This paper aims at describing the associations between workhours and psychosocial work characteristics and reviews the health effects of workhours and the related pathways. The role of insufficient sleep as a possible common pathway from workhours and work stress to cardiovascular illness is discussed. Finally, the key possibilities for improving recovery and health through changes in workhours are identified. Night work and shift work are related to a wide range of health effects, the evidence for the risk of cardiovascular morbidity being the strongest. Insufficient or poor sleep, related to insufficient recovery, can be a common pathway from long workhours, shift work, and work stress to cardiovascular illness. The most promising worktime-related means for decreasing the psychosocial workload and negative health effects of workhours would be (i) to regulate overtime and excessive workhours, (ii) increase individual worktime control, and (iii) increase recovery from the introduction of sleep-promoting principles into shift rotation.