Given that hospitalized patients require 24-hour access to clinicians, management of fatigue due to shift work is an important consideration for overnight care teams. Discussing the physiological impacts of working during typical sleep time, or circadian misalignment, this review explores on-site naps, appropriate caffeine intake, and light exposure as techniques hospitalists can utilize to manage the negative effects associated with sleep disruption. A PSNet perspective described how fatigue can affect physician performance.