Keywords
Shift work
Recovery Illusion Framework
Allostatic load
Heart rate variability
Occupational health
How to Cite
Abstract
Background: Recovery following circadian disruption is commonly inferred from behavioural indicators such as sleep timing, sleep duration, and subjective improvements in fatigue. However, emerging evidence suggests that physiological restoration may not occur simultaneously with behavioural recovery, potentially creating a period of hidden biological vulnerability with implications for both physical and psychological functioning.
Methods: This Perspective Review synthesises evidence from experimental and observational studies examining recovery following circadian misalignment. Particular emphasis is placed on autonomic regulation, neuroendocrine function, circadian biology, cognitive and psychological outcomes, and allostatic load.
Results: Available evidence indicates that circadian misalignment is associated with persistent autonomic dysregulation, altered neuroendocrine activity, and impaired physiological recovery despite apparent behavioural realignment. Emerging evidence further suggests associations between circadian disruption and impairments in cognitive, executive, and decision-making functions, as well as in emotional regulation and psychological resilience. Collectively, these findings support the possibility that behavioural and physiological recovery occur on different timescales.
Conclusion: This Perspective proposes the Recovery Illusion Framework, a conceptual model describing a state in which behavioural recovery precedes complete physiological restoration following circadian disruption. The framework integrates behavioural, physiological, and psychological dimensions of recovery and proposes that repeated recovery gaps may contribute to cumulative allostatic load and long-term health consequences. Although the framework requires empirical validation, it provides a foundation for future research and may inform more comprehensive approaches to recovery assessment in clinical, occupational, and public health settings.
Keywords: Circadian disruption; Shift work; Recovery Illusion Framework; Allostatic load; Heart rate variability; Occupational health.
Received: June 5, 2026
Accepted: June 25, 2026
Published: June 30, 2026
References
Baron, K. G., & Reid, K. J. (2014). Circadian misalignment and health. International Review of Psychiatry, 26(2), 139–154.
Boivin, D. B., Boudreau, P., & Kosmadopoulos, A. (2022). Disturbance of the circadian system in shift work and its health impact. Journal of Biological Rhythms, 37(1), 3–28.
Boudreau, P., Dumont, G. A., & Boivin, D. B. (2013). Circadian adaptation to night shift work influences sleep, performance, mood and the autonomic modulation of the heart. PLoS ONE, 8(9), e70813.
Caruso, C. C. (2014). Negative impacts of shiftwork and long work hours: Rehabilitation nursing implications. Rehabilitation Nursing, 39(1), 16–25.
Czeisler, C. A., & Gooley, J. J. (2007). Sleep and circadian rhythms in humans. Cold Spring Harbor Symposia on Quantitative Biology, 72, 579–597.
Dibner, C., Schibler, U., & Albrecht, U. (2010). The mammalian circadian timing system: Organisation and coordination of central and peripheral clocks. Annual Review of Physiology, 72, 517–549.
Gao, M., Ou, J., Cao, H., & Lv, F. (2026). Association between nursing work environment and decision fatigue among clinical nurses: A moderated mediation analysis on the roles of job stress and resilience. Frontiers in Psychology, 16, 1676964.
Grimaldi, D., Carter, J. R., Van Cauter, E., & Leproult, R. (2016). Adverse impact of sleep restriction and circadian misalignment on autonomic function in healthy young adults. Hypertension, 68(1), 243–250.
Juster, R. P., McEwen, B. S., & Lupien, S. J. (2010). Allostatic load highlights mechanisms of medical and psychiatric disease. Molecular Psychiatry, 15(8), 785–802.
Kalkanis, A., Demolder, S., Papadopoulos, D., Testelmans, D., & Buyse, B. (2023). Recovery from shift work. Frontiers in Neurology, 14, 1270043.
Lin, L., Gao, Z., Peng, Y., Li, S., Chen, L., & Lin, Y. (2024). The relationship between poor sleep and memory impairment among shift nurses in China: A cross-sectional study. Nature and Science of Sleep, 16, 1653–1663.
McEwen, B. S. (1998). Protective and damaging effects of stress mediators. The New England Journal of Medicine, 338(3), 171–179.
Moosavi, S., Ghalenoei, M., Amerzadeh, M., & Variani, A. S. (2025). The relationship between shift work, circadian rhythms, and cognitive function in ICU nursing. BMC Nursing, 24(1), 324.
Park, G., Park, W.-J., Kang, K. W., & Kim, H. (2025). Chronotype prior to shift work influences outcomes: Resilience as a mediator of sleep and mental health. Sleep, 48(11), zsaf180.
Reynolds, A. C., Paterson, J. L., Ferguson, S. A., Stanley, D., Wright, K. P., Jr., & Dawson, D. (2017). Sleepy, circadian disrupted and sick: Could intestinal microbiota play an important role in shift worker health? Molecular Medicine, 23, 334–343.
Somers, V. K., Dyken, M. E., Mark, A. L., & Abboud, F. M. (1993). Sympathetic-nerve activity during sleep in normal subjects. The New England Journal of Medicine, 328(5), 303–307.
Tobaldini, E., Nobili, L., Blanco, S., & Montano, N. (2013). Heart rate variability in normal and pathological sleep. Frontiers in Physiology, 4, 294.
Van Cauter, E., Spiegel, K., Tasali, E., & Leproult, R. (2007). Metabolic consequences of sleep restriction. Endocrine Development, 11, 23–28.
Welsh, D. K., Takahashi, J. S., & Kay, S. A. (2010). Suprachiasmatic nucleus: Cell-autonomous clock, network pacemaker. Annual Review of Physiology, 72, 551–577.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Oluwagbemiga Oluwafemi Fajimi, Kehinde Owolanke, Mercy Aanuoluwapo Omoyajowo, Micheal Ayomide Akinbomi, Pelumi Molade Adereti