Cited by 1,195Sleep and Work-Related FatigueCircadian rhythm and melatoninWorkplace Health and Well-being

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Health consequences of shift work and insufficient sleep

Kecklund, Göran, Axelsson, John·2016·BMJ

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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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Authors: Kecklund, G., & Axelsson, J.
Affiliations: Radboud University Nijmegen (NL)
Karolinska Institutet (SE)
Corresponding author: Kecklund, Göran
ORCID: Kecklund, Göran
Axelsson, John
Venue: BMJ
Publisher: BMJ
Published: 2016-11-01
Volume: 355
Pages: i5210
ISSN: 1756-1833 (ISSN-L)
DOI: 10.1136/bmj.i5210
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
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
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 › Medicine › Public Health, Environmental and Occupational Health › 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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Health consequences of shift work and insufficient sleep

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