Very little is known about the prevalence of morning work and its relationship with sleep and fatigue. The present study obtained data from a representative sample of the Swedish population (N = 5489) to address this limitation in the literature. The results show that 15% of the population commenced work, at least occasionally, before 05:30 h and approximately 2% did so most of the time. With the increasing phase advance of the start time, the time of rising also advanced, but bedtime changed very little. Thus, early start times were not compensated with earlier bedtimes. Total sleep time decreased as the work start time was advanced; sleep duration was <5 h for work start times between 03:00 and 04:30 h. The results also indicated that advanced start times were linked with increased fatigue, feelings of not being well rested, and reports of early start times as a rather large or very large problem. However, difficulties in waking and disturbed sleep did not change with advanced start times. It was concluded that early start times are common and are associated with sleep problems and fatigue.