Poor Sleep Quality in Nurses Working or Having Worked Night Shifts: A Cross-Sectional Study

Effects of photobiomodulation on the sleep quality and quality of life of night-shift nurses

Quality of life (QoL) and sleep quality are critical to the well-being of night-shift nurses. This study evaluates the therapeutic effects of an 830 nm laser array on QoL and sleep quality among this population. A total of 60 night-shift nurses participated in the study. The 830 nm laser array was applied to the palm and a localized painful area at an energy density of 252 J/cm2. Changes in QoL and sleep quality were assessed using standardized questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), the Athens Insomnia Scale (AIS), the MOS 36-item short-form health survey, v. 2 (SF-36v2), and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). Following treatment, participants exhibited significant reductions in global PSQI (p < 0.001) and AIS scores (p < 0.001), indicating improved sleep quality. Positive changes were also observed in global scores on the SF-36v2 (p < 0.01) and the WHOQOL-BREF (p < 0.05). Additionally, pain levels were significantly reduced during the one-month treatment period (p < 0.001). The beneficial effects of photobiomodulation are sustained for a duration of at least one month. This approach offers a promising means of mitigating the adverse effects of night shifts and improving overall well-being.

Fatigue and coping strategies among Chinese night-shift nurses: a cross-sectional study

BACKGROUND

Night-shift work is a crucial component of nursing but is associated with significant fatigue, which may impact both nurse well-being and patient safety. Understanding the levels of fatigue and the coping strategies employed by nurses can help develop effective interventions. This study aimed to assess the fatigue levels of Chinese night-shift nurses and explore commonly used anti-fatigue strategies.

METHODS

A cross-sectional study was conducted in Zhejiang Province, China, using the Occupational Fatigue Exhaustion/Recovery Scale (OFER) questionnaire. The survey assessed acute and chronic fatigue levels, fatigue recovery, and anti-fatigue strategies among nurses. Statistical analysis was performed using SPSS 26.0.

RESULTS

Among the 371 valid responses, chronic fatigue levels (66.41 ± 24.17) were higher than acute fatigue levels (57.31 ± 15.61). Nurses with higher education levels reported lower acute fatigue, while older, more experienced nurses and those working in higher-grade hospitals had lower chronic fatigue. Common coping strategies included naps (63.88%) and stimulant consumption (54.72%), with coffee (45.37%) and milk tea (23.28%) being the most popular drinks.

CONCLUSION

Our findings indicate that Chinese night-shift nurses experience substantial fatigue, especially chronic fatigue, which is influenced by factors including education, age, clinical experience, exercise frequency, and hospital grade. Although personal coping strategies are common, they fall short in mitigating fatigue, underscoring the need for comprehensive interventions that combine individual and organizational measures.

CLINICAL TRIAL NUMBER

not applicable.

Relationship between shift type and sleep quality in rotating-shift nurses with chronotype as a moderator variable

BACKGROUND

Rotating-shift nurses are susceptible to sleep disorders due to numerous factors, such as their biological clock, emotions, and age. At present, a lack of research exists on whether chronotype and shift type jointly influence the sleep quality of nurses.

AIM

To verify whether chronotype is a moderator variable of the relationship between shift type and sleep quality in nurses in order to provide empirical evidence for future mental and physical health improvement.

METHOD

Clinical rotating-shift nurses at a medical center in northern Taiwan were recruited as participants between November 1, 2023, and December 13, 2023. All of the nurses were working a monthly rotating shift schedule. Hierarchical multiple regression analysis was employed to investigate whether the influence of shift type on sleep quality in nurses varied with chronotype. The STROBE checklist was used for reporting this study.

RESULTS

The participants were 255 rotating-shift nurses in this study. Hierarchical multiple regression results revealed that rotating-shift nurses who were older (B = 0.19, p = 0.029), had greater physical fatigue (B = 0.27, p = 0.016), and had more negative emotions (B = 0.17, p = 0.011) suffered from poorer sleep quality. After controlling the above factors, we further found that chronotype indeed had moderating effects on the influence of shift type on sleep quality (B = -1.83, p = 0.049).

CONCLUSIONS

This study demonstrates that early- and intermediate-type nurses are more suitable for working the day and evening shifts, whereas late-type nurses are more suitable for working the night shift.

IMPLICATION FOR NURSING AND HEALTH POLICY

Coordinating chronotype with shift type will ensure that shift schedules better match the biological clocks of nurses; such individual considerations could help to improve their sleep quality.

Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model

Background/Objectives: Several studies have reported alarming rates of mental health issues and sleep problems among nurses even in the post-pandemic era. The objective was to investigate the prevalence of stress, anxiety and depressive symptoms, burnout and insomnia among nurses in Greece one year after the end of the pandemic and to construct a mediation model evaluating the impact of stress on insomnia, the chain mediating roles of depressive symptoms and burnout, as well as the moderating role of anxiety symptoms in the model. Methods: This cross-sectional study was conducted online in July 2024 and included 380 hospital nurses who completed the Depression Anxiety Stress Scale (DASS-21), the Copenhagen Burnout Inventory (CBI) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of stress, anxiety and depressive symptoms, burnout and insomnia were 33.9% with 95% confidence interval (CI): [0.292, 0.390], 33.3% (95% CI: [0.284, 0.381]), 35% (95% CI: [0.302, 0.400]), 46.8% (95% CI: [0.399, 0.502]) and 56.1% (95% CI: [0.509, 0.611]), respectively. Multiple regression analysis indicated that the Depression subscale of the DASS-21 explained 40.6% of the variance in the AIS, while an additional 7.6% was explained by the CBI and another 1.3% rate by the Stress subscale of the DASS-21. Mediation analysis revealed that stress affected insomnia both directly and indirectly through the chain mediating roles of depressive symptoms and burnout. Anxiety symptoms moderated the chain mediation path by enhancing the negative impact of stress on depressive symptoms. Conclusions: The proposed moderated chain mediation model introduces certain factors influencing insomnia and explains how changes in any one of these factors effectuate changes in the other factors, offering insights for individualized interventions.

The Association of Sleep Quality and Internet Addiction With Health Status in Hospital Nurses

AIM

The aims of this study were to explore the correlation of sleep quality and Internet addiction (IA) with the health status of hospital nurses and to investigate whether sleep quality is a mediator in the influence of IA on the health of the nurses.

BACKGROUND

Excessive Internet use is a public health concern. However, few researchers have investigated the interrelationship of the IA, sleep quality, and health status of hospital nurses.

DESIGN

This study used a descriptive and cross-sectional design.

METHODS

The study was conducted using survey data from a medical center in Taiwan. The Chen Internet Addiction Scale, Chinese version of the Pittsburgh Sleep Quality Index, and Chinese Health Questionnaire-12 were provided to the participants. Independent t tests, chi-square test, and structural equation model were performed for analysis.

RESULTS

A total of 628 participants were recruited. The participants with IA exhibited significantly worse health status and poorer sleep quality compared with the participants without IA. Participants with poor sleep quality exhibited significantly worse health status and higher IA than those with normal sleep quality. The influence of IA on health status was indirect, with sleep quality as a mediator.

CONCLUSIONS

Hospital nurses with IA or poor sleep quality exhibited poor health status. Sleep quality mediated the influence of IA on the health status of the nurses. Hospital administrators should identify nurses at a high risk of IA, provide support strategies, and schedule work shifts more reasonably to improve their sleep quality. The hospital nurses' health and patients' safety could be further protected.

Determinants of sleep quality and their impact on health outcomes: a cross-sectional study on night-shift nurses

Purpose

This study aimed to identify determinants of sleep quality and explore their adverse health outcomes among night-shift nurses in China.

Method

Through convenience sampling, this cross-sectional study enrolled a total of 711 night-shift nurses aged 20-55 years who completed questionnaires from which details regarding their sociodemographic characteristics, health-related indicators and sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) were extracted. A generalized linear regression analysis was then created to identify factors influencing sleep quality. Pearson correlation analysis was used to analyze the relationship between sleep quality and chronic fatigue.

Results

The prevalence rate of poor sleep quality among night-shift nurses reached as high as 90.1%. Our results showed that education level, years of working experience, quality of make-up sleep before and after night shifts, daily routine and diet were the primary factors affecting sleep quality (p < 0.01). Nurse fatigue had a significant positive correlation with subjective sleep quality, sleep latency, sleep duration, sleep disturbance, medications to sleep, daytime dysfunctions and global sleep quality (p < 0.01). However, nurse sleep efficiency had a significant negative correlation with fatigue (p < 0.01).

Conclusions

Higher education level, longer working years, worse quality of make-up sleep before and after night shifts, daily routine and daily diet were risk factors for poor sleep quality among nurses. Poor sleep among night-shift nurses is strongly correlated with chronic fatigue.

An evaluation of sleep quality and nutritional status in nurses with different chronotypes

This study was conducted to investigate the effect of shift work on the sleep quality and nutritional status of nurses with different chronotypes. The study was designed to include 21 people from each chronotype and was completed with 60 participants. The participants were asked to record their food consumption during three different types of shifts they worked over a period of three days. We found that the Pittsburgh Sleep Quality Index (PSQI) score of the evening types was higher than that of the morning types (p < 0.05). The evening types had significantly higher weight, BMI, waist circumference, hip circumference, waist-to-height ratio and neck circumference measurements than the morning types (p < 0.05). The daily energy, fat and SFA intakes of the morning types were significantly higher for those working 16:00-08:00 and 08:00-08:00 compared to those working 08:00-16:00 (p < 0.05). The highest carbohydrate intake was between 08:00-08:00. The amount of carbohydrate, energy and SFA consumed by the intermediate types between 08:00 and 08:00 was significantly higher than that consumed between 08:00 and 16:00. Chronotype and shift hours should also be taken into account when developing nutrition plans for participants who work shifts.

Personality and sleep quality among nursing interns: Traditional Chinese medicine constitution as a mediator and sedentary time as a moderator

Aims

This study investigated whether the relationship between neuroticism and sleep quality in nursing interns is mediated by traditional Chinese medicine (TCM) constitution. In addition, the study examined whether sedentary behaviour affects this mediating model.

Background

The importance of sleep quality for nursing interns cannot be overstated. Previous studies have demonstrated that neuroticism negatively affects sleep quality. However, little is known about the path of the relationship between neuroticism and sleep quality among nursing interns.

Design

A cross-sectional study was conducted in Central and South China.

Methods

A total of 630 nursing interns participated in this study. Neuroticism, TCM constitution, sleep quality, and sedentary behaviour were measured using reliable and valid questionnaires. Data were analysed using the PROCESS macro in SPSS.

Results

Neuroticism significantly predicted the Pittsburgh Sleep Quality Index (PSQI; β = 0.144, P < 0.001). Neuroticism exerted a significant indirect effect on the PSQI through gentleness and damp heat constitution (β = 0.265, 95 % CI [0.214, 0.315]). In addition, sedentary time moderated this mediation model. Sedentary time marginally moderated the direct pathway from neuroticism to the PSQI (B = -0.025, 95 % CI [-0.046, -0.004]) and the pathway from neuroticism to the damp heat constitution (B = 0.175, 95 % CI [0.021, 0.329]) in the nursing interns.

Conclusion

TCM constitution mediates the relationship between neuroticism and sleep quality. Given the moderating effect of sedentary behaviour, targeting sedentary behaviour can be an effective approach to improve the sleep quality of nursing interns.

Factors associated with sleep quality among Afghan healthcare workers

Background and Aims

Sleep is a complex physiological process during which the body and mind enter a period of rest. For a healthy lifestyle, different cohort groups can be affected in different ways. One such cohort is healthcare workers (HCWs)-an unexplored group in Afghanistan. Therefore, the present study examined the association between a range of sociodemographic factors including having night shift work and sleep quality among Afghan HCWs.

Methods

A cross-sectional survey was administered in January 2023 among HCWs (N = 342) in the Herat province of Afghanistan. The survey examined sleep quality and its association with a range of sociodemographic factors among HCWs. Logistic regression models were used to examine the association of sleep quality with sociodemographic characteristics among HCWs. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among HCWs.

Results

A total of 342 HCWs participated in the present study with an age range of 18 to 60 years. The mean age of the participants was 28.90 years (SD ± 8.10). Just over half of the participants were male (50.3%). Of the 342 participants, 58.5% reported poor sleep quality. Being married status, having higher number of children, not being a doctor, having low economic status, working night shifts, and having a traumatic event occur during past month were among the main variables associated with sleep quality among Afghan HCWs. Multiple regression analysis indicated that having high income [negatively] (AOR = 4.132, p = 0.002), working night shifts [positively] (AOR = 0.288, p < 0.001), and having a traumatic event occur during past month [positively] (AOR = 0.504, p = 0.007) were significantly associated with sleep quality.

Conclusion

The study suggests the need for Afghan health employers to create a healthy work environment that prioritizes the well-being of their employees by limiting overtime hours, providing rest breaks during long shifts, and ensuring that HCWs have access to necessary resources for coping with work-related stressors. These policies would promote the overall health and well-being of the workforce and would likely lead to better patient care outcomes.

Prevalence and factors associated with the poor quality of sleep among Indian nurses

BACKGROUND

Nursing health workers deal with a variety of issues that may have an unfavorable influence on their capability to peaceful sleep. The consequences of poor quality of the sleep can lead to increased fatigue, decreased concentration, and a higher risk of medical and nursing errors. The purpose of this research study was to determine in the occurrence and associated factors for poor quality of the sleep among Indian nurses.

MATERIALS AND METHODS

The participants in this cross-sectional study were selected by the use of a multi-stage sampling technique. A total of 25 hospitals (across 4 zones) were randomly sampled. A total of 850 (out of 1250) nurses participated in the study. To collect socio-demographic data, a self-administered questionnaire was employed. PSQI scale was implemented to assess quality of sleep, and the other scale of DASS-21 was used to assess mental well-being.

RESULTS

The majority of nurses had mild (6-7 hours) as well as moderate (5-6 hours) levels of difficulty in the duration of sleep time. The occurrence of poor quality of the sleep in nursing professionals is high. 9.2% had depression, 13.7% had anxiety, and 18.9% faced, which appears to be linked to insufficient sleep in the adjusted model. In the univariate study, additional night shifts and additional shift hours were substantially related to insufficient sleep.

CONCLUSION

Nurses' quality of sleep is substantially hampered due to various reasons, and nurse mangers should devise the framework to avoid its harmful effects and to provide desirable management and high-quality patient care.

Effects of work environments on satisfaction of nurses working for integrated care system in South Korea: a multisite cross-sectional investigation

BACKGROUND

Nurses' satisfaction has an impact on organizational and patient outcomes. Integrated care system in South Korea was established in 2015 to improve care quality and decrease caregiving burden. Since then, nurses' satisfaction has increased due to an increase in nursing staffing. However, besides nurse staffing, various work environments still affect nurse satisfaction.

METHODS

Individual online surveys were conducted with participants to determine their personal characteristics, work environments, and hospital characteristics. We used mixed-effects linear regression equation contained both fixed and random effects.

RESULTS

This study included 2,913 nurses from 119 hospitals. Their average job satisfaction was less than 6 points out of 10 points. Age, shift type, perceived workload, and delegation criteria were significant factors influencing nurses' satisfaction. There was no significant factor among hospital characteristics. The satisfaction level of nurses was high for no-night rotating shift, low perceived workload, and clear delegation criteria.

CONCLUSIONS

Nurses' satisfaction is affected by several work environmental factors. Low nurse satisfaction has a substantial impact on both patients and nurses. Therefore, nurse managers and hospitals should determine factors influencing their satisfaction and develop strategies to improve their satisfaction.

Alcohol Use Predicts Longer But More Fragmented Sleep: A Daily Diary Study of Alcohol, Sleep, and PTSD in Nurses

BACKGROUND

Due to the demanding nature of their profession, nurses are at risk of experiencing irregular sleep patterns, substance use, and fatigue. Evidence supports a reciprocal relationship between alcohol use and sleep disturbances; however, no research has examined such a link in a sample of nurses. One factor that may further impact the dynamic between alcohol and sleep patterns is posttraumatic stress disorder (PTSD) symptoms. We investigated the daily bidirectional associations between alcohol use and several sleep domains (i.e., self-report and actigraphy-determined sleep), and moderation by baseline PTSD symptom severity.

METHOD

Over a 14-day period, 392 nurses (92% female; 78% White) completed sleep diaries and actigraphy to assess alcohol use and sleep patterns. Within-person bidirectional associations between alcohol and sleep were examined using multilevel models, with symptoms of PTSD as a cross-level moderator.

RESULTS

Daily alcohol use (i.e., ≥ 1 alcoholic beverage; 25.76%) was associated with shorter self-reported sleep onset latency (b = -4.21, p = .003) but longer self-reported wake after sleep onset (b = 2.36, p = .009). Additionally, days with any alcohol use were associated with longer self-reported sleep duration (b = 15.60, p = .006) and actigraphy-determined sleep duration (b = 10.06, p = .037). No sleep variables were associated with next-day alcohol use. Bidirectional associations between alcohol consumption and sleep were similar regardless of baseline PTSD symptoms.

CONCLUSION

Our results suggested that on days when nurses drank alcohol, they experienced longer but also more fragmented sleep.

Strategies that nurses working irregular night shifts use to improve sleep quality: A qualitative study among good and poor sleepers

AIMS

To assess the sleep strategies that nurses working irregular night shifts use to improve their sleep quality, and to compare the strategies of good and poor sleepers to determine whether the differences between the two groups could provide insights into possible effective strategies.

DESIGN

A qualitative descriptive study.

METHODS

The study was conducted from September 2019 to January 2020. Thirty-four nurses working irregular night shifts participated; 17 were classified as good sleepers and 17 as poor sleepers based on the Sleep-Wake Experience List, a validated self-report instrument that measures one's sleep quality. Interviews were conducted using open questions to explore strategies around the night-shift set. The interviews were analysed using thematic analysis.

FINDINGS

Both groups described similar and different strategies that help them work and sleep well during and after night shifts. However, good sleepers mentioned a greater number of strategies and seemed to have thought about them more than poor sleepers. The most common strategies were having a clear structure, being organized-especially regarding sleeping time-maintaining a daily routine and adjusting their sleep environment.

CONCLUSION

Healthcare institutions should consider offering education and training programs aimed at empowering nurses who work irregular night shifts. These programs should provide nurses with various sleep strategies to enhance their sleep quality and overall well-being.

IMPLICATIONS FOR THE PROFESSION

Nurses working irregular night shifts can possibly enhance their sleep quality by making personalized plans, for example, including a clear day structure, or an optimized sleep environment.

IMPACT

The study focused on how nurses working night shifts could possibly enhance their sleep quality. The findings highlight the importance of providing nurses with diverse sleep strategies to improve sleep quality, helping them to identify what works best for them and consistently apply these strategies.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research guidelines were followed.

PATIENT OR PUBLIC CONTRIBUTION

Nurses working irregular night shifts at Maastricht University Medical Center in Maastricht, the Netherlands, who agreed to participate in the study, engaged in a discussion to assess the relevance of sleep quality to their work. They were also encouraged to share their perspectives during the interviews.

Circadian dysfunction and cardio-metabolic disorders in humans

The topic of human circadian rhythms is not only attracting the attention of clinical researchers from various fields but also sparking a growing public interest. The circadian system comprises the central clock, located in the suprachiasmatic nucleus of the hypothalamus, and the peripheral clocks in various tissues that are interconnected; together they coordinate many daily activities, including sleep and wakefulness, physical activity, food intake, glucose sensitivity and cardiovascular functions. Disruption of circadian regulation seems to be associated with metabolic disorders (particularly impaired glucose tolerance) and cardiovascular disease. Previous clinical trials revealed that disturbance of the circadian system, specifically due to shift work, is associated with an increased risk of type 2 diabetes mellitus. This review is intended to provide clinicians who wish to implement knowledge of circadian disruption in diagnosis and strategies to avoid cardio-metabolic disease with a general overview of this topic.

Influence of chronotype on sleep quality and menstrual regularity in nurses on monthly shift rotations

OBJECTIVES

This study aimed to investigate factors that influence the sleep quality and menstrual cycles of female rotating-shift nurses.

METHODS

A cross-sectional study was conducted in which 213 female rotating-shift nurses between the ages of 20 and 45 were recruited from a medical center in Taiwan from November 1, 2023, to December 31, 2023. Binary logistic regression analysis was performed with regard to sleep quality or menstrual cycle.

RESULTS

Female rotating-shift nurses who perceived a higher level of stress (P < .001), were late chronotypes (P = .020), or were working the night shift (P = .006) were more likely to have poor sleep quality. Late-type nurses working the day shift were more likely to have poor sleep quality than were early- and intermediate-type nurses (P < .001). With regard to menstrual cycles, female rotating-shift nurses who perceived a higher level of stress (P = .008), were working the night shift (P < .001), or had poor sleep quality (P = .001) were more likely to have irregular menstrual cycles. Late-type nurses working the day shift were more likely to have irregular menstrual cycles than were early- and intermediate-type nurses (P = .013).

CONCLUSIONS

A higher likelihood of poor sleep quality was found in female rotating-shift nurses when they perceived high levels of stress, and the interactions between chronotype and shift type could influence sleep quality. Shift type and the interactions between chronotype and shift type could also influence menstrual regularity.

Relationship between night shift and sleep problems, risk of metabolic abnormalities of nurses: a 2 years follow-up retrospective analysis in the National Nurse Health Study (NNHS)

BACKGROUND AND PURPOSE

Efforts to improve nurses' physical and mental health are critical to ensuring the safety and quality of the healthcare system. Long-term studies targeting the relevancy of nurses' occupation characteristics with health conditions remain insufficient. This study aimed to examine the relationship between nurses' night shift and sleep problems and metabolic abnormalities risk.

METHODS

This study was a part of the National Nurse Health Study, an ambispective cohort study in China, in 2021. Based on an integration physical examination data system, this study carried out a retrospective analysis of 730 nurses from 2018 to 2020 and combined with a questionnaire survey in 2021. The STROBE guidelines were adopted for reporting.

RESULTS

In the 23 (23.0, 24.0) months follow-up, higher night shift load was associated with more sleep problems such as shortened sleep duration, sleep disorders, poor sleep quality, and sleep deprivation. Moreover, night shift load was associated with chronic diseases risk factors, increasing body mass index and body fat, with more night shift density, increasing the occurrence of low levels of high-density lipoprotein cholesterol, high triglyceride, triglyceride/high-density lipoprotein cholesterol ratio, and serum uric acid.

CONCLUSION

The night shift load has become an occupational health concern, contributing to chronic diseases relevant metabolic risk factors and negative influence on sleep health. Focus on the strategies to improve the sleep quality of nurses undergoing night shift work, optimize work scheduling and ongoing monitor the relevant risk factors are essential to enhance the stability and well-being of the nursing workforce.

CLINICAL TRIALS REGISTRATION INFORMATION

NCT04572347, on October 1, 2020. https://www.

CLINICALTRIALS

gov/ct2/show/NCT04572347.

Wake-up Call: Night Shifts Adversely Affect Nurse Health and Retention, Patient and Public Safety, and Costs

The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.

Nurses and midwives' sleep quality and its associated factors during the early COVID-19 pandemic in Iran

Objectives

Good sleep quality is crucial for medical staff especially nurses and midwives to prevent possible errors and injuries during the providing care. The aim here is to investigate the sleep quality of nurses and midwives during the early corona pandemic and its related factors.

Methods

An online observational and cross-sectional study included 340 medical staff who engaged in the treatment of patients with COVID-19 infection in 2020. Participants completed questionnaires about working characteristics, Pittsburgh Sleep Quality Index (PSQI), and Social Support Indexes (SSI). Pearson's correlation analysis and Multivariate logistic regression identified the interactions between these factors.

Results

The mean PSQI and SSI were 8.4 ± 4.46 and 28.6 ± 13.29, respectively, indicating poor sleep quality and moderate social support. The condition of the participants was serious in terms of sleep efficiency, and sleep disturbance. More than half of the participants reported severe and very serious daytime dysfunction. Poor sleep quality was more common, in nurses than in midwives (OR:0.074, CI; 0.032-0.098, P < 0.001), nurses working in intensive care units than in other wards (OR:1.082, CI; 1.003-4.023, P = 0.005), in people who had long shifts (OR:1.757, CI; 1.123-4.323, P = 0.003), and in people working more than 5 years (OR:4.949, CI; 1.673-6.023, P = 0.028). Social support has a statistically significant relationship with the quality of sleep (OR:0.013, CI; 0.001-0.244, P = 0.004).

Conclusion

The sleep quality of the medical staff has been impaired during the epidemic period, especially among nurses. Targeting staff who are more prone to sleep disturbance, such as nurses with longer work experience, helps us design an optimal strategy to support them through sleep hygiene education.

Association between circadian rhythm and sleep quality among nursing interns: A latent profile and moderation analysis

BACKGROUND

Disturbances in circadian rhythms are common among night-shift workers and result in poor sleep quality. Nevertheless, the heterogeneity of circadian rhythms and their relationship with sleep quality is less explored in nursing interns. Therefore, we aimed to identify the latent subtypes of circadian rhythm, explore their relationship with sleep quality, and evaluate their moderating role between perceived stress and sleep quality in nursing interns.

MATERIALS AND METHODS

In all, 452 nursing interns were recruited between October 2020 and January 2021 from Be Resilient to Nursing Career (BRNC), which is a multicenter, prospective cohort of a career growth program for nursing students. They were assessed using the 10-item Chinese Perceived Stress Scale, Circadian Type Inventory, and Pittsburgh Sleep Quality Index. Latent profile analysis and moderation analysis were performed.

RESULTS

Overall, 72.3% of the nursing interns reported poor sleep quality. We identified three latent subtypes of circadian rhythms, namely, Vigorousness (40.1%), Inadaptability (18.6%), and Flexibility (41.1%). Females (OR = 1.97, 95% Cl: 1.01-3.83, P = 0.047) with normal body mass index (OR = 1.62, 95% CI: 0.95-2.76, P = 0.078) were prone to Flexibility. Circadian rhythm types significantly moderated the association between perceived stress and sleep quality (P < 0.05).

CONCLUSION

Nursing interns suffer from poor sleep. There exists heterogeneity of circadian rhythm subtypes in nursing interns, and attention should be paid to those with Inadaptability type. The association between perceived stress and sleep quality is significantly moderated by circadian rhythm subtypes.

Which Shiftwork Pattern Is the Strongest Predictor for Poor Sleep Quality in Nurses?

Shiftwork is related to an increased risk of several diseases, including gastric ulcers, myocardial infarction, and diabetes. Several shiftwork patterns are related to poor sleep quality, such as a quick returns or extended shifts. This study aimed to find the shiftwork patterns strongly associated with poor sleep quality amongst nurses. A cross-sectional analytical study was conducted among nurses working for at least one month. The sub-groups were the good sleep quality group (n = 150) and the poor sleep quality group (n = 472). Eligible participants were asked to complete a self-reported questionnaire comprising personal characteristics, job characteristics, shiftwork characteristics, and sleep quality. Factors associated with poor sleep quality were determined using logistic regression analysis. Two factors associated with poor sleep quality remained in the final model: viz., depression and backward rotational shift. The only independent factor for poor sleep quality was a backward rotational shift with an adjusted odds ratio (95% CI) of 1.946 (1.344, 2.871). In conclusion, compared with other shift patterns, backward shiftwork was the most significant factor associated with poor sleep quality and should be avoided.