Shift work has been associated to a higher risk of depression and other health problems.
Objective
This study aims to explore the connection between shift work and depression using NHANES data, with a focus on the roles of sleep duration and physical activity.
Methods
NHANES data from 2007 to 2010 were examined using weighted multivariable logistic regression and stratified analysis, adjusting for demographic, chronic disease, and lifestyle factors. The impact of sleep duration and physical activity on depression among shift workers was examined using generalized additive models.
Results
The study included 4965 participants. Adjusting for all covariates, shift work was significantly linked to increased depression risk (OR = 1.25, 95% CI: 1.05–1.48, p = 0.0127). For shift workers, each additional hour of sleep reduced depression risk by 19% (OR = 0.81, 95% CI: 0.72–0.91, p = 0.0007), and those with adequate sleep had a 40% lower depression risk compared to those with insufficient sleep (OR = 0.60, 95% CI: 0.42–0.87, p = 0.0072). Regular physical activity reduced depression risk by 44% (OR = 0.56, 95% CI: 0.36–0.87, p = 0.0104), whereas insufficient activity showed no significant impact (OR = 0.83, 95% CI: 0.50–1.38, p = 0.4731).
Conclusions
Shift work increases depression risk, while sufficient sleep and physical activity are protective. These findings underscore the importance of improving conditions for shift workers and developing preventive strategies.
ÅkerstedtT. Shift work and disturbed sleep/wakefulness. Occup Med2003; 53: 89–94.
2.
AnttilaTHärmäMOinasT. Working hours–tracking the current and future trends. Ind Health2021; 59: 285–292.
3.
MorenoCRMarquezeECSargentC, et al.Working time society consensus statements: evidence-based effects of shift work on physical and mental health. Ind Health. 2019; 57: 139–157.
4.
KecklundGAxelssonJ. Health consequences of shift work and insufficient sleep. Bmj2016; 355: i5210. doi:https://doi.org/10.1136/bmj.i5210
5.
PatilSMoreNBhawtankarA, et al.Artificial intelligence and machine learning-based advanced depression detection system. In: Thakare AD, Wagh SJ, Bhende MS, Anter AM, Gao X-Z, editors. Handbook of research on applied intelligence for health and clinical informatics. London, UK: BMJ Publishing Group, 2022, pp.92–114.
6.
Health WHODoM, Abuse S, Evidence WHOMH, Team R. Mental health atlas 2005. Geneva, Switzerland: World Health Organization, 2005.
7.
BeckATAlfordBA. Depression: Causes and treatment. Philadelphia, PA: University of Pennsylvania Press, 2009.
8.
KroenkeKSpitzerRLWilliamsJB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med2001; 16: 606–613.
9.
BehrensTBurekKRabsteinS, et al.Impact of shift work on the risk of depression. Chronobiol Int2021; 38: 1761–1775.
10.
WalkerWHWaltonJCDeVriesAC, et al.Circadian rhythm disruption and mental health. Transl Psychiatry2020; 10: 1–13.
11.
VetterCDevoreEEWegrzynLR, et al.Association between rotating night shift work and risk of coronary heart disease among women. Jama2016; 315: 1726–1734.
12.
BuxtonOMCainSWO’ConnorSP, et al.Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Sci Transl Med2012; 4: 129ra43-ra43.
13.
SieniawskaDSieniawskaJProszowskaP. The impact of physical activity on depression treatment: a literature review. Qual Sport2024; 16: 52858.
14.
de LacerdaDAdo ValeMEMde OliveiraAVL, et al.The influence of physical activity on mental health: a systematic review. Revista Sistemática2024; 14: 283–285.
15.
PaluskaSASchwenkTL. Physical activity and mental health: current concepts. Sport Med2000; 29: 167–180.
16.
WillisSKHatchEEWesselinkAK, et al.Female sleep patterns, shift work, and fecundability in a north American preconception cohort study. Fertil Steril2019; 111: 1201–1210. e1.
17.
KhiariHHakiriABouchendiraM, et al.Exploring psychological distress among psychiatric nurses in Tunisia. Eur Psychiatry2024; 67: S603–S60S.
18.
KyungMParkSParkCG, et al.Association between sleep duration, social jetlag, and the metabolic syndrome by shift works. Int J Environ Res Public Health2024; 21: 668.
19.
LeiSLiuZLiH. Sleep duration and age-related macular degeneration: a cross-sectional and Mendelian randomization study. Front Aging Neurosci2023; 15: 1247413. doi:https://doi.org/10.3389/fnagi.2023.1247413
20.
MarschollekM.Clustering physical activity phenotypes using the ATLAS index on accelerometric data from an epidemiologic cohort study. In: Hasman A, Lovis C, Andersen SK, Séroussi B, Pape-Haugaard L, Saka O, editors. e-Health–For continuity of care. Amsterdam, Netherlands: IOS Press, 2014, pp.763–767.
21.
AlmohamadMKrall KayeEMoflehD, et al.The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011–2012. J Clin Periodontol2022; 49: 758–767.
22.
JiaHLubetkinEI. Incremental decreases in quality-adjusted life years (QALY) associated with higher levels of depressive symptoms for US adults aged 65 years and older. Health Qual Life Outcomes2017; 15: 1–9.
23.
OgdenCLCarrollMDFakhouriTH, et al. Prevalence of obesity among youths by household income and education level of head of household — United States 2011–2014. MMWR Morb Mortal Weekly Rep2018; 67: 186–189.
24.
Serrano-FernándezM-JBoada-GrauJBoada-CuervaM, et al.Work addiction as a predictor of anxiety and depression. Work2021; 68: 779–788.
25.
de OliveiraATRodriguesAICarvalhoDCD, et al.Depression in the context of shift work schedule: a systematic review. Res Soc Dev2022; 11: e37711528470–e.
26.
XuMYinXGongY. Lifestyle factors in the association of shift work and depression and anxiety. JAMA Netw Open2023; 6: e2328798–e.
27.
Granholm ValmariENygrenUGhazinourM, et al.How police officers juggle work, a life partner, and kids. Front Psychol2023; 14: 1178314.
28.
TorquatiLMielkeGIBrownWJ, et al.Shift work and poor mental health: a meta-analysis of longitudinal studies. Am J Public Health2019; 109: e13–e20.
29.
TogoFYoshizakiTKomatsuT. Association between depressive symptoms and morningness-eveningness, sleep duration and rotating shift work in Japanese nurses. Chronobiol Int2017; 34: 349–359.
30.
HolstMMWirthMDAllisonP, et al.An analysis of shiftwork and self-reported depressive symptoms in a police cohort from Buffalo, New York. Chronobiol Int2021; 38: 830–838.
31.
PeterLReindlRZauterS, et al.Effectiveness of an online CBT-I intervention and a face-to-face treatment for shift work sleep disorder: a comparison of sleep diary data. Int J Environ Res Public Health2019; 16: 3081.
32.
WangPSBeckALBerglundP, et al.Effects of major depression on moment-in-time work performance. Am J Psychiatry2004; 161: 1885–1891.
33.
LynchDTamburrinoMNagelR, et al.Telephone-based treatment for family practice patients with mild depression. Psychol Rep2004; 94: 785–792.
34.
KauerSDReidSCCrookeAHD, et al.Self-monitoring using mobile phones in the early stages of adolescent depression: randomized controlled trial. J Med Internet Res2012; 14: e1858.
35.
KroenkeKSpitzerRWilliamsJ. The patient health questionnaire (phq-9)–overview. J Gen Intern Med2001; 16: 606–616.
36.
LöweBUnützerJCallahanCM, et al.Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care2004; 42: 1194–1201.
37.
ManeaLGilbodySMcMillanD. Optimal cut-off score for diagnosing depression with the patient health questionnaire (PHQ-9): a meta-analysis. Cmaj2012; 184: E191–E1E6.
38.
FrazierC. Working around the clock: the effect of shift work and sleep on depressive symptoms. Innov Aging2022; 6: 655.
39.
KnauthPLandauKDrögeC, et al.Duration of sleep depending on the type of shift work. Int Arch Occup Environ Health1980; 46: 167–177.
40.
KhorasanihaRSotoudehGMilajerdiA, et al.The relationship between dietary patterns and sleep disorders in shift workers. Work2022; 73: 667–673.
41.
KimS-YKimSILimW-J. Association of sleep duration and working hours with suicidal ideation in shift workers: the Korean national health and nutrition examination survey 2007–2018. Psychiatry Investig2021; 18: 400.
42.
KalmbachDAPillaiVChengP, et al.Shift work disorder, depression, and anxiety in the transition to rotating shifts: the role of sleep reactivity. Sleep Med2015; 16: 1532–1538.
43.
YangMChenBZhouH, et al.Relationships among short self-reported sleep duration, cognitive impairment, and insular functional connectivity in late-life depression. J Alzheimer's Dis2023; 93: 1317–1327.
44.
OkechukwuCEMasalaDD'EttorreG, et al.Moderate-intensity aerobic exercise as an adjunct intervention to improve sleep quality among rotating shift nurses. La Clinica Terapeutica2022; 173: 184–186.
45.
CooneyGMDwanKGreigCA, et al.Exercise for depression. Cochrane Database Syst Rev2013: CD004366.
46.
AtkinsonGFullickSGrindeyC, et al.Exercise, energy balance and the shift worker. Sports Medicine2008; 38: 671–685.
47.
TeychenneMBallKSalmonJ. Physical activity and likelihood of depression in adults: a review. Prevent Med2008; 46: 397–411.
48.
RosenbergerMEFultonJEBumanMP, et al.The 24-h activity cycle: a new paradigm for physical activity. Med Sci Sport Exer2019; 51: 454.
49.
ChennaouiMArnalPJSauvetF, et al.Sleep and exercise: a reciprocal issue?Sleep Med Rev2015; 20: 59–72.
50.
MeadMPBaronKSorbyM, et al.Daily associations between sleep and physical activity. Int J Behav Med2019; 26: 562–568.
51.
OlsonRDVaux-BjerkeAQuamJB, et al.Physical activity guidelines for Americans. NADAR! SWIMMING MAGAZINE-Periódico científico em esportes e fitness aquático-natação, pólo aquático, nado sincronizado, saltos ornamentais, travessias aquáticas. 2023.
52.
LoprinziPD. The effects of shift work on free-living physical activity and sedentary behavior. Prevent Med2015; 76: 43–47.
53.
YouYWeiMChenY, et al.The association between recreational physical activity and depression in the short sleep population: a cross-sectional study. Front Neurosci2023; 17: 1016619.
54.
LaurenSChenYFrielC, et al.Free-living sleep, food intake, and physical activity in night and morning shift workers. J Am Coll Nutr2020; 39: 450–456.
55.
KalmbachDAFangYArnedtJT, et al.Effects of sleep, physical activity, and shift work on daily mood: a prospective mobile monitoring study of medical interns. J Gen Intern Med2018; 33: 914–920.
56.
FengTBoothBMBaldwin-RodríguezB, et al.A multimodal analysis of physical activity, sleep, and work shift in nurses with wearable sensor data. Sci Rep2021; 11: 8693.
