work.

NEXT STEPS, IF THE PROJECT MOVES FORWARD

  • Have night-shift nurses review it, then write it up as a handout and a one-page schedule.
  • Ask about their sleep and confidence before and after.

3 · Results / Outcomes / Impact

This project is still in the planning stage, so I do not have outcome data yet. What I hope it does:

  • Nurses learn how important sleep is, and how to use what is here
  • Nurses sleep better on a night rotation
  • Nurses feel more confident moving between nights and days

4 · Conclusions

The research on circadian health is already out there. It just has not been turned into something nurses can use.

Shift work is essential to healthcare, but nurses deserve education that helps them work with their biology instead of against it.

Shift work is necessary. The biological cost nurses pay is not.

See the Full Poster

The complete conference poster, Empowering the Night Shift: The Circadian Home. Its text appears in the sections above.

Tap or click the poster to open it full size. On a phone, pinch to zoom.

Open full-size poster
Selected evidence (references)

Authoritative source: International Agency for Research on Cancer. Night Shift Work. IARC Monographs, Vol. 124. Lyon: IARC; 2020. Overall evaluation, §6.4.

  1. Molzof HE, et al. Neurobiol Learn Mem. 2019;160:151–159. doi:10.1016/j.nlm.2019.01.002
  2. Resuehr D, et al. J Biol Rhythms. 2019;34(2):167–177. doi:10.1177/0748730419826694
  3. Montgomery AP, et al. West J Nurs Res. 2025;47(10):942–951. doi:10.1177/01939459251340779
  4. Gamble KL, et al. PLoS ONE. 2011;6(4):e18395. doi:10.1371/journal.pone.0018395
  5. Imes CC, et al. Nurs Adm Q. 2023;47(4):E38–E53. doi:10.1097/NAQ.0000000000000595
  6. Patrician PA, et al. Nurs Adm Q. 2024;48(2):165–179. doi:10.1097/NAQ.0000000000000626
  7. Moore-Ede M, et al. J Biol Rhythms. 2020;35(4):405–415. doi:10.1177/0748730420923164
  8. Czeisler CA, et al. Science. 1982;217(4558):460–463. doi:10.1126/science.7089576

A Night-to-Day Example

Three 12-Hour Night Shifts → Four Days Off

This is an educational example, not a one-size-fits-all schedule. Individual needs vary based on work hours, commute, family responsibilities, sleep needs, chronotype, health considerations, and lifestyle.

PREPARE

Getting Ready for Night 1

Morning

Wake normally → Morning daylight → Hydrate → Breakfast

12–1 PM

Balanced lunch

2–5 PM

Protected nap opportunity

5 PM

Wake → Brighter light → Hydrate → Get moving

5:30–6 PM

Balanced pre-shift meal

PERFORM

During the Night Shift

7–10 PM

Light + activity → Hydrate → Caffeine early in the shift if used

10–11 PM

Planned snack if hungry

1–2 AM

Example caffeine cutoff if planning to sleep around 8:30–9 AM. Individual caffeine response varies.

2–3 AM

Smaller overnight meal rather than making the middle of the biological night the largest meal of the day

3–5 AM

Circadian low: movement → hydration → light → activity as work conditions allow

PROTECT

Transitioning Home

7 AM

Shift ends → Begin reducing unnecessary bright-light exposure if preparing for daytime sleep

8 AM

Home → Small snack if needed → Lower lights → Begin a predictable wind-down routine

SLEEP

Around 8:30–9 AM

DARK Blackout or room-darkening curtains
COOL Comfortable sleep temperature
QUIET Reduce noise and interruptions
DISCONNECT Phone outside the bedroom when practical
SIMPLIFY Standalone alarm clock and no television
PROTECT Create a protected daytime sleep opportunity
Adults generally need at least 7 hours of sleep per 24-hour period, although daytime sleep may be shorter or more fragmented.

RECOVER

Between Nights 1–3

WAKE → LIGHT → HYDRATE → PRE-SHIFT MEAL → EARLY CAFFEINE IF USED → PLANNED OVERNIGHT FOOD → CAFFEINE CUTOFF → LIGHT DOWN → PROTECTED SLEEP

RESET

After Night 3: Returning to Days

7 AM

Final shift ends

8:30 AM–12:30/1 PM

Shorter recovery sleep

Early Afternoon

Wake → Daylight → Hydrate → Eat → Daytime activity

Afternoon / Evening

Avoid late caffeine → Avoid another long nap when possible

8–9 PM

Lower evening light → Reduce stimulating activities and screens → Prepare for sleep

9:30–10:30 PM

Return toward nighttime sleep

The goal isn't a perfect schedule.

It's knowing which signals tell your body “BE ALERT” and which help PREPARE IT FOR SLEEP.

One schedule does not fit every nurse. Circadian education can be individualized around work hours, commute, family responsibilities, sleep needs, chronotype, health considerations, and what is realistically sustainable.

A nurse-centered wellness approach considers the individual behind the schedule and helps identify realistic strategies that fit that nurse's life and needs. 


  
  










  
  
Help Shape Future Resources
If you work nights—or have worked nights—I'd love to know what would be most useful to you. Your feedback will help guide future educational resources.
No name or email is required. Your feedback will help guide future night-shift educational resources.



  


















  

    
    
    
    
    
    





    
      
  
    
      


    
  
    
      
    
  

    

    

      
    

    
    
      
    
    

    



  



  
  
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