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Updated: Jun 16, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments
Published on: August 8, 2019
Working against the clock: the impact of shift patterns on cognitive function, mental health, and stimulant use among
Jehad F AlSamhori1, Ansam Z Baniamer2, Hanen Batat2
1School of Medicine, The University of Jordan, P.O.Box 11942, Amman, 11941, Jordan.
Background:
Shift work is common in healthcare and has been associated with negative physical, cognitive, and mental health consequences. It may also associate with greater dependency on stimulants as a way of overcoming fatigue and a lowered level of alertness.
Aim:
This study was to investigate an association between shift pattern, cognitive function, mental health (depression and anxiety), and stimulant use among healthcare workers.
Methods:
A descriptive cross-sectional design was used. A convenience sampling of 445 healthcare workers was recruited from two university-affiliated and two private hospitals in Jordan. Data was obtained from a self-administered questionnaire of sociodemographic characteristics, clinical symptoms, cognitive function, stimulant use, and validated scales.
Results:
A total of 445 healthcare workers were included (58.7% night shift, n = 261; 41.3% day shift, n = 184). Night shift workers reported significantly higher levels of fatigue (n = 200, 76.6%), headache (n = 164, 62.8%), and tremors (n = 114, 43.7%) and greater impairment in cognitive functions, especially memory (n = 173, 66.3%) and learning abilities (n = 156, 59.8%), than day shift workers (p < 0.05). Caffeine consumption and the use of stimulants were also considerably higher in the night shift workers. The mean depression score showed that the symptoms of depression were mild (M = 9.75, SD = 5.47) and the level of anxiety was moderate (M = 8.97, SD = 5.04). Stronger associations were found between depressive and anxiety symptoms and clinical symptoms and cognitive impairment among night shift workers.
Conclusion:
Night shift work was associated with more physical symptoms, cognitive impairment, and stimulant use and greater associations to depression and anxiety among healthcare workers. These results highlight the need for targeted interventions to ensure the safety of patients by attending to mental health, decreasing fatigue, and improving cognitive performance.
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