Health consequences of shift work and insufficient sleep

Abstract

This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adverse health. Evidence shows that the effect of shift work on sleep mainly concerns acute sleep loss in connection with night shifts and early morning shifts. A link also exists between shift work and accidents, type 2 diabetes (relative risk range 1.09-1.40), weight gain, coronary heart disease (relative risk 1.23), stroke (relative risk 1.05), and cancer (relative risk range 1.01-1.32), although the original studies showed mixed results. The relations of shift work to cardiometabolic diseases and accidents mimic those with insufficient sleep. Laboratory studies indicate that cardiometabolic stress and cognitive impairments are increased by shift work, as well as by sleep loss. Given that the health and safety consequences of shift work and insufficient sleep are very similar, they are likely to share common mechanisms. However, additional research is needed to determine whether insufficient sleep is a causal pathway for the adverse health effects associated with shift work.

Night work, long work weeks, and risk of accidental injuries. A register-based study

“…When persons are affected by sleepiness or fatigue, their attention and decision-making abilities during work activities, on the road or in relation to home or leisure-time activities, can become seriously weakened. However, the evidence of a causal pathway from shift work through sleepiness to accidental injuries remains unestablished due to limited epidemiological support [reviewed in (18)]. …”

Health challenges in long-distance dog sled racing: A systematic review of literature

“…Studies have in fact consistently shown that sleep loss, resulting for example from shift-working schedules, is associated with increased risk of accidents and, in the long-term, even health consequences such as type-2 diabetes and cancer [25]. Furthermore, when recurrent sleep loss is not followed by adequate sleep recovery, it can lead to increased risk of infections as well as chronic conditions [26].…”

Clocks in the clinic: circadian rhythms in health and disease

“…This disruption may be temporary, as occurs with travel between time zones ‘jetlag’ or with society-wide changes to wake times via daylight savings time, or more permanent as with ongoing shift work. Night shift work, in particular, may result in profound circadian misalignment and many studies on shift workers have demonstrated the negative influence this can have on health 25. A milder, yet chronic, form of circadian misalignment is social jetlag (SJL).…”