Sleep

Prevalence of poor sleep quality and its associated factors in nurses: a multicenter cross-sectional study.

Li M, Zheng X, Yin X, Mou Q • Frontiers in public health • 2026

PubMed 42630364 DOI 10.3389/fpubh.2026.1927513
TL;DR

Poor sleep quality was highly prevalent among nurses (63.1%) and was significantly associated with age, work unit, work experience, night shift, workload, and self-regulatory fatigue.

Key Findings

Results

Nearly two-thirds of nurses reported poor sleep quality in this multicenter sample.

  • A total of 1,289 nurses were included in the study.
  • 813 nurses (63.1%) reported poor sleep quality as measured by the Pittsburgh Sleep Quality Index.
  • Data were collected between October and December 2025 from eight tertiary hospitals across Sichuan Province, China.
  • Convenience sampling was used to recruit participants.
Results

Older age was significantly associated with higher odds of poor sleep quality among nurses.

  • Nurses aged 31–45 years had 1.628 times higher odds of poor sleep quality compared to the youngest age group (OR = 1.628, 95% CI: 1.200–2.209, p = 0.002).
  • Nurses aged 46–60 years had 2.440 times higher odds of poor sleep quality (OR = 2.440, 95% CI: 1.608–3.702, p < 0.001).
  • Age was identified as a significant correlate via binary logistic regression.
Results

Working in high-acuity units was significantly associated with greater odds of poor sleep quality.

  • Nurses working in the intensive care unit had the highest odds of poor sleep quality (OR = 3.178, 95% CI: 1.993–5.068, p < 0.001).
  • Nurses in the emergency department had 2.492 times higher odds (OR = 2.492, 95% CI: 1.664–3.732, p < 0.001).
  • Nurses in the pediatric ward had 2.063 times higher odds (OR = 2.063, 95% CI: 1.407–3.024, p < 0.001).
  • Work unit was identified as a significant correlate via binary logistic regression.
Results

Greater work experience was significantly associated with higher odds of poor sleep quality.

  • Nurses with 11–20 years of work experience had 1.430 times higher odds of poor sleep quality compared to those with less experience (OR = 1.430, 95% CI: 1.031–1.984, p = 0.032).
  • Nurses with more than 20 years of experience had 2.237 times higher odds (OR = 2.237, 95% CI: 1.422–3.518, p < 0.001).
  • Work experience was identified as a significant correlate via binary logistic regression.
Results

Working night shifts was significantly associated with poor sleep quality among nurses.

  • Nurses who worked night shifts had 1.857 times higher odds of poor sleep quality compared to those who did not (OR = 1.857, 95% CI: 1.381–2.498, p < 0.001).
  • Night shift work was identified as a significant correlate via binary logistic regression.
  • The study instrument used was the Pittsburgh Sleep Quality Index.
Results

Higher workload was significantly associated with poor sleep quality in nurses.

  • Workload was associated with increased odds of poor sleep quality (OR = 1.223, 95% CI: 1.142–1.261, p < 0.001).
  • Workload was measured using the NASA Task Load Index.
  • Workload was identified as a significant correlate via binary logistic regression.
Results

Higher self-regulatory fatigue was significantly associated with poor sleep quality in nurses.

  • Self-regulatory fatigue was associated with increased odds of poor sleep quality (OR = 1.346, 95% CI: 1.221–1.384, p < 0.001).
  • Self-regulatory fatigue was measured using the Self-Regulatory Fatigue Scale.
  • Self-regulatory fatigue was identified as a significant correlate via binary logistic regression.

What This Means

This research suggests that poor sleep quality is extremely common among hospital nurses in China, with nearly two out of three nurses (63.1%) reporting it in a sample of 1,289 nurses across eight hospitals. The study used validated tools to measure sleep quality, workload, and fatigue, and found that certain groups of nurses are at particularly high risk: older nurses, those who have worked in nursing longer, those who work night shifts, and those assigned to high-pressure units like intensive care, emergency departments, and pediatric wards. Nurses experiencing heavier workloads and greater self-regulatory fatigue—the mental effort required to manage one's own behavior and emotions—were also significantly more likely to report poor sleep. These findings matter because poor sleep in nurses is not just a personal health concern. It has been linked in other research to burnout, medical errors, and reduced patient safety. This study highlights that sleep problems are not evenly distributed among nursing staff but are concentrated among those already under the most strain—experienced nurses in demanding environments working overnight hours. The compounding effects of age, long careers, and high-stress units may create a cycle where fatigue and poor sleep reinforce each other. This research suggests that hospitals and health systems should consider targeted strategies for high-risk nursing populations, particularly those in intensive care, emergency, and pediatric settings, as well as nurses working rotating night shifts. Approaches that address both workplace-level stressors—such as workload distribution—and individual-level resilience and recovery may be needed to meaningfully reduce sleep problems among nursing staff.

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Citation

Li M, Zheng X, Yin X, Mou Q. (2026). Prevalence of poor sleep quality and its associated factors in nurses: a multicenter cross-sectional study.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1927513