Research

Chronotype modulates sleep and well‑being on shift schedules (Munich ChronoType Questionnaire cohort)

Cohort study

Chronotype Cross‑sectional Occupational health

Evening types had better tolerance of night shifts but worse on early shifts; morning types the reverse—highlighting chronotype‑schedule fit.

Strategic caffeine use for sustained operations: randomized field study

Randomized controlled trial

Fatigue & alertness First responders RCT

Timed caffeine dosing schedules improved vigilance and reaction time during sustained wakefulness protocols simulating overnight operations.

Armodafinil for Treatment of Excessive Sleepiness Associated with Chronic Shift Work Disorder

Randomized controlled trial

Armodafinil Night-shift workers RCT

12‑week, multi‑center RCT found armodafinil significantly improved wakefulness during scheduled night work and overall clinical condition vs placebo.

Circadian misalignment and adverse cardiometabolic consequences in humans

Protocol / Registration

Cardiometabolic Circadian Lab

Forced circadian misalignment (shifted sleep/meal schedule) increased glucose, insulin, and BP and reduced leptin—independent of sleep duration.

Caffeine vs Nap vs Placebo on Memory and Performance

Crossover randomized controlled trial

Cognitive performance Fatigue & alertness General population

Compared 200 mg caffeine, 60–90 min nap, and placebo on memory and performance; napping improved some tasks vs caffeine.

Efficacy and Hypnotic Effects of Melatonin in Shift‑Work Nurses

Randomized controlled trial

Melatonin Nurses RCT

Compared 5 mg melatonin vs placebo after night shifts; melatonin improved some sleep outcomes in shift‑working nurses.

Nurse Work Schedules, Sleep Duration, and Drowsy Driving

Cross-sectional study

Commute safety Nurses Observational

Longer hours and more overtime associated with higher drowsy‑driving episodes among nurses.

Bright Light vs Melatonin vs Placebo in Shift Workers: Randomized Field Study

Randomized controlled trial

Light & environment Melatonin Night-shift workers

Compared bright light, melatonin, and placebo across day and night shifts; mixed benefits with modest effects on sleep and sleepiness.

Napping Plus Caffeine: Laboratory and Field Studies in Shift Workers

Randomized controlled trial

Caffeine Fatigue & alertness Night‑shift workers

Shows combined napping and caffeine improves performance and alertness of night‑shift workers vs control conditions.

Extended-duration work shifts and risk of motor vehicle crashes among interns

Prospective cohort study

Cohort Commute safety Physicians

Across thousands of monthly reports, extended shifts (≥24 h) and more consecutive long shifts were associated with higher risk of post‑shift drowsy‑driving crashes and near‑misses.

Modafinil for Excessive Sleepiness Associated with Shift-Work Sleep Disorder

Randomized controlled trial

Modafinil Night-shift workers RCT

Three‑month, double‑blind RCT (n=209) in diagnosed SWSD; 200 mg modafinil reduced excessive sleepiness and improved functional outcomes vs placebo.

Shift length, overtime, and patient safety: nurses’ reports from 12‑hour shifts

Cross-sectional study

Cross‑sectional Nurses Safety (workplace)

Long shifts and overtime were associated with increased odds of errors, near‑misses, and reduced safety climate in nursing units.

The Alerting Effects of Caffeine, Bright Light, and Face Washing After a Short Nap

Crossover randomized controlled trial

Fatigue & alertness General population Light & environment

Combining caffeine, bright light, or face washing after a short nap enhanced alertness vs nap alone in mid‑afternoon sleepiness.

Effect of light at night on melatonin suppression and circadian phase in humans

Laboratory simulation (human)

Circadian Lab Light & environment

Demonstrated dose‑ and spectrum‑dependent melatonin suppression by nighttime light, foundational to blue‑light mitigation strategies.

Reduced Tolerance to Night Shift in Chronic Shift Workers

Field / Observational study

Adaptation Circadian Field study

Suggests chronic shift work degrades adaptability of circadian control, reducing night‑shift tolerance.

The impact of meal timing on performance, sleepiness, gastric upset, and hunger during simulated night shift

Randomized controlled trial

Lab Meal timing Performance

Eating a 01:30 night meal worsened vigilance at ~04:00 compared to not eating at night; not eating increased hunger/minor GI upset.

Timing of food intake during simulated night shift impacts glucose metabolism: a controlled study

Randomized controlled trial

Diabetes Lab Meal timing

Healthy adults completed four nights of simulated night work with either a 01:30 night meal or no night meal; glucose AUC worsened only when eating at night.

Work schedule characteristics and injury risk: a systematic review of quick returns and long shifts

Systematic review

Safety (workplace) Systematic review Work schedules & policy

Synthesized studies linking <11‑hour returns and long shifts with injuries, errors, and sleepiness across sectors including health care.

Association Between Rotating Night Shift Work and Risk of Coronary Heart Disease Among Women

Prospective cohort study

Cardiovascular Epidemiology Nurses

Among 189,158 nurses followed up to 24 years, longer duration of rotating night shift work was associated with a small but significant increase in CHD risk.

Effects of the Internal Circadian System and Circadian Misalignment on Glucose Tolerance in Chronic Shift Workers

Crossover randomized controlled trial

Circadian Diabetes Lab

In chronic shift workers, post‑meal glucose tolerance was worse in the biological evening vs biological morning, and circadian misalignment independently reduced glucose tolerance.

Near‑Crash Driving Events After Night‑Shift Work: Real‑World Driving Study

Field / Observational study

Commute safety Fatigue & alertness Field study

In 16 night‑shift workers, objective and subjective drowsiness rose during a daytime post‑shift drive; near‑crash events increased with drive duration.

Night Shift Work and Erosive Esophagitis: Endoscopy‑Verified Association

Field / Observational study

Cross‑sectional GERD GI & microbiome

Night‑shift workers had higher prevalence of endoscopy‑verified erosive esophagitis; stronger in younger/female subgroups.

Rotating night-shift work and coronary heart disease among women

Prospective cohort study

Cardiometabolic Cohort Mortality & longevity

Among ~189k person‑years, more years of rotating nights were associated with higher CHD risk; risk attenuated after quitting night work.

Armodafinil Improves Simulated Driving and Alertness in Shift Work Disorder

Crossover randomized controlled trial

Armodafinil Commute safety Fatigue & alertness

Armodafinil 150 mg taken early in the night shift improved driving simulator performance and alertness in diagnosed SWD, with effects extending into the commute home.

Impact of forward‑rotating schedules on sleep and alertness in hospital staff

Field / Observational study

Field study Sleep Work schedules & policy

Switching from backward to forward rotation improved sleep duration and reduced sleepiness in hospital workers.

Negative Impacts of Shiftwork and Long Work Hours (NIOSH Review)

Umbrella review

Long hours Occupational health Review

Summarizes links between shift work/long hours and obesity, injuries, chronic disease, and performance outcomes.

CBT‑I adapted for shift workers: randomized controlled pilot

Randomized controlled trial

CBT‑I Night‑shift workers RCT

Adapted CBT‑I delivered to shift workers improved insomnia severity and sleep efficiency versus waitlist control.

Exposure to Shift Work as a Risk Factor for Diabetes: Workplace Study

Cross-sectional study

Cross-sectional Diabetes General population

Shift‑exposed groups reported higher diabetes prevalence with odds ratios around 2, suggesting a meaningful association in working populations.

Night shift work and fecundability among nurses

Prospective cohort study

Cohort Nurses Pregnancy

Rotating nights were associated with modestly reduced fecundability; circadian disruption and sleep loss proposed as mechanisms.

Two 15‑Minute Naps on the Night Shift: Effects on Sleepiness, Fatigue, and HRV

Field / Observational study

Fatigue & alertness Field study Naps

Two short naps reduced tension and stabilized autonomic markers during night shift duty.

Blue‑enriched light to improve alertness on the night shift: randomized trial

Randomized controlled trial

Fatigue & alertness Light & environment Nurses

Blue‑enriched white light increased subjective alertness and reduced sleepiness during night shifts compared with standard lighting.

Impact of Shiftwork on IBS and Functional Dyspepsia: A Hospital Study

Field / Observational study

Cross‑sectional GI & microbiome IBS

Rotating shift workers had higher IBS risk; poor sleep quality was a significant factor.

Risk of Miscarriage and Occupational Activity: Systematic Review and Meta‑analysis

Systematic review

Night‑shift workers Pregnancy Reproductive health

Synthesizes evidence linking shift work, long hours, lifting/standing with miscarriage risk; pooled estimates suggest modestly elevated risk for some exposures.

Shift Work and Vascular Events: Systematic Review & Meta‑analysis (BMJ)

Systematic review

Cardiometabolic General population Meta‑analysis

Pooled data (2M+ participants) linked shift work with higher risk of myocardial infarction and ischemic stroke.

Shift work disorder in nurses: prevalence and consequences

Field / Observational study

Cross‑sectional Nurses Shift Work Disorder (SWD)

Estimated prevalence of SWD in nurses and associations with insomnia, exhaustion, and errors; identified risk factors (quick returns, consecutive nights).

Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women

Prospective cohort study

Diabetes Epidemiology Metabolic health

Across two nurse cohorts, longer duration of rotating night shift work was associated with higher risk of type 2 diabetes, partly mediated by body weight.

Shift Work and Sleep: Medical Implications and Management (Review)

Editorial / Overview

Narrative review Occupational health Shift Work Disorder (SWD)

Overview of SWD, health impacts of shift schedules, and management strategies including light, naps, melatonin, and wake‑promoting agents.

Effect of Shift Work on Hypertension: Cross‑sectional Study

Field / Observational study

Cardiometabolic Cross‑sectional Hypertension

Shift workers had higher odds of hypertension than day workers; continuous long work periods increased risk further.

Night Shift Work and Depression: Meta‑analysis of Observational Studies

Field / Observational study

Mental health Meta‑analysis Night‑shift workers

Meta‑analysis across observational studies found night‑shift work associated with higher depression risk.

Randomized controlled trial of blue‑enriched light to improve alertness and performance in night shift workers

Randomized controlled trial

Alertness Lighting RCT

Blue‑enriched light during night shifts improved alertness/performance measures compared with control lighting.

Long Working Hours and Shift Work During Pregnancy: Obstetric and Perinatal Outcomes

Cohort study

Cohort Healthcare workers Pregnancy

More night shifts and long hours in early pregnancy were linked to higher risks of several adverse obstetric outcomes including preterm labor and SGA.

Night Shift Work (IARC Monographs on the Identification of Carcinogenic Hazards to Humans, Volume 124)

Guideline / Policy / Monograph

Cancer Policy Shift work

IARC’s expert working group evaluated epidemiologic, animal, and mechanistic evidence on night shift work and cancer risk.

Night‑Shift Work, Short Sleep, and Obesity

Systematic review

Meta‑analysis Night‑shift workers Obesity

Across 28 studies, night work increased risk of overweight/obesity; short sleep likely mediates part of the effect.

Pilot Study: Caffeine‑Nap on Night‑Shift Alertness

Randomized controlled trial

Caffeine Fatigue & alertness Night‑shift workers

Compared caffeine‑nap vs placebo; improved vigilant attention and reduced subjective fatigue after the nap window.

The effectiveness of bright light exposure in shift‑worker nurses: a meta‑analysis

Meta-analysis

Alertness Lighting Nurses

Across five studies in nurses, bright light exposure during night shifts reduced sleepiness and improved alertness and post‑shift sleep duration.

Workplace napping policies and outcomes: scoping review

Scoping review

Naps Policy Review

Maps night‑shift napping policies, implementation barriers, and reported effects on alertness and safety across industries.

Night Work During Pregnancy and Preterm Birth—Register Study

Cohort study

Cohort Night‑shift workers Pregnancy

Large registry found nuanced associations between night work timing/intensity and preterm birth; meta‑analyses to date show mixed results.

Shift Work and Poor Mental Health: Meta‑Analysis of Longitudinal Studies

Systematic review

Epidemiology Mental health Meta‑analysis

Shift work associated with higher risk of adverse mental health outcomes; depressive symptoms notably elevated.

Shift Work and Risk of Occupational, Transport and Leisure‑time Injury: Systematic Review & Meta‑analysis

Systematic review

General population Meta‑analysis Safety (workplace)

Higher risk of injuries during evening/night shifts and after quick returns; fatigue and scheduling factors implicated.

Shift Work and Shift Work Sleep Disorder: Clinical Review

Field / Observational study

Narrative review Occupational health Shift Work Disorder (SWD)

Defines SWD, its prevalence and impact, and summarizes treatment options and workplace strategies.

Shift Work, Chronotype, and Melatonin Rhythm in Nurses (NHS II Sub‑study)

Field / Observational study

Circadian Field study Light & environment

Night shifts and evening chronotype aligned with altered light exposure and suppressed melatonin rhythms in active nurses.

Shift work and risk of breast cancer: updated meta-analysis of observational studies

Systematic review & meta-analysis

Cancer Meta‑analysis Night‑shift workers

Pooled studies exploring breast cancer risk and night/rotating shift exposure; dose/duration patterns remained key sources of heterogeneity.

Short time between shifts (‘quick returns’) and risk of injury among Danish hospital workers

Cohort study

Cohort Hospital Quick returns

Quick returns (<11 h between shifts) were associated with higher injury risk—especially within two days after a quick return.

Bright Environmental Light Reduces Post‑Shift Sleepiness in ICU Nurses

Crossover randomized controlled trial

Fatigue & alertness Light & environment Nurses

High‑intensity light during nights reduced post‑shift sleepiness; some trade‑offs noted in performance metrics.

Bright Environmental Light and Sleepiness in Night‑Shift ICU Nurses

Laboratory simulation (human)

Fatigue & alertness Field study Light & environment

In ICU nurses, high‑intensity light during night shifts reduced sleepiness but increased some psychomotor errors, suggesting trade‑offs.

Comparative Study of Shift Work Effects and Injuries Among Hospital Nurses

Field / Observational study

Cross‑sectional Nurses Occupational health

Rotating shift work associated with higher injury risk factors and poorer health indicators versus dayshift.

Near‑real‑time fatigue risk management in rail operations: field implementation

Field / Observational study

Field study Safety (workplace) Work schedules & policy

Deployment of a fatigue‑risk scoring and scheduling system reduced high‑risk duties and incident proxies in rail operations.

Night Shift Preparation, Performance, and Perception

Randomized controlled trial

Light & environment Naps Review

Reviews strategies like melatonin, bright light, naps, and schedule design; cites small RCTs in physicians and nurses.

Night‑Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank

Prospective cohort study

Cardiometabolic Cohort Diabetes

Night‑shift work—especially rotating—was associated with higher odds of type 2 diabetes; shift exposure did not modify polygenic risk.

Psychomotor Driving Performance in Night‑Shift Nurses: Prospective Study

Field / Observational study

Commute safety Fatigue & alertness Field study

Night‑shift nurses showed impaired psychomotor driving performance vs day‑shift nurses; repeated measures across work and off days.

Rotating night shift work and colorectal cancer risk in the nurses’ health studies

Prospective cohort study

Cancer Cohort Nurses

Across two large nurse cohorts, long-term rotating night shift work was not linked to overall colorectal cancer but was associated with higher rectal cancer risk after long durations.

A validation study of a commercial wearable (WHOOP) against polysomnography

Validation study

Sleep tracking Wearables

Compared commercial wearable sleep staging and detection against PSG and actigraphy; explored utility for sleep tracking.

Association between shift work and sleep apnea: systematic review & meta‑analysis

Systematic review

Meta‑analysis Occupational health Sleep apnea (OSA)

Pooled workplace studies suggested a small, non‑significant increase in possible OSA among shift workers; evidence limited and heterogeneous.

Bright Light Treatment During Three Consecutive Night Shifts: Mixed Results in Nurses

Protocol / Registration

Field study Light & environment Nurses

A scheduled bright‑light protocol did not convincingly reduce sleepiness across all measures among nurses working three consecutive night shifts.

Evening Blue‑Depleted Light Environment in Hospitals and Nonvisual Effects

Field / Observational study

Circadian Field study Light & environment

Evening blue‑depleted lighting reduced melatonin suppression and improved sleep metrics compared to standard lighting in a hospital setting.

Evening Blue‑Light Blocking Glasses: Randomized Crossover Trial

Crossover randomized controlled trial

Blue‑blocking glasses Circadian General population

Two‑week randomized crossover comparing blue‑blocking vs control lenses on sleep outcomes in healthy adults.

Non‑Pharmacological Interventions to Improve Chronic Disease Risk Factors and Sleep in Shift Workers: A Systematic Review and Meta‑Analysis

Systematic review & meta-analysis

Cardiometabolic Occupational health Sleep

Synthesizes trials and interventions (e.g., lighting, scheduling, naps, diet/activity) showing modest improvements in sleep and cardiometabolic risk factors among shift workers.

Safety Incidents Associated with Extended Working Hours: Meta‑analysis

Systematic review

Meta‑analysis Safety (workplace) Work schedules & policy

Risk of occupational injuries and accidents rose with extended working hours; risk escalated beyond standard limits.

Scheduled naps on the night shift: effects on drowsiness and nursing care quality

Field / Observational study

Field Naps Nursing

Implementing planned 30‑minute naps on night shift reduced drowsiness and improved self‑reported care quality and willingness to nap.

Shift and Night Work During Pregnancy and Preterm Birth—Cohort Study

Prospective cohort study

Cohort Healthcare workers Pregnancy

Frequent consecutive nights and quick returns in first trimester associated with increased preterm birth risk.

Shift rotation direction and sustained attention in nurses

Prospective cohort study

Attention Nurses Rotation

Compared forward vs backward rotations; examined sleepiness and attention outcomes after schedule changes.

Shift work and health outcomes: an umbrella review of systematic reviews and meta‑analyses

Umbrella review

Evidence review Health outcomes Shift work

Summarizes associations between shift work and diverse outcomes, with varying strength of evidence across categories.

Sleep Problems and Commuting vs Workplace Accidents in Workers

Field / Observational study

Commute safety Field study General population

Sleep problems were more strongly related to commuting accidents than workplace accidents in both sexes.

Sleep‑scheduling strategies in hospital shiftworkers: a scoping review

Scoping review

Hospital Review Scheduling

Maps scheduling/sleep strategies used in hospitals and their reported effects on sleep and alertness.

A Longitudinal Study on Quick Returns and Occupational Accidents in Nurses

Cohort study

Cohort Nurses Quick returns

More quick returns (<11 h between shifts) were associated with a higher risk of occupational accidents over time.

Characteristics of working hours and the risk of occupational injuries among hospital employees: a case‑crossover study

Field / Observational study

Case‑crossover Hospital Injuries

Using payroll‑linked rosters, injury risk rose on evening shifts and on the day following a night shift; longer single shifts also raised risk.

Circadian timing of food intake and cardiometabolic health: review

Field / Observational study

Cardiometabolic Chrononutrition Review

Summarizes evidence on eating timing (e.g., earlier vs late intake, TRE) and metabolic outcomes, including implications for shift workers.

Effect of Suvorexant vs Placebo on Daytime Sleep in Shift Workers: Randomized Clinical Trial

Randomized controlled trial

Medication Night-shift workers RCT

Double‑blind RCT testing the dual orexin receptor antagonist suvorexant vs placebo showed increased daytime sleep time among shift workers with insomnia complaints.

High‑protein night meal and circadian measures in shift workers

Crossover randomized controlled trial

Meal composition Night eating Nutrition

Compared a high‑protein night meal vs control on metabolic/circadian endpoints during night work.

IARC Monographs Volume 124: Night shift work (carcinogenicity evaluation)

Guideline / Policy / Monograph

Cancer Monograph/Guideline Occupational health

IARC evaluated the carcinogenicity of night shift work and classified it as probably carcinogenic to humans (Group 2A) based on limited evidence in humans and sufficient in animals.

Sleep and work functioning in nurses undertaking inpatient shifts in a blue‑depleted light environment

Field / Observational study

Lighting Nurses Real‑world

Compared a blue‑depleted light environment versus standard lighting for nurses; assessed sleep and on‑shift functioning.

Shift Work and Metabolic Syndrome Updates: Systematic Review

Systematic review

Cardiometabolic Occupational health Systematic review

Synthesizes recent evidence on circadian disruption from shift work and metabolic alterations consistent with metabolic syndrome.

Sleep Quality and Depression Symptoms Among Nurses Working Night Shifts (Saudi Arabia)

Field / Observational study

Cross‑sectional Mental health Nurses

Poor sleep quality correlated with higher depression symptoms among night‑shift nurses in a tertiary hospital sample.

The Impact of 12‑h Night Shifts on Nurses’ Driving Safety

Field / Observational study

Commute Nurses Safety

Night‑shift nurses showed greater lane deviation post‑shift compared with day‑shift nurses, indicating increased crash risk.

The Relationship between Working Night Shifts and Depression in Nurses: Systematic Review and Meta-analysis

Systematic review & meta-analysis

Mental health Nurses Systematic review

Pooled analyses show night-shift work in nurses is associated with a higher risk of depression, likely via sleep and circadian disruption.

Twelve‑Hour Night Shifts and Nurses’ Driving Safety: Simulator Study

Laboratory simulation (human)

Commute safety Fatigue & alertness Field study

Compared nurses after three consecutive 12‑h day vs night shifts; night‑shift condition showed worse simulated driving performance post‑shift.

Two‑Nap Strategy in Simulated Night Work (90‑min + 30‑min) vs One 120‑min Nap

Laboratory simulation (human)

Fatigue & alertness Field study Safety (workplace)

Split‑nap strategy reduced fatigue and maintained reaction time better than a single long nap across a 16‑h simulated night.

A Shift to Something Better? Work Schedule Change and Sleep Medication Use

Cohort study

Cohort General population Sleep

Switching from night‑inclusive schedules to day work was linked to >50% lower probability of sleep‑medication use.

Association Between Shift Work and Reflux Esophagitis (Endoscopy‑Based)

Field / Observational study

Cross‑sectional GERD GI & microbiome

Shift work significantly associated with incident reflux esophagitis, especially in younger and female workers.

Data‑Driven Working‑Hour Patterns and Accident Risk

Field / Observational study

Field study Safety (workplace) Work schedules & policy

Modeling suggested late/long work with insufficient rest increased accident probability; informed safer schedule designs.

Feasibility of Time‑Restricted Eating and Impacts on Cardiometabolic Health in Firefighters on 24‑h Shifts

Randomized controlled trial

Cardiometabolic Chrononutrition First responders

RCT (n=137) found a 10‑hour eating window feasible in 24‑h shift firefighters and associated with improved cardiometabolic markers vs control.

Impact of Light Therapy on Rotating Night‑Shift Workers

Randomized controlled trial

Light & environment RCT Rotating shifts

Intermittent bright‑light therapy had no clear effect on inflammatory markers or glucose tolerance in rotating shift workers.

Influence of Shift Work on the Health of Nursing Professionals

Field / Observational study

GI Nurses Occupational health

Synthesizes evidence on how shift patterns affect nurses’ gastrointestinal symptoms, sleep, mood, and overall health.

Irritable Bowel Syndrome and Shift Work: Meta‑analysis

Systematic review

GI & microbiome IBS Meta‑analysis

Shift work associated with ~80% higher prevalence of IBS; evidence for functional dyspepsia was weaker.

Lighting Interventions and Sleepiness in Night‑Shift Workers: Meta‑analysis

Systematic review

Fatigue & alertness Light & environment Night-shift workers

Across 14 studies, lighting interventions—especially blue‑enriched light >5000 K—significantly improved sleepiness in night‑shift workers.

Metabolic Syndrome Risk Among Health‑Sector Shift Workers: Systematic Review

Systematic review

Cardiometabolic Healthcare workers Systematic review

Health‑sector shift workers show elevated odds of metabolic syndrome vs day workers, with years on nights contributing.

Night/Shift Work and Cerebrovascular Disease: Systematic Review/Meta‑analysis

Systematic review

Cardiometabolic General population Meta‑analysis

Evidence suggests small increases in stroke mortality with shift work; heterogeneity and exposure assessment vary across studies.

SHIFTPLAN: Multimodal Shift‑Work Intervention Randomized Trial

Randomized controlled trial

Occupational health RCT Sleep

Tested a multimodal program (education, scheduling tweaks, light, naps) vs control; reported improvements in perceived fatigue, sleepiness, and cardiometabolic markers.

Shift Work Characteristics and Burnout Among Nurses

Field / Observational study

Burnout Nurses Occupational health

Long shifts (≥12 h) associated with higher burnout; other schedule variables explored (rotations, breaks, choice).

Shift Work and GERD: Systematic Review and Meta‑analysis

Systematic review

GERD GI & microbiome Meta‑analysis

Pooled studies show a significant positive association between shift work and GERD symptoms.

Shift Work and Health Outcomes: Umbrella Review of Systematic Reviews

Umbrella review

Cancer Cardiometabolic Occupational health

Synthesizes dozens of systematic reviews on shift work and health (cardiometabolic, mental health, cancer, sleep).

Shift Work and Risk for Metabolic Syndrome Among Healthcare Workers

Systematic review

Cardiometabolic Healthcare workers Systematic review

Health‑sector shift workers show elevated odds of metabolic syndrome versus day workers; tenure and nights appear contributory.

Shift and Night Work and Mortality: Prospective Cohort Study

Prospective cohort study

Cohort Mortality & longevity Occupational health

Shift and/or night work were associated with higher all‑cause and cause‑specific mortality in a large French working cohort.

Shift work is significantly and positively associated with possible gastro-esophageal reflux disease: A meta-analysis study

Systematic review & meta-analysis

General population GI & microbiome Meta-analysis

Pooled data from observational studies suggest shift work, particularly rotating and night shifts, is associated with higher odds of GERD symptoms.

Shift‑Work Schedule Intervention for Extending Restart Breaks after Consecutive Night Shifts: a 5‑month study in nurses

Guideline / Policy / Monograph

Fatigue Nurses Scheduling

Extending restart breaks from 31 h to 55 h after consecutive night shifts was evaluated for effects on fatigue and sleep.

Consequences of Shift Work and Night Work: Literature Review

Field / Observational study

Occupational health Sleep Systematic review

Broad review of effects of shift and night work across health, family, and organizational domains.

Effect of Meal Glycemic Index and Meal Frequency on Glycemic Variability During Night Shifts

Crossover randomized controlled trial

Chrononutrition Diabetes General population

Compared fasting, low‑GI, and high‑GI meals and frequencies during simulated night work; higher GI increased glycemic variability.

Effectiveness of Sleep Interventions for Rotating Night‑Shift Workers

Systematic review

Rotating shift workers Sleep Systematic review

Across randomized and non‑randomized studies, several interventions (light, naps, CBT‑I, scheduling) improved sleep/disturbance in rotating night workers.

Evening Light Intervention Before Night Shifts: Reduced Fatigue and Errors

Randomized controlled trial

Fatigue & alertness Light & environment Night-shift workers

Evening bright‑light exposure prior to the night shift improved fatigue, work performance, mood, and sleep vs usual conditions.

How Tired is Too Tired to Drive? Systematic Review

Systematic review

Commute safety Fatigue & alertness Systematic review

Synthesizes evidence linking fatigue and near‑crash/crash risk, including naturalistic studies in post‑night‑shift nurses.

Light‑Emitting Blue‑Enriched Glasses During Early‑Morning Night‑Shift Hours: Field Study

Field / Observational study

Fatigue & alertness Field study Light & environment

Evaluated blue‑enriched light‑emitting glasses for sleepiness and attention near the circadian low during night shifts.

Night Shift Work Characteristics and Incident Coronary Heart Disease

Prospective cohort study

Cardiometabolic Cohort General population

Exposure‑response relations between quantitative night‑work characteristics and coronary heart disease were examined to inform low‑risk schedules.

Night and Shift‑Work Patterns and Next‑Year Type 2 Diabetes Incidence

Cohort study

Cohort Diabetes General population

Permanent night work and frequent night shifts predicted higher odds of T2D the following year; patterns mattered more than hypertension.

PERCLOS‑Based Drowsiness Detection: Relevance to Post‑Night‑Shift Driving

Field / Observational study

Commute safety Review Wearables & digital health

Reviews eye‑blink metrics (PERCLOS/%TEC) and notes increases after night shifts in simulator and on‑road studies.

Pros and Cons of Quick Returns: Nurses’ Perspectives

Cross-sectional study

Nurses Quick returns Scheduling

Nurses report quick returns hinder recovery and health despite some schedule‑planning advantages.

Recovery from shift work: what is the evidence?

Field / Observational study

Recovery Review Scheduling

Overviews time‑course and strategies for recovery from night and rotating shifts, including sleep, light, and scheduling tactics.

Shift Work Hazards (StatPearls)

Editorial / Overview

Clinical Overview Safety

Clinical overview of health risks, accidents, and mitigation strategies related to shift work.

Long‑Term Night Shift Work and Incident COPD Risk

Prospective cohort study

Cohort General population Occupational health

Assessed relationships between long‑term night‑shift exposure and COPD incidence, including genetic modifiers.

Night Shift Work Associates with All‑Cause and Cause‑Specific Mortality: UK Biobank

Prospective cohort study

Cohort General population Mortality & longevity

In UK Biobank participants, night shift exposure—especially 20–30 years—was associated with higher all‑cause and cardiovascular mortality hazards.

Night Shift Work and Myocardial Infarction in the UK Biobank

Prospective cohort study

Cardiometabolic Cohort General population

Present and lifetime night‑shift exposure were associated with increased myocardial infarction risk; longer rest days did not offset risk.

Night shift work and breast cancer risk (review)

Systematic review

Cancer Evidence review Women’s health

Synthesizes six cohort and four case‑control studies; persistent or long‑duration night work showed some association with increased risk.

Night shift work and female breast cancer: a two‑stage dose–response meta‑analysis

Case-control study

Cancer Epidemiology Women’s health

Across case‑control studies, breast cancer risk rose with longer cumulative exposure to night shift work in dose–response analyses.

Night‑Shift Status During Pregnancy and Small‑for‑Gestational‑Age Risk

Cohort study

Cohort Healthcare workers Pregnancy

Night‑shift work during pregnancy increased risk of SGA, while overall work during pregnancy was not linked to preterm birth.

Night‑Shift Work and Female Breast Cancer: Two‑Stage Dose–Response Meta‑analysis

Field / Observational study

Cancer Meta‑analysis Night‑shift workers

Dose–response analysis indicates higher breast cancer risk with increasing duration/frequency of night‑shift exposure.

Occupational Risk for Coronary Artery Disease in Shift Workers: Review

Systematic review

Cardiometabolic Occupational health Systematic review

Review of shift work and coronary artery disease risk across studies, summarizing risk and management approaches.

Shifting Rhythms: Systematic Review of Night Shift Work and Cardiovascular Biomarkers

Systematic review

Cardiometabolic Occupational health Systematic review

Synthesizes associations between night‑shift work and six cardiovascular biomarkers across studies.

Shiftwork and Insulin Resistance in Professional Drivers

Cohort study

Cardiometabolic Cross‑sectional Diabetes

Professional drivers working shifts showed higher insulin resistance (multiple non‑insulin surrogates) with contributions from poor meal timing and sleep.

Sleep Regularity is a Stronger Predictor of Mortality than Sleep Duration

Prospective cohort study

Cohort General population Mortality & longevity

In a large cohort, lower sleep regularity predicted higher all‑cause mortality independent of sleep duration.

Sleep, mental health and physical health in new shift workers: longitudinal study

Cohort study

Adjustment Cohort Mental health

Following new shift workers, sleep and mental health worsened after starting shift work; physical health showed smaller changes.

The Effects of Fasting vs Meal or Snack During Simulated Night Work

Laboratory simulation (human)

Chrononutrition Diabetes General population

Synthesizes lab studies showing that fasting overnight or restricting night‑shift intake may mitigate metabolic impairments versus eating at night.

The effects of time‑restricted eating on sleep in adults: a systematic review

Systematic review

Chrononutrition Sleep

Synthesizes evidence on how TRE affects sleep parameters; short‑ to mid‑term TRE typically does not worsen sleep.

Two‑nap strategy in simulated night work: a 90‑min followed by a 30‑min nap maintains performance

Crossover randomized controlled trial

Napping Performance Safety

In night‑shift simulations, a split‑nap (90 + 30 min) strategy reduced fatigue and stabilized reaction times compared with a single long nap.

Adapting shift work schedules for sleep quality, sleep duration, and sleepiness in shift workers (Cochrane Review)

Systematic review

Evidence review Policy Scheduling

Evidence suggests forward/faster rotation may reduce on‑shift sleepiness, with very uncertain effects on sleep quality and off‑shift duration.

Association between night shift work and non‑alcoholic fatty liver disease (NAFLD): UK Biobank cohort

Prospective cohort study

Cardiometabolic Cohort Exposure‑response

In >280,000 adults, usual/permanent night shifts were linked to higher NAFLD risk; longer duration, more consecutive nights, and >12‑hour shifts carried higher risk.

Blue‑light filtering spectacle lenses for visual performance, sleep, and macular health in adults (Cochrane Review)

Systematic review

Light & environment Sleep Systematic review

Across 17 RCTs, blue‑light filtering lenses showed little to no short‑term benefit for visual fatigue or sleep versus non‑filtering lenses; evidence quality varied.

Circadian Alignment of Food Intake and Glycaemic Control by Time‑Restricted Eating: Meta‑analysis

Field / Observational study

Chrononutrition Diabetes General population

TRE reduced HbA1c and insulin; timing of intake influenced metabolic benefit across studies.

Circadian Misalignment Increases 24‑h Acylated Ghrelin in Chronic Shift Workers (Randomized Crossover)

Crossover randomized controlled trial

Circadian Night‑shift workers Nutrition & diet

Circadian misalignment raised 24‑h acylated ghrelin (~17%) and hunger without altering energy expenditure.

Circadian‑Informed Lighting Improves Vigilance and Sleep in Simulated Night Shifts

Randomized controlled trial

Cognitive performance Light & environment RCT

Compared circadian‑informed lighting vs dim control during simulated night shifts; improved cognitive performance and sleep outcomes.

Cumulative Night Shift Work and Incident Cardiovascular Disease: Gutenberg Health Study

Prospective cohort study

Cardiometabolic Cohort General population

Exposure‑response patterns between years of night work and incident CVD were examined in a German population cohort.

Digital cognitive behavioural therapy for insomnia reduces insomnia in nurses with shift work disorder: a randomized controlled pilot trial

Randomized controlled trial

Digital health Insomnia Nurses

A guided digital CBT‑I tailored to shift work reduced insomnia severity in nurses with shift work disorder versus waitlist control.

Effect of a 2‑Hour On‑Shift Nap vs 30‑Minute or No‑Nap on Post‑Night‑Shift Performance

Crossover randomized controlled trial

Fatigue & alertness Nap strategy Night‑shift workers

A 2‑hour nap opportunity yielded better alertness and mood immediately after 12‑hour night shifts than a 30‑min or no‑nap condition.

Effects of Abated Quick Returns (<11 h) on Insomnia and Sleepiness

Guideline / Policy / Monograph

Field study Occupational health Sleep

Reducing quick returns was associated with improvements in insomnia and daytime sleepiness among shift workers.

Fasting Overnight During Simulated Night Shift Mitigates Glucose Impairment

Crossover randomized controlled trial

Chrononutrition Diabetes General population

Holding food during the night shift and eating in daytime improved glucose tolerance versus snacking or eating at night in a lab model.

Fasting as an Intervention to Alter Impacts of Simulated Night‑Shift Work on Glucose Metabolism

Crossover randomized controlled trial

Chrononutrition Diabetes General population

Meal timing intervention (fasting across the night) mitigated impairments in glucose metabolism during simulated night shifts.

Global prevalence of occupational injuries in iron and steel industries: a systematic review and meta‑analysis

Systematic review

Night work Occupational Safety

Night work and lack of PPE were major contributors to occupational injury prevalence in iron and steel industries.

Intra‑individual Study: Quick Returns, Sleepiness, and Restedness in Nurses

Field / Observational study

Field study Nurses Quick returns

Nurses felt less rested and more sleepy after quick returns versus day‑day transitions.

Chrono‑nutrition and sleep: systematic scoping review

Scoping review

Chrononutrition Review Sleep

Maps evidence on how eating timing relates to sleep outcomes across human studies.

Association of Shift Work with TyG Index (Insulin Resistance) in Male Workers

Field / Observational study

Cardiometabolic Cross‑sectional Diabetes

Shift work status was associated with higher triglyceride‑glucose (TyG) index, an insulin resistance proxy, among male workers.

Changing Organizational Work Schedules Reduces Quick Returns: Effects on Sleep and Fatigue

Guideline / Policy / Monograph

Field study Occupational health Sleep

Reducing quick returns (<11 h) was associated with improvements in sleepiness and fatigue metrics after schedule changes.

Chrononutrition and health (Frontiers editorial)

Editorial / Overview

Chrononutrition Overview

Brief overview of why meal timing intersects with circadian biology and metabolic health, including shift‑work implications.

Artificial Light at Night and Type 2 Diabetes: Review

Field / Observational study

Circadian Diabetes General population

Summarizes links between artificial light at night, sleep disruption, and type 2 diabetes risk, with implications for light hygiene.

American Academy of Nursing Policy Recommendations to Reduce Health Risks of Night‑Shift Work

Guideline / Policy / Monograph

Guidelines/Policy Nurses Work schedules & policy

Summarizes evidence and offers system‑level recommendations to reduce adverse health impacts of night work among nurses.

Determinants of Sleep Quality and Health Outcomes Among Night‑Shift Nurses: Cross‑sectional Study (China)

Field / Observational study

Cross‑sectional Nurses Sleep

Identified work and personal factors linked to poor sleep quality and related health outcomes among night‑shift nurses.

Effects of Taking a Nap or Break Immediately After a 16‑h Night Shift (Nurses)

Randomized controlled trial

Naps Nurses RCT

A 30‑min nap or quiet break right after a 16‑h night shift improved fatigue recovery and subsequent sleep episodes.

GLU24/7 study: cardiometabolic risk factors in night‑shift workers (protocol)

Protocol / Registration

Cardiometabolic CGM Cohort

Will track continuous glucose, sleep, timing of food intake, and cardiometabolic markers across consecutive night shifts and recovery days in an industrial cohort.

How Shift Work Affects Our Gut Microbiota

Field / Observational study

GI & microbiome Inflammation Review

Synthesizes evidence that shift/night work alters microbiota composition and inflammation, though findings remain inconsistent.

Intermittent Fasting for Weight Loss in Night‑Shift Workers: Three‑Arm Randomized Trial

Randomized controlled trial

Night-shift workers Nutrition & diet Obesity

A large RCT in night‑shift workers compared moderate calorie restriction, diet advice, and time‑restricted strategies; moderate restriction produced the most weight loss at primary end‑point.

Low‑Level LED Light Therapy for Sleep and HRV in Shift‑Work Nurses: Randomized Trial

Randomized controlled trial

Light & environment Nurses RCT

Examined low‑energy light therapy effects on sleep quality, psychological symptoms, and heart‑rate variability among shift‑working nurses.

Meta‑analysis: Night‑Shift Work and Type 2 Diabetes Incidence

Field / Observational study

Cardiometabolic Diabetes General population

Night‑shift workers had higher incidence of type 2 diabetes than non‑night workers; effects varied by sex and BMI.

Night-Shift Work and Gastrointestinal Cancer Risk in Nurses: Review

Field / Observational study

Cancer Circadian Narrative review

Summarizes evidence on how night‑shift schedules may promote GI carcinogenesis via circadian disruption and hormonal/metabolic pathways among nurses.

Optimizing the Potential Utility of Blue‑Blocking Glasses for Sleep and Circadian Health

Field / Observational study

Blue‑blocking Lighting Practical

Discusses when and how to use blue‑blocking glasses, highlighting applications for night‑shift workers (e.g., morning commute, pre‑sleep).

Risk and Protective Factors for Shift‑Work Sleep Disorder (UK Biobank)

Cohort study

Cross‑sectional General population Shift Work Disorder (SWD)

Analyzed individual and work‑pattern factors associated with SWSD among night‑shift workers in UK Biobank.

Sleep Trajectories and All‑Cause Mortality Among Low‑Income Adults

Prospective cohort study

Cohort General population Mortality & longevity

In a community cohort, suboptimal 5‑year sleep duration trajectories were associated with up to 29% higher mortality risk.

The effectiveness of time‑restricted eating as an intermittent fasting approach in shift workers (systematic review)

Systematic review

Chrononutrition Evidence review TRE

Reviews TRE studies in shift workers, focusing on glucose metabolism and feasibility; evidence remains limited but promising.

Time‑restricted eating in shift workers: a systematic review and meta‑analysis

Systematic review

Glucose Meta‑analysis Shift workers

Evaluates the metabolic effects of TRE specifically among shift workers across small trials and pilots.

Optimization of Chrononutrition to Reduce the Risk of Disease in Shift Workers (SHIFT)

Randomized controlled trial

Chrononutrition Clinical trial Nurses

UCSD/Salk RCT for night‑shift nurses testing a 10‑hour daytime eating window with/without one low‑GI on‑shift snack vs monitoring.

Shift Worker Intervention for Sleep Health (SWISH – CBT‑I adapted for nights)

Randomized controlled trial

CBT‑I Nurses Sleep

Night‑shift nurses with insomnia receive CBT‑I that is structured for post‑night sleep timing; sleep efficiency and symptoms are primary.

Personalized Circadian mHealth App for Shift Workers (SHIFT app pilot)

Interventional (pilot) trial

App Circadian Digital health

mHealth pilot using wearable data to deliver circadian‑aligned guidance in real time for night‑shift workers.

Melatonin for Daytime Sleep in Resident Trainees During Night Float

Randomized controlled trial

Melatonin Physicians Sleep

Resident physicians on night float trialing timed melatonin before daytime sleep; aims to improve consolidation and quality.

Melatonin and Oxidative DNA Damage Repair in Night‑Shift Workers

Randomized controlled trial

Circadian Melatonin Night‑shift workers

Tests whether 3 mg melatonin prior to daytime sleep shifts markers of DNA damage repair capacity in night‑shift workers.

High‑Intensity Light Exposure for ICU Nurses on Night Shifts

Randomized controlled trial

ICU Light Nurses

Unit‑level trial of bright light early on shift to reduce fatigue and bolster alertness, with attention to post‑shift sleep impact.

Evening Blue‑Depleted Lighting in Hospital Wards

Protocol / Registration

Blue‑depleted Hospital Lighting

Ward‑level evening spectrum shift toward warmer light to protect melatonin and improve sleep‑related outcomes.

Sleep Schedule Intervention for Shift‑Work Disorder

Interventional (field) trial

Scheduling Sleep SWD

Three‑week schedule intervention for shift‑work disorder using actigraphy and symptom tracking in active workers.

Sleep & Circadian Treatments for Shift Workers (Field Trial)

Interventional (field) trial

Circadian Field Sleep

Multi‑component sleep/circadian treatments delivered in real settings to shift‑work populations, beyond lab constraints.

Skeletal Effects of Chronic Night Shift in New Nurse Hires

Prospective cohort study

Bone health Cohort Nurses

Longitudinal cohort of new nurses following bone and turnover markers under chronic night‑shift exposure.

Shift‑Work Biomarkers of Obesity Risk in Workers

Cohort study

Cardiometabolic Healthcare Industrial

Compares obesity‑risk biomarkers between shift workers and day workers across industrial and healthcare settings.

Dietary Intervention to Mitigate Night‑Shift Effects

Protocol / Registration

Chrononutrition Diet Trial registration

Interventional diet protocol in healthy night‑shift adults to test mitigation of metabolic strain.

Mediterranean Diet Education in Shift‑Working Nurses

Interventional (education) study

Diet education Nurses Trial registration

Education program around Mediterranean‑style eating for nurses working shifts; registry indicates 2024 recruitment window.

Lemborexant in Shift‑Work Insomnia

Randomized controlled trial

Insomnia Medication Trial registration

Dual‑orexin receptor antagonist tested for insomnia complaints across night schedules.

Solriamfetol for Excessive Sleepiness in Shift Workers

Randomized controlled trial

Medication Trial registration Wake‑promoting

Wake‑promoting agent evaluated for on‑shift sleepiness and related function in shift‑work settings.

Circadian Phase Adjustment and Metabolic Control in Night‑Shift Workers

Protocol / Registration

Circadian Metabolic Protocol

Protocol to align sleep and light with circadian markers and examine metabolic outcomes under night exposure.

The Healthy Heroes Study (Time‑Restricted Eating in Emergency Responders)

Protocol / Registration

Chrononutrition Clinical trial First responders

Trial registration describing a 10‑hour time‑restricted eating intervention in 24‑hour shift emergency responders.

Acute Night Shift Work Elevates Ambulatory Blood Pressure

Field / Observational study

Cardiometabolic Field study Hypertension

Ambulatory monitoring showed acute BP elevations during night shifts versus day shifts; contextualizes chronic CVD risk in shift workers.

Associations Between Shift Work and Insulin Resistance Markers in >53,000 Workers (Spain)

Field / Observational study

Cardiometabolic Cross‑sectional Diabetes

Large occupational study found significant associations between shift work and multiple insulin‑resistance indices across industries.

Daytime Eating During Simulated Night Work Mitigates Cardiometabolic Changes

Randomized controlled trial

Cardiometabolic Chrononutrition General population

Keeping meals to daytime during simulated night work mitigated adverse changes in cardiovascular risk factors vs eating at night.