Protocol for a systematic review and meta-analysis on the associations between short rest periods between shifts and health, function, and behavioral outcomes

PURPOSE: This paper presents a protocol for a planned systematic review and meta-analysis that will investigate the impact of short rest periods between shifts (i.e., quick returns, <11 h rest) on various outcomes in terms of physical health of workers (e.g., cardiovascular disease, infections, headaches, back pain) and/or mental health of workers (e.g., anxiety, depression, fatigue, sleep problems, insomnia, impaired mental health), as well as sickness absence (proxy of health), work performance (e.g., occupational accidents), social factors (e.g., social support), and psychosocial work-related factors (e.g., job satisfaction). The planned review further aims to identify different types of quick returns, such as evening to day shift and night to evening shift, and examine their relationship to these outcomes provided a sufficient number of studies (e.g., ≥5). The research will identify demographic and methodological factors that may moderate the relationship between quick returns and the specified outcomes.

METHODS: A systematic review and meta-analysis will be carried out. Predefined search terms for short rest between consecutive shifts will be developed and employed to identify relevant studies examining quick returns and all aforementioned outcomes. The databases MEDLINE, Web of Science, PsychInfo, EMBASE, ProQuest, BASE, and Cochrane Trials and the 200 first hits in Google Scholar will be searched up to April 2026. Two reviewers will independently screen identified records and assess eligible full texts for inclusions. The risk-of-bias of included studies will be assessed using the Mixed Methods Appraisal Tool (MMAT) for systematic mixed study reviews. A random effects meta-analytic synthesis will be conducted using Comprehensive Meta-Analysis software. The primary measure of effect size will be odds ratio with 95% confidence interval. Heterogeneity will be evaluated using Cochran's Q test and the I2 statistics. Publication bias will be assessed using Duval and Tweedie trim and fill procedure. The protocol adheres to PRISMA and MOOSE reporting guidelines and is registered in the International Prospective Register of Systematic Reviews.

DISCUSSION: This planned systematic review and meta-analysis will be the first to synthesize the current evidence systematically and quantitatively regarding the consequences of quick returns, including demographic and methodological moderators. Aggregation of the existing evidence will improve our understanding of the consequences of quick returns and, as such, provide directions for practitioners in terms of possible preventive initiatives and work environment improvements.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024533607.