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 with higher odds of sleep disturbances. Among occupational groups, healthcare professionals showed higher odds (OR = 1.56, 95% CI: 1.21–2.01). Associations were observed across different types of sleep disturbances, with variation by geographic region and assessment method. Sensitivity analyses indicated the robustness of the estimates. Conclusions Shift work, particularly rotating schedules and short night shifts, is robustly and consistently associated with sleep disturbances, with healthcare professionals showing comparatively higher odds. These findings underscore the need for evidence-based occupational health policies and workplace interventions designed to stabilize circadian rhythms and mitigate sleep-related risks in vulnerable populations. Trial registration PROSPERO CRD420261285200.