Skip to main content

Advertisement

SpringerLink
Log in

Night shift work and depression among Chinese workers: the mediating role of sleep disturbances

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Background

Depression is considered as a global problem. Recently, the prevalence of depression among night shift workers has been attracting people's attention. This study aims to explore the associations among night shift work, shift frequency and depression among Chinese workers and to explore whether sleep disturbances are a critical factor.

Methods

The cross-sectional survey consists of 787 autoworkers from a manufacturing plant in Fuzhou, China. Information about night shift work, shift frequency, depression, and sleep disturbances were collected from work records and responses to the Patient Health Questionnaire (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI). A mediation model was generated to examine relationship between night shift work, sleep disturbances, and depression.

Results

Our results found that night shift work, shift frequency, sleep disturbances, and depression had positive and significant relationships in a sample of Chinese workers. Night shift work, shift frequency and sleep disturbances were associated with an increased risk of depression among workers (OR: 4.23, 95% CI 2.55–7.00; 3.91, 2.31–6.63; 6.91, 4.40–10.86, respectively). Subsequent mediation analysis found that the association between night shift work and depression appeared to be partially mediated by sleep disturbances.

Conclusion

These findings suggest that appropriate intervention and management strategies should be considered to alleviate the mental health burden of night shift workers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig.1
Fig.2

Similar content being viewed by others

References

  • Angerer P, Schmook R, Elfantel I, Li J (2017) Night work and the risk of depression. Dtsch Arztebl Int 114(24):404–411

    Google Scholar 

  • Arimura M, Imai M, Okawa M, Fujimura T, Yamada N (2010) Sleep, mental health status, and medical errors among hospital nurses in Japan. Ind Health 48(6):811–817

    Article  Google Scholar 

  • Behrens T, Burek K, Rabstein S et al (2021) Impact of shift work on the risk of depression. Chronobiol Int 38(12):1761–1775

    Article  CAS  Google Scholar 

  • Berthelsen M, Pallesen S, Mageroy N et al (2015) Effects of psychological and social factors in shiftwork on symptoms of anxiety and depression in nurses a 1-year follow-up. J Occup Environ Med 57(10):1127–1137

    Article  Google Scholar 

  • Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfe DJ (1989) The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  Google Scholar 

  • Caruso CC (2014) Negative impacts of shiftwork and long work hours. Rehabil Nurs 39(1):16–25

    Article  Google Scholar 

  • Chellappa SL, Morris CJ, Scheer FAJL (2020) Circadian misalignment increases mood vulnerability in simulated shift work. Sci Rep 10(1):18614

    Article  CAS  Google Scholar 

  • Cheng WJ, Cheng Y (2017) Night shift and rotating shift in association with sleep problems, burnout and minor mental disorder in male and female employees. Occup Environ Med 74(7):483–488

    Article  Google Scholar 

  • Driesen K, Jansen NW, Kant I, Mohren DC, van Amelsvoort LG (2010) Depressed mood in the working population: associations with work schedules and working hours. Chronobiol Int 27(5):1062–1079

    Article  Google Scholar 

  • Faraut B, Bayon V, Léger D (2013a) Neuroendocrine, immune and oxidative stress in shift workers. Sleep Med Rev 17(6):433–444

    Article  Google Scholar 

  • Faraut B, Bayon V, Leger D (2013b) Neuroendocrine, immune and oxidative stress in shift workers. Sleep Med Rev 17(6):433–444

    Article  Google Scholar 

  • Fonken LK, Nelson RJ (2013) Dim light at night increases depressive-like responses in male C3H/HeNHsd mice. Behav Brain Res 243:74–78

    Article  Google Scholar 

  • GBD (2016) Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390(10100): 1211–1259

  • Hayes AF (2013) Methodology in the social sciences. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press

  • Jagannath A, Taylor L, Wakaf Z, Vasudevan SR, Foster RG (2017) The genetics of circadian rhythms, sleep and health. Hum Mol Genet 26(R2):R128–R138

    Article  CAS  Google Scholar 

  • Jaradat R, Lahlouh A, Mustafa M (2020) Sleep quality and health related problems of shift work among resident physicians: a cross-sectional study. Sleep Med 66:201–206

    Article  Google Scholar 

  • Kalmbach DA, Fang Y, Arnedt JT, Cochran AL, Deldin PJ, Kaplin AI et al (2018) Effects of sleep, physical activity, and shift work on daily mood: a prospective mobile monitoring study of medical interns. J Gen Intern Med 33(6):914–920

    Article  Google Scholar 

  • Khosravipour M, Khanlari P, Khazaie S, Khosravipour H, Khazaie H (2021) A systematic review and meta-analysis of the association between shift work and metabolic syndrome: The roles of sleep, gender, and type of shift work. Sleep Med Rev 57:101427

    Article  Google Scholar 

  • Koritala BSC, Porter KI, Arshad OA et al (2021) Night shift schedule causes circadian dysregulation of DNA repair genes and elevated DNA damage in humans. J Pineal Res 70(3):e12726

    Article  CAS  Google Scholar 

  • Lee HY, Kim MS, Kim O, Lee IH, Kim HK (2016) Association between shift work and severity of depressive symptoms among female nurses: the Korea Nurses’ Health Study. J Nurs Manag 24(2):192–200

    Article  Google Scholar 

  • Levis B, Sun Y, He C, Wu Y, Krishnan A, Bhandari PM, Neupane D, Imran M (2020) Accuracy of the PHQ-2 alone and in combination with the PHQ-9 for screening to detect major depression systematic review and meta-analysis. JAMA 323(22):2290–2300

    Article  Google Scholar 

  • Lim YC, Hoe VCW, Darus A, Bhoo-Pathy N (2020) Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting. BMJ Open 10(9):e034455

    Article  Google Scholar 

  • Lu S, Reavley N, Zhou J, Su J, Pan X, Xiang Q, Zhang Y, Oldenburg B, Wu M (2018) Depression among the general adult population in Jiangsu Province of China: prevalence, associated factors and impacts. Soc Psychiatry Psychiatr Epidemiol 53(10):1051–1061

    Article  Google Scholar 

  • Lu J, Xu X, Huang Y, Li T, Ma C, Xu G et al (2021) Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study. Lancet Psychiatry 8(11):981–990

    Article  Google Scholar 

  • Lyall LM, Wyse CA, Graham N, Ferguson A, Lyall DM, Cullen B, Celis Morales CA, Biello SM et al (2018) Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: a cross-sectional study of 91 105 participants from the UK Biobank. Lancet Psychiatry 5(6):507–514

    Article  Google Scholar 

  • McLean L, Connor CM (2015) Depressive symptoms in third-grade teachers: relations to classroom quality and student achievement. Child Dev 86(3):945–954

    Article  Google Scholar 

  • Mollayeva T, Thurairajah P, Burton K, Mollayeva S, Shapiro CM, Colantonio A (2016) The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Med Rev 25:52–73

    Article  Google Scholar 

  • Nabe-Nielsen K, Garde AH, Albertsen K, Diderichsen F (2011) The moderating effect of work-time influence on the effect of shift work: a prospective cohort study. Int Arch Occup Environ Health 84(5):551–559

    Article  Google Scholar 

  • Otte C, Gold SM, Penninx BW, Pariante CM, Etkin A, Fava M et al (2016) Major depressive disorder. Nat Rev Dis Primers 2:16065

    Article  Google Scholar 

  • Park JN, Han MA, Park J, Ryu SY (2016) Prevalence of depressive symptoms and related factors in korean employees: the third Korean working conditions survey (2011). Int J Environ Res Public Health 13(4):424

    Article  Google Scholar 

  • Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891

    Article  Google Scholar 

  • Reynolds AC, Ferguson SA, Appleton SL, Crowther ME, Melaku YA, Gill TK et al (2021) Prevalence of probable shift work disorder in non-standard work schedules and associations with sleep, health and safety outcomes: a cross-sectional analysis. Nat Sci Sleep 13:683–693

    Article  Google Scholar 

  • Shi L, Liu Y, Jiang T, Yan P, Cao F, Chen Y et al (2020) Relationship between mental health, the CLOCK gene, and sleep quality in surgical nurses: a cross-sectional study. BioMed Res Int 2020:4795763

    Article  Google Scholar 

  • Silva-Costa A, Griep RH, Rotenberg L (2015) Disentangling the effects of insomnia and night work on cardiovascular diseases: a study in nursing professionals. Braz J Med Biol Res 48:120–127

    Article  CAS  Google Scholar 

  • Stenvers DJ, Scheer FAJL, Schrauwen P, la Fleur SE, Kalsbeek A (2019) Circadian clocks and insulin resistance. Nat Rev Endocrinol 15:75–89

    Article  Google Scholar 

  • Stevens RG, Hansen J, Costa G, Haus E, Kauppinen T, Aronson KJ et al (2011) Considerations of circadian impact for defining “shift work” in cancer studies: IARC Working Group Report. Occup Environ Med 68(2):154–162

    Article  Google Scholar 

  • Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Bouvard V et al (2007) Carcinogenicity of shift-work, painting, and fire-fighting. Lancet Oncol 8(12):1065–1066

    Article  Google Scholar 

  • Ustun TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJL (2004) Global burden of depressive disorders in the year 2000. Br J Psychiatry 184:386–392

    Article  CAS  Google Scholar 

  • Vallières A, Azaiez A, Moreau V, LeBlanc M, Morin CM (2014) Insomnia in shift work. Sleep Med 15(12):1440–1448

    Article  Google Scholar 

  • Wang D, Ruan W, Chen Z, Peng Y, Li W (2018) Shift work and risk of cardiovascular disease morbidity and mortality: A dose-response meta-analysis of cohort studies. Eur J Prev Cardiol 25(12):1293–1302

    Article  CAS  Google Scholar 

  • Weil ZM, Hotchkiss AK, Gatien ML, Pieke-Dahl S, Nelson RJ (2006) Melatonin receptor (MT1) knockout mice display depression-like behaviors and deficits in sensorimotor gating. Brain Res Bull 68(6):425–429

    Article  CAS  Google Scholar 

  • Werneck AO, Vancampfort D, Stubbs B et al (2022) Prospective associations between multiple lifestyle behaviors and depressive symptoms. J Affect Disord 301:233–239

    Article  Google Scholar 

  • Wickwire EM, Geiger-Brown J, Scharf SM, Drake CL (2017) Shift work and shift work sleep disorder clinical and organizational perspectives. Chest 151(5):1156–1172

    Article  Google Scholar 

  • World Health Organization (2017) Depression and Other Common Mental Disorders. Global Health Estimates.

  • Wright KP, Bogan RK, Wyatt JK (2013) Shift work and the assessment and management of shift work disorder (SWD). Sleep Med Rev 17(1):41–54

    Article  Google Scholar 

  • Wyse CA, Celis Morales CA, Graham N, Fan Y, Ward J, Curtis AM et al (2017) Adverse metabolic and mental health outcomes associated with shiftwork in a population-based study of 277,168 workers in UK biobank. Ann Med 49(5):411–420

    Article  Google Scholar 

  • Yang Y, Chen B, Huang P et al (2022) Prevalence and influencing factors of depressive symptoms among rural-to-urban migrant workers in China: A systematic review and meta-analysis. J Affect Disord 307:11–19

    Article  Google Scholar 

  • Zuelke AE, Luck T, Schroeter ML, Witte AV, Hinz A, Engel C et al (2018) The association between unemployment and depression-Results from the population-based LIFE-adult-study. J Affect Disord 235:399–406

    Article  Google Scholar 

Download references

Acknowledgements

The authors want to express their sincere gratitude to all participants for participating in the study.

Funding

This work was supported by the Natural Science Foundation of Fujian Province, China (Grant number 2020J01642); Fujian Provincial Health Research Talent Training Project-Youth Research Project (Grant number 2019-1-59); and Fujian Medical University's Research Foundation for Talented Scholars (Grant number XRCZX2018011).

Author information

Author notes

  1. Guanglu Zhang and Bo Shen authors contribute equally to this work.

Authors and Affiliations

  1. Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment Factors and Cancer, Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, No.1 Xuefu North Road, Fuzhou, 350122, China

    Guanglu Zhang, Peixin Li, Yuxi Wang & Yu Jiang

  2. Department of Occupational Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China

    Bo Shen & Peifang Liu

Authors
  1. Guanglu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bo Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peixin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuxi Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peifang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yu Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

GZ: Data collation, Analysis, Drafted the manuscript. BS and PL: Investigation, Collected the data. YW and PL: Data curation, Formal analysis. YJ: Study design, Writing-review& editing, Supervision.

Corresponding author

Correspondence to Yu Jiang.

Ethics declarations

Conflict of interest

None.

Ethical approval

Ethical approval was obtained from the institutional ethical committees of Fujian Medical University.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, G., Shen, B., Li, P. et al. Night shift work and depression among Chinese workers: the mediating role of sleep disturbances. Int Arch Occup Environ Health 95, 1905–1912 (2022). https://doi.org/10.1007/s00420-022-01889-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-022-01889-x

Keywords

Search

Navigation