Poor sleep quality was significantly associated with poor work functioning among ICU nurses, with poor sleep associated with over four times the odds of poor work functioning (OR 4.29; 95% CI, 1.74-10.58).
Key Findings
Results
ICU nurses with poor sleep quality had significantly higher median NWFQ scores than those with good sleep quality, indicating worse work functioning.
Median NWFQ score was 27.57 for poor sleepers versus 17.44 for good sleepers (p < 0.0001)
Higher NWFQ scores indicate worse work functioning on the Nurses Work Functioning Questionnaire
The difference was statistically significant across all NWFQ subscales (p ≤ 0.02) except for the item 'conflicts and irritations with colleagues'
Study was conducted at an academic tertiary hospital in Saudi Arabia between December 2023 and January 2024 with 131 ICU nurse participants
Results
Global PSQI scores demonstrated a moderate negative correlation with NWFQ scores, indicating that worse sleep quality was associated with worse work functioning.
Spearman correlation between NWFQ total scores and Global PSQI Scores was rs = -0.37 (p < 0.0001)
Mild-to-moderate negative correlations were observed between Global PSQI scores and six of the seven NWFQ subscales (rs = -0.21 to -0.41; p ≤ 0.05)
The one NWFQ subscale not significantly correlated was 'conflicts and irritations with colleagues'
Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality; higher PSQI scores indicate poorer sleep quality
Results
Poor sleep quality was independently associated with poor work functioning in multivariable regression analysis, while no other participant characteristics were associated.
Poor sleep was associated with poor work functioning with an odds ratio of 4.29 (95% CI, 1.74–10.58)
None of the participants' demographic or other characteristics were independently associated with poor work functioning in the multivariable model
Analysis was conducted using multivariable logistic regression
Methods
The study sample was predominantly female, middle-aged, and had a median of 8 years of ICU nursing experience.
Of 131 participants, 118 (90.1%) were female
60 participants (45.8%) were aged 35–44 years
Median [interquartile range] number of years working in the ICU was 8 [4–16]
The study used a cross-sectional questionnaire-based design with self-administered surveys including the PSQI and NWFQ
What This Means
This research suggests that the quality of sleep that ICU nurses get has a meaningful impact on how well they are able to perform at work. The study surveyed 131 intensive care unit nurses at a tertiary hospital in Saudi Arabia, measuring their sleep quality with a validated tool (the Pittsburgh Sleep Quality Index) and their ability to function at work with another validated tool (the Nurses Work Functioning Questionnaire). Nurses who reported poor sleep quality had noticeably worse work functioning scores across nearly all measured areas of job performance compared to nurses who slept well.
The statistical analysis found that poor sleep quality was associated with more than four times the odds of poor work functioning, even after accounting for other factors like age, sex, and years of experience. Interestingly, none of the personal or professional characteristics of the nurses — apart from sleep quality — were independently linked to worse work functioning. The one work-related area not significantly affected by sleep quality was conflicts and irritations with colleagues.
This research suggests that sleep problems among ICU nurses are not just a personal health concern but a professional and patient safety issue. Since ICU nurses care for the most critically ill patients, impaired functioning due to poor sleep could have serious consequences for patient outcomes. The findings point to the importance of healthcare institutions addressing sleep-related challenges for nursing staff, such as through scheduling practices, workload management, or wellness programs, to support both nurse well-being and the quality of care they deliver.
Almotary H, Kattan W, Thabit A. (2026). Impact of Sleep Quality on Work Functioning Among Critical Care Nurses at an Academic Tertiary Hospital.. International journal of nursing practice. https://doi.org/10.1111/ijn.70116