Please login or register to print this page.

Clinical Articles, Lead Article

Longer breaks between shifts improve heart rate variability

Increasing the length of breaks between shifts helps nurses recover from work, according to a study published recently in Clinical Nursing Studies.1 The study analysed the effects of longer rest and recovery periods between shifts on heart rate variability, as an indicator of recovery.

The study participants were 39 female shift-working nurses with the mean age of 45 years. At the onset of the study, their shifts were adjusted in a more ergonomic direction, reducing the number of less-than-11-hour breaks between shifts by half. The nurses’ recovery from work was analysed before the shift adjustment and one year after by conducting a survey and by recording heart rate variability, indicative of the function of the autonomic nervous system. These recordings were performed while the nurses were on duty, off duty and during sleep.

The results show that adjusting the shifts in a more ergonomic direction further enhanced the nurses’ recovery from work. The recovery from work was especially demonstrated by the nurses’ higher parasympathetic activation and lower sympathetic activation of the autonomic nervous system during the first hours of sleep. These positive changes during sleep are reflective of the body’s recovery from stress and transition in a state of relaxation. Earlier research on recovery from shift work hasn’t much focused on heart rate variability during sleep, despite it being one of the key indicators of recovery.

Ms Susanna Järvelin-Pasanen (University of Eastern Finland)

Ms Susanna Järvelin-Pasanen (University of Eastern Finland)

According to the researchers, the results show that in order to promote nurses’ coping, ability to work and well-being at work, it is advisable to use a forward-rotating shift system, in which a shift is always followed by a shift that begins later (i.e. a morning shift followed by an evening shift). This would leave sufficient time for recovery in between the shifts, they say.

Speaking to BJC Arrhythmia Watch, co-author Ms Susanna Järvelin-Pasanen (University of Eastern Finland, Kuopio, Finland) said: “As far as we are aware, the effects of ergonomic working time arrangements have not been studied with regard to objective measures of strain and recovery in shift work. However, previous studies in this area, which are commonly based on questionnaires, have indicated that the implementation of ergonomic recommendations for shift work can have positive effects on sleep, alertness and overall subjective well-being.2,3,4


1. Järvelin-Pasanen S, Hakola T, Lindholm H, et al. Effects of a reduction in the number of short intervals between work shifts on heart rate variability: A prospective field study of female nurses. Clin Nurs Stud 2015;3.

2. Härmä M, Hakola T, Kandolin I, Sallinen M, Vahtera J, Bonnefond A, Mutanen P. A controlled intervention study on the effects of a very rapidly forward rotating shift system on sleep-wakefulness and well-being among young and elderly shift workers. Int J Psychophysiol 2006;59:70–9.

3. Hakola T, Härmä M. Evaluation of a fast forward rotating shift schedule in the steel industry with a special focus on ageing and sleep. J Hum Ergol 2001;30:315–9.

4. Hakola T, Paukkonen M, Pohjonen T. Less quick returns–greater well-being. Ind Health 2010;8:390–4.

Published on: June 26, 2015

Members Area

Log in or Register now.

 For healthcare professionals only
Angina book sky



Subscribe to our RSS feed


Sign up for our regular email newsletters & be the first to know about fresh articles and site updates.


    None Found


  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

You are not logged in

You need to be a member to print this page.
Sign up for free membership, or log in.

You are not logged in

You need to be a member to download PDF's.
Sign up for free membership, or log in.