ORIGINAL RESEARCH article
Front. Neurosci.
Sec. Sleep and Circadian Rhythms
Inflammatory Marker Dynamics in Shift Work Sleep Disorder: A Data-driven Approach among Rotating Shift Workers
Yiren Bao 1
Bo Liang 2
Tianhao Zhan 1
Guan Shen 1
Dai Sun 1
Jialong Lin 1
Linlin Hu 1
Rui Wang 1
1. Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
2. Army Medical University Xinqiao Hospital, Chongqing, China
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Abstract
Background: Shift work sleep disorder (SWSD) negatively affects overall health and quality of life. This cross-sectional study aimed to elucidate the association of SWSD with blood cell counts (BCCs) and related inflammatory indices over a period of three years. Method: This retrospective cross-sectional study involved rotating shift workers. Linear mixed-effects models were applied to examine the associations between group stratification (based on sex and sleep status) and longitudinal trajectories of inflammation indices. Results: Participants with SWSD (regardless of sex) showed significantly steeper increases in neutrophil levels during the second year (female: β = 0.079, p = 0.030; male: β = 0.076, p = 0.032). By the third year, marked changes were observed in monocyte levels, although these were not statistically significant in mixed models. Composite inflammatory indices, including the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, systemic inflammatory composite index, and neutrophil-to-monocyte ratio, exhibited consistent and significant upward trends in the SWSD group (all p < 0.05, adjusted for false discovery rate). Notably, the platelet-to-lymphocyte ratio showed a sex-specific increase only in males with SWSD (β = 7.310, p = 0.006). Conclusion: Long-term rotating shift workers with sleep disorders exhibited fluctuating trends in BCCs and related inflammatory indices over time, with neutrophil and monocyte counts showing increases. These patterns suggest that dynamic alterations in BCCs and related inflammatory indices This is a provisional file, not the final typeset article are associated with circadian disruption among rotating shift workers and may have potential relevance for future risk stratification and monitoring.
Summary
Keywords
Circadian Rhythm, Cross-Sectional Studies, Inflammation, Shift work schedule, Sleep Disorders
Received
10 December 2025
Accepted
16 February 2026
Copyright
© 2026 Bao, Liang, Zhan, Shen, Sun, Lin, Hu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Linlin Hu; Rui Wang
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