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.
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Shift work is frequently associated with circadian misalignment and self-reported poor or insufficient sleep, with adverse effects on occupational health and safety.
“Shift work is frequently associated with circadian misalignment and self‐reported poor or insufficient sleep, with adverse effects on occupational health and safety (Kecklund and Axelsson 2016; Landrigan 2004).”
From Adapting shift work schedules for sleep quality, sleep duration, and sleepiness in shift workers (2023) · cites this paper as Kecklund and Axelsson 2016
Desynchronization of the circadian timing system from behavioral rhythms over time results in metabolic disorders including obesity, metabolic syndrome, and type 2 diabetes.
“Desynchronization of this circadian timing system from externally imposed behavioral rhythms (light/dark exposure; sleep/wakefulness; rest/activity; feeding/fasting)—such as occurs in shift workers—over time results in a number of metabolic disorders including obesity, metabolic syndrome, and type 2 diabetes (2).”
From Separation of circadian- and behavior-driven metabolite rhythms in humans provides a window on peripheral oscillators and metabolism (2018) · cites this paper as [2]
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- Authors
- Kecklund, G., & Axelsson, J.
- Affiliations
- Radboud University Nijmegen (NL)
- Karolinska Institutet (SE)
- Corresponding author
- Kecklund, Göran
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2016-11-01
- Volume
- 355
- Pages
- i5210
- ISSN
- 1756-1833 (ISSN-L)
- OpenAlex
- W2547412109
- Semantic Scholar
- 8bb9ca2cf097d0c38064bebd0cbbc2fb40418fb9
- Cited by
- 1,195
- References
- 129
- Citations by year
- 2026: 130 · 2025: 162 · 2024: 159 · 2023: 129 · 2022: 147 · 2021: 138 · 2020: 129 · 2019: 94 · 2018: 64 · 2017: 39 · 2016: 2
- FWCI
- 94.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- NordForsk (74809)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Keywords
- shift work, insufficient sleep, sleep deprivation, night shift work, type 2 diabetes, coronary artery disease, stroke, cancer, cardiometabolic disease, weight gain, accidents, cognitive impairment, circadian rhythm disruption
- MeSH terms
- Accidents, Chronic Disease, Circadian Rhythm, Humans, Risk, Risk Factors, Sleep Deprivation, Work Schedule Tolerance
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