Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies

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Abstract

This study aimed to assess whether night shift work is associated with the risk of depression by using a meta-analysis of observational studies. We searched PubMed and EMBASE in August, 2016 to locate eligible studies and investigated the association between night shift work and the risk of depression, reporting outcome measures with adjusted odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs). In the meta-analysis of a total of 11 observational studies with 9 cross-sectional study, 1 longitudinal study, and 1 cohort study, night shift work was significantly associated with an increased risk of depression (OR/RR, 1.43; 95% CI, 1.24–1.64; I ² = 78.0%). Also, subgroup meta-analyses by gender, night shift work duration, type of occupation, continent, and type of publication showed that night shift work was consistently associated with the increased risk of depression. The current meta-analysis suggests that night shift work is associated with the increased risk of depression. However, further large prospective cohort studies are needed to confirm this association.

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Most cited references 22

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Impacts of shift work on sleep and circadian rhythms.

D Boivin, G Boudreau (2014)

Shift work comprises work schedules that extend beyond the typical "nine-to-five" workday, wherein schedules often comprise early work start, compressed work weeks with 12-hour shifts, and night work. According to recent American and European surveys, between 15 and 30% of adult workers are engaged in some type of shift work, with 19% of the European population reportedly working at least 2 hours between 22:00 and 05:00. The 2005 International Classification of Sleep Disorders estimates that a shift work sleep disorder can be found in 2-5% of workers. This disorder is characterized by excessive sleepiness and/or sleep disruption for at least one month in relation with the atypical work schedule. Individual tolerance to shift work remains a complex problem that is affected by the number of consecutive work hours and shifts, the rest periods, and the predictability of work schedules. Sleepiness usually occurs during night shifts and is maximal at the end of the night. Impaired vigilance and performance occur around times of increased sleepiness and can seriously compromise workers' health and safety. Indeed, workers suffering from a shift work sleep-wake disorder can fall asleep involuntarily at work or while driving back home after a night shift. Working on atypical shifts has important socioeconomic impacts as it leads to an increased risk of accidents, workers' impairment and danger to public safety, especially at night. The aim of the present review is to review the circadian and sleep-wake disturbances associated with shift work as well as their medical impacts.

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Associations Between Night Work and Anxiety, Depression, Insomnia, Sleepiness and Fatigue in a Sample of Norwegian Nurses

Nicolas M. F. Øyane, Ståle Pallesen, Bente Elisabeth Moen … (2013)

Background Night work has been reported to be associated with various mental disorders and complaints. We investigated relationships between night work and anxiety, depression, insomnia, sleepiness and fatigue among Norwegian nurses. Methods The study design was cross-sectional, based on validated self-assessment questionnaires. A total of 5400 nurses were invited to participate in a health survey through the Norwegian Nurses' Organization, whereof 2059 agreed to participate (response rate 38.1%). Nurses completed a questionnaire containing items on demographic variables (gender, age, years of experience as a nurse, marital status and children living at home), work schedule, anxiety/depression (Hospital Anxiety and Depression Scale), insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale) and fatigue (Fatigue Questionnaire). They were also asked to report number of night shifts in the last 12 months (NNL). First, the parameters were compared between nurses i) never working nights, ii) currently working nights, and iii) previously working nights, using binary logistic regression analyses. Subsequently, a cumulative approach was used investigating associations between NNL with the continuous scores on the same dependent variables in hierarchical multiple regression analyses. Results Nurses with current night work were more often categorized with insomnia (OR = 1.48, 95% CI = 1.10–1.99) and chronic fatigue (OR = 1.78, 95% CI = 1.02–3.11) than nurses with no night work experience. Previous night work experience was also associated with insomnia (OR = 1.45, 95% CI = 1.04–2.02). NNL was not associated with any parameters in the regression analyses. Conclusion Nurses with current or previous night work reported more insomnia than nurses without any night work experience, and current night work was also associated with chronic fatigue. Anxiety, depression and sleepiness were not associated with night work, and no cumulative effect of night shifts during the last 12 months was found on any parameters.

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Gender differences in the effects from working conditions on mental health: a 4-year follow-up.

Hans Michélsen, Carina Bildt (2002)

The overall aim was to examine how working conditions in 1993 influenced the occurrence of poor mental health in 1997 among women and men from the general population. Also, the relative importance of other living conditions in relation to poor mental health in 1997 was examined. A sample from the general Swedish population (originally examined in 1969) was followed up in 1993 and 1997. Data from these follow-ups were analysed, and both bivariate and multivariate analyses of associations between occupational and non-occupational conditions in 1993 and poor mental health in 1997 -- defined as sub-clinical depression, reduced psychological well-being and high alcohol consumption -- were performed. Several occupational risk indicators were identified for poor mental health among women, especially sub-clinical depression and high alcohol consumption. Occupational factors such as shift work, job strain, no education at the employer's expense, low occupational pride, low stimulation at work and poor social support were related to poor mental health among women. For poor mental health among men, mainly sub-clinical depression, shift work and low occupational pride were identified as risk indicators. Non-occupational factors related to poor mental health among women were poor quality of social contacts, demanding life events, physical inactivity, high perceived physical load outside work and inadequate coping strategies. Among men, smoking and inadequate coping strategies were related to poor mental health. The difference between women and men, regarding the numbers of identified occupational and non-occupational risk indicators, may partly be explained by the gender-segregated labour market, and partly by other explanations. In our study, we have not succeeded in collecting the relevant information about occupational conditions that is important for men's mental health.

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Author and article information

Journal

Journal ID (nlm-ta): J Korean Med Sci

Journal ID (iso-abbrev): J. Korean Med. Sci

Journal ID (publisher-id): JKMS

Title: Journal of Korean Medical Science

Publisher: The Korean Academy of Medical Sciences

ISSN (Print): 1011-8934

ISSN (Electronic): 1598-6357

Publication date (Print): July 2017

Publication date (Electronic): 28 April 2017

Volume: 32

Issue: 7

Pages: 1091-1096

Affiliations

[1 ]Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

[2 ]Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.

[3 ]Molecular Epidemiology Branch, Division of Cancer Epidemiology and Prevention, Research Institute, National Cancer Center, Goyang, Korea.

[4 ]Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Korea.

Author notes

Address for Correspondence: Jung Jin Cho, MD, MPH, PhD. Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong 18450, Republic of Korea. threej@ 123456hallym.or.kr

^*Aeyoung Lee and Seung-Kwon Myung contributed equally to this work.

Author information

Aeyoung Lee https://orcid.org/0000-0002-7198-1710

Seung-Kwon Myung https://orcid.org/0000-0001-8911-1345

Jung Jin Cho https://orcid.org/0000-0001-8871-8858

Yu-Jin Jung https://orcid.org/0000-0001-6965-6129

Jong Lull Yoon https://orcid.org/0000-0001-8931-0256

Mee Young Kim https://orcid.org/0000-0002-1724-2175

Article

DOI: 10.3346/jkms.2017.32.7.1091

PMC ID: 5461311

PubMed ID: 28581264

SO-VID: 7f47c01d-4b54-4fd1-864b-07324a6bfc3b

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 13 January 2017

Date accepted : 10 March 2017

Funding

Funded by: Ministry of Health and Welfare, CrossRef http://dx.doi.org/10.13039/501100003625;

Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies

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Most cited references 22

Impacts of shift work on sleep and circadian rhythms.

Associations Between Night Work and Anxiety, Depression, Insomnia, Sleepiness and Fatigue in a Sample of Norwegian Nurses

Gender differences in the effects from working conditions on mental health: a 4-year follow-up.

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