Shift work and risk of sleep disturbances in occupational populations: a systematic review and meta-analysis
Abstract
Background: Shift work is common worldwide and disrupts circadian rhythms, which is associated with sleep disturbances. Previous studies have often focused on single occupations or countries, limiting the generalizability of findings. A comprehensive synthesis of the association between shift work and sleep disturbances across diverse populations is lacking.
Methods: We conducted a systematic search of major electronic databases up to August 15, 2025, for observational studies examining the association between shift work and sleep disturbances, using odds ratios (ORs) with 95% confidence intervals (CIs). Study quality was assessed using appropriate tools, and evidence certainty was evaluated with the GRADE framework. Heterogeneity was assessed, and pooled ORs were calculated using fixed- or random-effects models based on the level of heterogeneity. Subgroup analyses were performed by sleep disturbance type, shift type, night-shift duration, occupation, country, region, diagnostic method, and adjustment status. Publication bias was also assessed.
Results: Twenty-two cross-sectional studies involving 21,677 participants from eight countries contributed 24 estimates. Shift work was associated with higher odds of sleep disturbances (OR = 1.42, 95% CI: 1.24-1.62), with comparable estimates observed after covariate adjustment (OR = 1.41, 95% CI: 1.18-1.68). Rotating shift (OR = 1.48, 95% CI: 1.23-1.77) and night shift of ≤ 8 hours (OR = 1.77, 95% CI: 1.11-2.81) were associated…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 21,677 participants or records.
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