Associations between shift work patterns and sleep disturbance: an analysis of cross-sectional data from UK Biobank

Xianqi Li; David W Ray; Simon D Kyle; Karl Smith-Byrne; Leah Holmes; Annie Keane; Mahboubeh Parsaeian; Ruth C Travis; Rebecca Richmond

doi:10.1136/bmjopen-2025-102976

Associations between shift work patterns and sleep disturbance: an analysis of cross-sectional data from UK Biobank

BMJ Open. 2026 Jan 21;16(1):e102976. doi: 10.1136/bmjopen-2025-102976.

Authors

Xianqi Li¹, David W Ray^{2

3}, Simon D Kyle^{3

4}, Karl Smith-Byrne¹, Leah Holmes^{3

5}, Annie Keane^{3

5}, Mahboubeh Parsaeian¹, Ruth C Travis¹, Rebecca Richmond^{6

7

8}

Affiliations

¹ Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
² Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
³ National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK.
⁴ Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK.
⁵ Vocal, Manchester University NHS Foundation Trust, Manchester, UK.
⁶ National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK rebecca.richmond@bristol.ac.uk.
⁷ MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK.
⁸ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Abstract

Objective: To investigate associations between shift work patterns and sleep disturbance, and to assess if the association is modified by demographic factors, socioeconomic factors, anthropometric and lifestyle factors, health conditions or sleep traits.

Design: Analysis of cross-sectional data obtained from the UK Biobank baseline assessment.

Setting: UK Biobank, a large-scale prospective cohort study which recruited half a million participants aged 40-69 years between 2006 and 2010 from across the UK.

Participants: A total of 285 175 employed or self-employed participants at baseline (2006-2010), including 148 296 (52.0%) females and 136 879 (48.0%) males. The sample comprised 94.0% White, 0.7% Mixed race, 0.36% East Asian, 2.0% South Asian, 1.8% Black and 0.89% from other ethnic backgrounds.

Outcome measures: Sleep disturbance was defined as the presence of both insomnia and excessive sleepiness symptoms.

Results: A total of 42 181 (14.8%) participants had sleep disturbance defined based on insomnia and excessive sleepiness. 236 200 (82.8%) were non-shift workers, while 48 975 (17.2%) were shift workers, which included 24 062 (49.1%) working day shifts only, 17 940 (36.6%) working night shifts sometimes or usually, and 6973 (14.2%) working night shifts always. Compared with non-shift workers, all shift workers had higher multivariable-adjusted odds of sleep disturbance: (non-night shifts: OR in model 3 (OR) 1.21 (95% CI 1.16 to 1.27); sometimes/usually night shifts: OR 1.37 (95% CI 1.30 to 1.44) and always night shifts: OR 1.50 (95% CI 1.38 to 1.63)). The association between shift work pattern and sleep disturbance was modified by age (p_interaction<0.0001), ethnicity (p_interaction=0.0005) and smoking status (p_interaction=0.04).

Conclusions: Shift work is associated with a higher odds of sleep disturbance compared with non-shift work in all participants, with greatest odds observed among those always working night shifts. The association was stronger among individuals who were younger than 55 years old, from an ethnic minority background and never smokers. Future large-scale longitudinal studies are needed to further investigate these associations.

Keywords: Cross-Sectional Studies; EPIDEMIOLOGY; Insomnia; OCCUPATIONAL & INDUSTRIAL MEDICINE; PUBLIC HEALTH; SLEEP MEDICINE.

MeSH terms

Adult
Aged
Biological Specimen Banks
Cross-Sectional Studies
Disorders of Excessive Somnolence* / epidemiology
Female
Humans
Life Style
Male
Middle Aged
Prospective Studies
Risk Factors
Shift Work Schedule* / adverse effects
Sleep Initiation and Maintenance Disorders* / epidemiology
Sleep Initiation and Maintenance Disorders* / etiology
Socioeconomic Factors
UK Biobank
United Kingdom / epidemiology
Work Schedule Tolerance*