Sleep health interventions for managing mental health in shift workers: A systematic review

Shift work can reduce sleep duration and quality, increasing the risk of mental health disorders which burden individuals, their families and productivity. This systematic review aimed to identify and characterise studies evaluating a sleep health intervention in shift workers and measuring a mental health outcome. Searching of seven academic databases identified 102 eligible studies. Interventions predominantly evaluated shift rostering (n=39); pharmacological interventions (n=25); and lighting (n=14). Almost half (n=43) of the included studies recruited healthcare workers. Effective sleep interventions for optimising mental health included forward-rotating (day, afternoon, night) shifts, restricting work hours, pharmaceutical agents and lighting interventions. Insights on the findings provided by two experienced shift workers identified relatively low awareness of the link between sleep and mental health, and variation in acceptability and feasibility of interventions between sectors. Business leaders and policymakers should work to increase awareness of sleep health in shift workers and consider tailored implementation of evidence-based interventions. Future research should prioritise under-represented populations, including those outside of the health and manufacturing sectors and in low- and middle-income countries, and consider expanding the evidence base beyond shift design, medications and lighting.