Effects of clockwise and counterclockwise job shift work rotation on sleep and work-life balance on hospital nurses

Dana Shiffer, Maura Minonzio, Franca Dipaola, Mattia Bertola, Antonio Roberto Zamuner, Laura Adelaide Dalla Vecchia, Monica Solbiati, Giorgio Costantino, Raffaello Furlan, Franca Barbic

Research output: Contribution to journalArticlepeer-review


Rotational shift work is associated with sleep disturbances, increased risk of cardiovascular and psychological disorders, and may negatively impact work–life balance. The direction of shift rotation (Clockwise, CW or counterclockwise, CCW) and its role in these disorders are poorly understood. The aim of the study was to investigate the effect of the shift schedule direction on sleep quantity and quality, alertness and work performance, and on work–life balance on hospital nurses. One-hundred female nurses, working a continuous rapid shift schedule in hospitals in the north of Italy, participated in this cross-sectional study. Fifty worked on CW rotation schedule (Morning: 6 a.m.–2 p.m., Afternoon: 2 p.m.–10 p.m., Night: 10 p.m.–6 a.m., 2 rest days) and fifty on CCW rotation (Afternoon, Morning, Morning, Night, 3 rest days). Data were collected by ad hoc questionnaire and daily diary. During the shift cycle CW nurses slept longer (7.40 ± 2.24 h) than CCW (6.09 ± 1.73; p < 0.001). CW nurses reported less frequently than CCW awakening during sleep (40% vs. 80%; p < 0.001), attention disturbance during work (20% vs. 64%; p < 0.001), and interference with social and family life (60% vs. 96% and 20% vs. 70%, respectively; p < 0.001). CCW rotating shift schedule seems to be characterized by higher sleep disturbances and a worse work–life balance.

Original languageEnglish
Article number2038
JournalInternational Journal of Environmental Research and Public Health
Issue number9
Publication statusPublished - Sep 18 2018


  • Clockwise and counterclockwise shift rotation
  • Hospital nurses
  • Shift work
  • Sleep disturbances
  • Work-life balance

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'Effects of clockwise and counterclockwise job shift work rotation on sleep and work-life balance on hospital nurses'. Together they form a unique fingerprint.

Cite this