Shift work disorder, depression, and anxiety in the transition to rotating shifts: the role of sleep reactivity
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Aim The aim of this study is to investigate premorbid sleep reactivity as a vulnerability to incident shift work disorder (SWD), and related changes in depression as well as anxiety following a transition to a rotating shifts work schedule.Methods This is a longitudinal study with two waves of data collection. The community-based sample included normal sleeping non-shift workers (N = 96; 62.5% female; 47.9 ± 13.3 years) without a lifetime history of insomnia or baseline excessive daytime sleepiness who transitioned to rotating shift work one year later. Participants reported demographic characteristics, trait sleep reactivity on the Ford Insomnia Response to Stress Test, depression symptoms on the Quick Inventory of Depression Symptomatology, and anxiety symptoms on the Beck Anxiety Inventory. SWD was determined based on significant sleep disturbance and/or excessive sleepiness in the context of working in a rotating-shift schedule.Results Analyses revealed that the odds were over five times greater for highly sleep-reactive individuals to develop SWD after transitioning to rotating shifts (OR = 5.59, p = 0.04). Nearly 90% of participants who suffered from SWD were accurately identified as high risk at one year before disease onset. Furthermore, individuals who developed SWD reported greater increases in symptoms of depression and anxiety. Finally, analyses revealed significant indirect effects wherein high sleep reactivity increased risk for SWD, which led to greater severity of anxiety and depression symptoms.Conclusions The Ford Insomnia Response to Stress Test (FIRST) accurately identifies a focused target population in which the premorbid psychobiological processes complicit in SWD onset and progression, as well as shift work-related depression and anxiety changes, can be better investigated, thus improving future preventative efforts.
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A longitudinal study of day shift workers without prior sleep disturbances who transitioned to rotating shift work schedules reported elevated anxiety along with disordered sleep.
“For example, a longitudinal study of day shift workers without prior sleep disturbances who transitioned to rotating shift work schedules reported elevated anxiety along with disordered sleep98.”
From Circadian rhythm disruption and mental health (2020) · cites this paper as [98]
The Abstract (Methods and Results) describes a longitudinal study of normal sleepers who transitioned to rotating shifts; those who developed shift work disorder had greater increases in anxiety symptoms. The Methods (§2.1; page not provided) excludes baseline rotating and night-shift workers but does not establish that all participants worked day shifts, so that detail is unsupported. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAlthough causality is unclear, shift work is generally believed to lead to heightened stress reactivity and, in susceptible individuals, insomnia and shift work disorder.
“Although it is unclear whether disruption of cortisol rhythms is causally involved, it is generally believed that shift work leads to heightened stress reactivity and—in those who are especially susceptible—the development of insomnia and shift work disorder [96].”
From Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being (2017) · cites this paper as [96]
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- Authors
- Kalmbach, D. A., Pillai, V., Cheng, P., Arnedt, J. T., & Drake, C. L.
- Affiliations
- University of Michigan (US)
- Henry Ford Hospital (US)
- Henry Ford Health (US)
- Corresponding author
- Drake, Christopher L.
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 16
- Issue
- 12
- Pages
- 1532-1538
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC4803034
- OpenAlex
- W2118886536
- Cited by
- 205
- References
- 47
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 23 · 2023: 11 · 2022: 31 · 2021: 32 · 2020: 31 · 2019: 16 · 2018: 15 · 2017: 14 · 2016: 6
- FWCI
- 17.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Merck (50562, R01 MH082785)
- National Institute of Mental Health (50562, R01 MH082785)
- National Institutes of Health (50562, R01 MH082785)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- shift work disorder, rotating shifts, sleep reactivity, depression, anxiety, excessive daytime sleepiness, sleep disorders
- MeSH terms
- Adult, Anxiety, Depression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Sleep, Work Schedule Tolerance, Sleep Disorders, Circadian Rhythm
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