Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease

Abstract

Aims The aim of this study was to test whether current and past night shift work was associated with incident atrial fibrillation (AF) and whether this association was modified by genetic vulnerability. Its associations with coronary heart disease (CHD), stroke, and heart failure (HF) were measured as a secondary aim. Methods and results This cohort study included 283 657 participants in paid employment or self-employed without AF and 276 009 participants free of CHD, stroke, and HF at baseline in the UK Biobank. Current and lifetime night shift work information was obtained. Cox proportional hazard models were used. Weighted genetic risk score for AF was calculated. During a median follow-up of 10.4 years, 5777 incident AF cases were documented. From ‘day workers’, ‘shift but never/rarely night shifts’, and ‘some night shifts’ to ‘usual/permanent night shifts’, there was a significant increasing trend in the risk of incident AF (P for trend 0.013). Usual or permanent night shifts were associated with the highest risk [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.02–1.32]. Considering a person’s lifetime work schedule and compared with shift workers never working nights, participants with a duration over 10 years and an average 3–8 nights/month frequency of night shift work exposure possessed higher AF risk (HR 1.18, 95% CI 0.99–1.40 and HR 1.22, 95% CI 1.02–1.45, respectively). These associations between current and lifetime night shifts and AF were not modified by genetic predisposition to AF. Usual/permanent current night shifts, ≥10 years and 3–8 nights/month of lifetime night shifts were significantly associated with a higher risk of incident CHD (HR 1.22, 95% CI 1.11–1.35, HR 1.37, 95% CI 1.20–1.58 and HR 1.35, 95% CI 1.18–1.55, respectively). These associations in stroke and HF were not significant. Conclusion Both current and lifetime night shift exposures were associated with increased AF risk, regardless of genetic AF risk. Night shift exposure also increased the risk of CHD but not stroke or HF. Whether decreasing night shift work frequency and duration might represent another avenue to improve heart health during working life and beyond warrants further study.

Identifying Atrial Fibrillation Mechanisms for Personalized Medicine

“…Non-modifiable risk factors for AF include age, sex (AF is more common in males), and genetics [ 16 ]. Potentially modifiable risk factors include metabolic disorders and obesity [ 17 ], obstructive sleep apnea [ 18 ], alcohol use [ 19 ], vigorous endurance exercise [ 20 ], sleep deprivation [ 21 ], and risk factors from the Framingham Heart Study, namely, hypertension, congestive HF, coronary artery disease, valvular heart disease, and diabetes mellitus [ 22 , 23 ].…”

Efficacy of Dietary Supplements on Sleep Quality and Daytime Function of Shift Workers: A Systematic Review and Meta-Analysis

“…Exhaustive search strategies for each electronic database were developed by the review team members. The search strategy contained relevant terms, based on ( 1 ) “shift work” or “irregular working hours” or “nightshift” AND ( 2 ) “dietary supplements” or “nutraceutical” AND ( 3 ) “randomized clinical trial.” The search tactics are shown in Supplementary Files 2–5 .…”

“…Shift work refers to working time arrangements that differ significantly from society's traditional working hours (e.g., 9 a.m.−5 p.m.), or even night work that is completely reversed ( 1 ). It cannot be ignored that disruption of circadian rhythms caused by the inability to adapt to shift work may be a major trigger of sleep disturbances ( 2 ), cardiovascular disease ( 3 ), stroke ( 4 ), metabolic syndrome ( 5 ), mood problems ( 6 ), cancer ( 7 ), and sudden death ( 8 ). Furthermore, shift work negatively impacts job performance ( 9 ), driving safety ( 10 ), and health outcomes during pregnancy ( 11 ).…”

Schlafbezogene Atmungsstörungen – Update 2021

“…In derselben Kohorte wurden auch die Auswirkungen von Schlafstörungen durch lebenslange Nachtschichtexposition hinsichtlich des Risikos für Vorhofflimmern, KHK und Schlaganfall untersucht [ 6 ]. Die lebenslange Nachtschichtexposition war unabhängig von genetischen Faktoren mit einem erhöhten Risiko für Vorhofflimmern verbunden.…”

“…Die lebenslange Nachtschichtexposition war unabhängig von genetischen Faktoren mit einem erhöhten Risiko für Vorhofflimmern verbunden. Die Nachtschichtexposition erhöhte auch das KHK-Risiko, nicht aber das Risiko für einen Schlaganfall oder für die Entwicklung einer Herzinsuffizienz [ 6 ].…”