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Melatonin and Cortisol Suppression and Circadian Rhythm Disruption in Burnout Among Healthcare Professionals: A Systematic Review

Alexandru Ungurianu, V. Marina

Clinics and Practice, 2025

13 citations

Abstract

Background: Burnout among healthcare professionals is increasingly recognized as a syndrome with biological correlations. Beyond psychosocial factors, circadian misalignment, sleep disturbances, and hormonal dysregulation—particularly involving melatonin and cortisol—are emerging as relevant mechanisms. Methods: We systematically reviewed studies published between 2015 and 2025 examining associations between burnout, melatonin, circadian disruption, sleep quality, and related biomarkers in healthcare workers. Results: Across 14 included studies, burnout was associated with suppressed melatonin secretion, cortisol dysregulation, and circadian misalignment, including social jet lag and poor sleep quality. Night-shift nurses consistently displayed greater circadian disruption and higher burnout scores than day-shift colleagues. Evidence also suggests that environmental and interventional approaches—such as optimizing daylight exposure and melatonin supplementation to improve sleep quality and cognitive performance—may mitigate circadian disruption and occupational fatigue. Conclusions: Burnout should be recognized as a biopsychosocial syndrome with measurable chronobiological correlates. Future research should integrate circadian biomarkers into occupational health assessments and evaluate preventive strategies aimed at preserving circadian health in healthcare professionals.

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Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.

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