Nurses’ Sleep Characteristics by Shift Type in a Tertiary Hospital With Flexible Working Arrangements

Objectives: To improve the adaptation of shift work, various flexible shift patterns for nurses have introduced in addition to the existing eight-hour-three-shift system. This study aimed to compare the differences in rotating nurses’ sleep characteristics according to shift patterns. Methods: A total of 62 rotating nurses (all females, mean age 29.79±4.30 years) participated in sleep monitoring for consecutive two weeks. Objective sleep was obtained using Readiband (Fatigue Science, Inc., Vancouver, BC, Canada), a wrist-worn device that uses an accelerometer to distinguish sleep and wakefulness. Subjective sleep characteristics were measured using the Morningness-Eveningness questionnaire (MEQ), Bedtime Procrastination Scale (BPS), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI). Results: Mean BPS was 30.42±5.10, ESS was 10.42±4.27, and ISI was 11.58±4.16, and there were no statistical differences in sleep parameters except for total sleep time (TST). Although significant differences were not found in sleep parameters according to shift patterns, 27.4% of rotating nurses report subjective sleep problems. More than half (59.7%) suffer from excessive daytime sleepiness. ISI was negatively correlated with age (rho=-0.275, p=0.031) and shift work period (rho=-0.278, p=0.028), but it was positively correlated with ESS (rho=0.306, p=0.015). Furthermore, BPS was negatively correlated with MEQ (rho=-0.351, p=0.005) and TST (rho=-0.307, p=0.016). Conclusions: To improve the sleep of rotating nurses, more active interventions, such as sleep education to reduce bedtime procrastination and short naps during night shifts, are needed.