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DOI: 10.1055/s-0045-1812729
A Systematic Review of Permanent Night Work vs. Rotating Shift Work with Night Work: Relationships with Mental Health
Authors
Introduction: Approximately 20–25% of the global population is engaged in shift work. Shift work has no consensus definition but can be conceptualised as any work schedule that involves work outside traditional daytime hours (i.e., ~8 am to ~6 pm). Therefore, shift work encompasses morning, evening and night work, as well as rotating, permanent and irregular schedules. It is well established that the sleep loss and circadian disruption associated with shift work results in adverse health, psychosocial wellbeing and safety outcomes. As humans are day active, night work poses the greatest challenge to the circadian system. As such, many health and safety regulators and labor organisations worldwide encourage special provisions for health assessments for night workers, and some provide guidance to avoid permanent night work. We conducted a systematic review to evaluate the differential effects of permanent night work (PNW) and rotating shift work that includes night shifts (RWN) on health, safety and performance.
Methods: PubMed, CINAHL, PsycINFO, Medline and Scopus databases were searched for peer-reviewed scientific studies published between 1990 and 2024 that evaluated health, wellbeing, safety or performance outcomes in both PNW and RWN. Study quality was appraised using JBI critical appraisal checklists. Thirty-eight studies were included in the overall review, and three examined mental health outcomes.
Results: The design and quality of the reviewed studies that examined mental health varied considerably. The reporting of shift work schedules was poor in all studies, and details regarding exposure to night work were excluded, making evaluation difficult. While the sample size in two studies was sufficient to evaluate associations, one study had a very small sample size (n = 136). The sample of night workers in each study was comparatively small (2.3–7.4% of the overall sample). The studies suggest that compared with day work, PNW is associated with greater odds of having a mood disorder or reporting suicidal ideation, whereas RWN showed no association.
Conclusion: Few studies have examined the differential effects of PNW and RWN on mental health, and assessment of study quality suggests the findings should be interpreted with caution. Future studies must capture and adjust for night work exposure to determine differential effects. Support: The study was funded by the Civil Aviation Authority of New Zealand.
Die Autoren geben an, dass kein Interessenkonflikt besteht.
Publikationsverlauf
Artikel online veröffentlicht:
08. Oktober 2025
© 2025. Brazilian Sleep Academy. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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