Objectives The aims of the present study were to define the adjustment of sleep-wakefulness and other circadian rhythms during consecutive night shifts and to study the effect of gender on the adjustment to night work.Methods Twenty experienced shift workers, 9 men and 11 women, were studied under controlled laboratory conditions. After a night of habituation, the subjects worked one day shift and three night shifts. Rectal temperature was measured continuously during the study. Salivary melatonin and cortisol were assessed at 2-h intervals, and subjective sleepiness was checked every hour during the work shifts. Sleep was registered by the static-charge sensitive bed (SCSB) method after the workshifts.Results Subjective sleepiness varied both between the work shifts and between the men and women. The subjects felt most alert during the day shift and were the sleepiest during the first night shift. Sleepiness decreased during the consecutive night shifts but did not reach the level of the day shift during the three nights. The sleepiness of the women decreased more than that of the men, the difference being significant during the second and third night shifts (P