Association between matched chronotype and poor mental health among shift workers: a systematic review and meta‐analysis

May 31, 2023Journal of epidemiology and community health

Matching sleep-wake patterns with work schedule linked to worse mental health in shift workers

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Abstract

Shift workers with an evening chronotype may have a 1.47 times higher risk of poor mental health compared to those working during the day.

Among 49,909 workers, ever shift workers showed a higher risk of poor mental health than day workers.
The pooled odds ratio for ever shift workers compared to day workers was 1.15.
Evening chronotype shift workers were identified as having poorer mental health than those with other chronotypes.
Chronotype is currently unrecognized in shift scheduling, potentially impacting occupational mental health.
Further research is needed to explore the optimization of shift work schedules aligned with individual chronotype preferences.

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BACKGROUND: Nearly 0.7 billion workers are involved in the shift work system, leading to concerns about its potential impacts on the large-scale population mental health. This study aimed to synthesise evidence of the associations between matched chronotype and the risk of poor mental health among shift workers.

METHODS: Six computerised databases were searched from inception to September 2022. Observational studies were selected if they reported any association between common mental health parameters and chronotype scores/types of shift workers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist was followed. We extracted adjusted risk estimates to calculate pooled effect sizes and explore sources of heterogeneity. The study was registered in PROSPERO: CRD42022357437.

RESULTS: Fourteen studies including 49 909 workers were identified. Ever shift workers had a higher risk of poor mental health than the day workers (pooled OR 1.15, 95% CI 1.03 to 1.28; I=14%, p=0.29), with the evening chronotype ever shift workers having a 1.47 times higher risk than those who worked during the day (pooled OR 1.47, 95% CI 1.13 to 1.91; I=42%, p=0.16). Sensitivity analysis excluding studies with the highest risk of bias of each group demonstrated consistent findings. 2 2

CONCLUSIONS: Evening chronotype ever shift workers have poorer mental health than shift workers with other chronotypes. Chronotype remains unrecognised in the contemporary rostering system, making it a hidden contributor to occupational mental health. Work-related physical and mental stresses may be prevented/mitigated with further investigation on optimising shift work schedule combined with individual chronotype preference.

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Association between matched chronotype and poor mental health among shift workers: a systematic review and meta‐analysis

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