Occupational Sleep Disruption and Risk of Psychosis Development: A Systematic Review and Meta-analysis

Background:Psychosis carries major social and economic costs, whilst sleep disorders are common among shift workers. Under-standing whether occupational sleep disruption increases psychosis risk is important for workplace policy. No prior meta-analysishas addressed this link. This systematic review and meta-analysis examined the association between shift work, sleep disruptionand psychosis.Methods: Six databases were searched from January 2000 to June 2025 for studies on shift work, sleep disruption and psychosisin adults. A random-effects meta-analysis of three eligible studies was conducted using Hedges’ g.Results: Studies consistently showed that shift work impaired sleep quality, with insomnia symptoms more prevalent amongshift workers (42% vs. 28%, p < 0.001) and greater odds of sleep disturbance (OR= 1.82, 95% CI: 1.73, 1.92, p < 0.001).Sleep disruption was positively correlated with paranoid ideation (r= 0.41, p < 0.01). However, our meta-analysis did not find asignificant direct association between shift work and psychosis (Hedges’ g= 0.49; 95% CI: -0.23, 1.20; p = 0.099).Conclusions: This is the first comprehensive review of occupational sleep disruption and psychosis. Whilst a direct link betweenshift work and psychosis was not found, our systematic review evidence suggests a potential pathway from shift work to sleepdisruption and from disrupted sleep to psychosis. Findings highlight the importance of workplace interventions targeting sleephygiene and circadian alignment. Future research should employ larger, more diverse cohorts with standardised measures andexamine moderating factors such as gender, ethnicity, shift type and occupational sector.