This circadian process is counteracted by a homeostatic pressure for sleep, which builds across waking hours. In healthy, non-shift workers with normal sleep patterns, daytime wakefulness is driven by the biological clock, which produces circadian rhythmicity driving increased alertness during the daytime and decreased alertness during the nighttime. While this paper is concerned primarily with the long-term health consequences of shift work, the implications of circadian misalignment between the biological clock and the sleep/wake cycle are perhaps best illustrated by how such misalignment increases the risk of workplace accidents and injuries. However, the health consequences of shift work should first be understood in terms of a fundamental misalignment between the circadian (i.e., near-24-hour) rhythm of the endogenous biological clock and the timing of the sleep/wake cycle. Historically this has been attributed to adverse effects of long work hours, nighttime light exposure, and psychosocial factors-effects that are still recognized as relevant for tolerance to shift work. ![]() It has long been recognized that shift work has a negative impact on health and well-being.
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