Association between sleep disturbance and mental health of healthcare workers: A systematic review and meta-analysis

The effect of disaster resilience and trauma exposure on PTSD, depression, and sleep disorder among healthcare workers involved in the Kahramanmaraş Earthquakes (2023): a structural equation model

Healthcare workers (HCWs) serve as the cornerstone of health services, which are among the primary needs during disasters. The chaotic environment caused by disasters can lead to mental health disorders in HCWs, similar to those experienced by disaster victims. Experiencing mental health disorders can hinder HCW's professional approach to intervention. HCWs should not be overlooked for the possibility of experiencing mental health disorders while providing healthcare services during disasters. Therefore, this study aims to examine the impact of psychological resilience and trauma exposure on PTSD, depression, and sleep disorders among HCWs involved in the Kahramanmaraş Earthquakes, which were Turkey's most devastating earthquakes. In this quantitative research, a survey technique was employed, reaching 642 hCWs involved in the Kahramanmaraş Earthquakes. Structural Equation Modeling (SEM) was used to test the impact of variables on each other. According to the SEM results, trauma exposure in the HCWs had a significant and positive effect on PTSD (β=+0.899, p = 0.000), depression (β=+0.685, p = 0.000), and sleep disorders (β=+0.603, p = 0.000). Psychological resilience had a significant and negative effect on PTSD (β=-0.278, p = 0.004) and depression (β=-0.322, p = 0.008). Surprisingly, psychological resilience had a significant and positive effect on sleep disorders (β=+0.692, p = 0.000). In conclusion, while trauma exposure led to PTSD, depression, and sleep disorders in the HCWs, psychological resilience mitigated PTSD and depression. Unexpectedly, psychological resilience increased sleep disorders. For this reason, it is recommended that future studies investigate in detail the reasons why HCWs experience sleep disorders and examine them in depth.

Sleep patterns and their associations with psychiatric symptoms among Chinese healthcare workers: a latent profile analysis

Background

Healthcare workers often encounter inadequate sleep conditions. However, limited research has examined the underlying sleep patterns among healthcare workers. This study aimed to identify sleep patterns in healthcare workers, explore predictors associated with various sleep patterns, and investigate the relationship between sleep patterns and psychiatric symptoms.

Methods

This cross-sectional study was conducted in Shenzhen, China, from April 2023 to June 2023. In total, data from 1,292 participants were included using a convenience sampling method. A latent profile analysis was conducted to identify sleep patterns based on the seven dimensions of the Pittsburgh Sleep Quality Index. Multinomial logistic regression analysis was conducted to investigate the influence of socio-demographic variables on each profile. A one-way ANOVA test was employed to examine the relationships between sleep patterns and psychiatric symptoms.

Results

Three distinct profiles were identified: good sleepers (63.9%), inefficient sleepers (30.3%), and poor sleepers (5.7%). Multinomial logistic regression analysis indicated that gender and marital status were predictors of various sleep patterns. The ANOVA revealed significant differences in psychiatric symptoms scores among the three sleep patterns; poor sleepers exhibited the highest levels of mental distress.

Conclusion

This study identified three distinct sleep patterns in healthcare workers and their significant associations with psychiatric symptoms. These findings contribute to the development of targeted intervention strategies aimed at improving sleep and reducing psychiatric symptoms among healthcare workers.

Exploring Risk Perception, Mental Health, Mental Fatigue, Stigma, and the Quality of Life among UAE Healthcare Workers during the COVID-19 Pandemic: A National Multicentric Cross-Sectional Study

Globally, the COVID-19 pandemic has presented serious mental health challenges for healthcare professionals. This study investigated the mental health, mental fatigue, quality of life, and stigma of social discrimination among healthcare workers in the United Arab Emirates (UAE) during the COVID-19 pandemic. A correlational, cross-sectional, multi-centric design was employed to collect data from 1383 healthcare workers across various healthcare settings. Participants were recruited using combined cluster and purposive sampling techniques. Standardized questionnaires, including the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ), the Mental Fatigue Scale (MFS), the Social Discrimination Scale-Stigma Subscale (SDS), and the WHO Quality of Life Questionnaire-Brief (WHOQOL-BREF), were administered to assess the study variables. The results indicated significant mental health impacts, with high average scores for post-traumatic stress disorder (PTSD) (9.37 ± 6.74) and positive coping by inner strengths (17.63 ± 5.72). Mental fatigue was prevalent (8.15 ± 8.62), and stigma of social discrimination scored notably (23.83 ± 7.46). Quality of life was the highest in the social domain (65.38 ± 24.58). Significant correlations were observed between mental health subscales, mental fatigue, and quality of life domains. These findings highlight the critical need for targeted mental health support programs, improved social support networks, and personalized interventions to mitigate the mental health challenges faced by healthcare workers. Healthcare organizations can guarantee a resilient workforce that can handle future health crises by giving mental health resources and support systems top priority.

Mediation effect of perceived social support and psychological distress between psychological resilience and sleep quality among Chinese medical staff

Sleep quality is crucial for the personal well-being of healthcare professionals and the health outcomes of their patients. This study aims to explore the relationship between psychological resilience (PR), perceived social support (PSS), psychological distress (comprising anxiety,depression,and stress), and sleep quality. It also examines whether PSS and psychological distress function as chain mediators between PR and sleep quality. A cross-sectional online survey was conducted using a convenient sampling method, with 454 participants included. The survey instruments included the Connor and Davidson Resilience Scale, the Perceived Social Support Scale, the 21-item Depression Anxiety Stress Scale, and the Pittsburgh Sleep Quality Index. Structural equation modeling revealed that PR significantly predicted sleep quality of Chinese medical staff. Psychological distress was identified as a mediating factor between PR and sleep quality. However, PSS did not directly mediate the relationship between PR and sleep quality. Instead, PSS and psychological distress were found to play a chain mediating role in the relationship between PR and sleep quality. This study provides new insights into the impact of PR on sleep quality, highlights the importance of PSS and psychological distress, and suggests practical implications for enhancing sleep quality among medical staff.

Assessment of the importance of sleep quality and the effects of deprivation on Sudanese healthcare professionals amidst conflict in Sudan

Background

Quality sleep is vital for well-being, especially for healthcare workers facing high risks of fatigue and burnout. Sleep deprivation impairs cognitive and motor functions, contributing to medical errors. Addressing sleep disorders among healthcare professionals is crucial for enhancing patient care. Tailored interventions are needed to support their well-being and improve healthcare outcomes.

Objective

To evaluate the effect of Sleep Quality and its Deprivation on Sudanese Healthcare Professionals amidst conflict in Sudan.

Methods

A cross-sectional online survey of Sudanese doctors was conducted using convenience sampling. The questionnaire covered sleep quality, daytime sleepiness, and psychological well-being. Pilot testing ensured questionnaire clarity. Data collection utilized Google Forms distributed through social media and professional networks. A minimum sample size of 384 was calculated. Statistical analysis included descriptive statistics and various tests for significance. Data were securely stored and analyzed using SPSS and R software.

Results

Among 649 participants, 404 (62.2%) were women, with a mean age of 30.34 years. Most were single (434, 66.9%). General practitioners constituted the largest professional group (267, 41.1%), followed by registrars/residents (142, 21.9%). Participants took an average of 43.70 minutes to fall asleep and slept an average of 5.90 hours per night. According to the PSQI, 300 (46.2%) reported mild sleep disturbance, 287 (44.2%) moderate, 42 (6.5%) severe, and only 20 (3.1%) normal sleep. The ESS revealed 285 (43.9%) with lower normal daytime sleepiness, 188 (29.0%) with higher normal, and various levels of excessive daytime sleepiness. Stress levels varied, with 398 (61.3%) reporting normal stress, while anxiety ranged from 248 (38.2%) normal to 148 (22.8%) extremely severe.

Conclusion

This study emphasizes the importance of addressing sleep quality, mental health, and performance challenges among Sudanese healthcare professionals. It highlights the need for hospitals to implement measures enabling more time off, adequate sleep, and reduced on-call service days. Healthcare workers must recognize the significance of these factors for their well-being and patient care quality. The research outcomes can raise awareness about the necessity of regulating healthcare practitioners' working hours and ensuring adequate sleep.

Sleep duration and quality during the COVID-19 pandemic and the association with physical activity and screen time among Brazilian college students

BACKGROUND

As a result of social isolation during the COVID-19 pandemic, changes in sleep patterns have been observed in many countries, as well as changes in physical activity and screen time. The objective was to investigate sleep duration and quality during the COVID-19 pandemic and its association with physical activity and screen time.

METHODS

Cross-sectional study with students from a University in Rio de Janeiro who answered an online questionnaire between August 2020 and March 2021. Physical activity was assessed using IPAQ-SF. Sleep was investigated based on questions about duration and sleep quality change, and screen time through self-reported questions. Multinomial logistic regression was performed to assess the association between physical activity and screen time with sleep duration and quality. Secondary analyses investigated the influence of the isolation time on this association. The confounding factors used were diagnosis of COVID-19, time of isolation, anxiety, depression, skin color, and gender.

RESULTS

A total of 771 college students with a mean age of 24.5 years (±8.6) answered the questionnaire. About 75% reported more than 8 h of screen time per day and 49.8% were physically inactive. Regarding sleep, 54.9% had worsening sleep, while 40.6% had inadequate sleep duration during the pandemic. Physical activity was associated with improved sleep quality (Odds ratio (OR) 1.72; confidence interval (95% CI) 1.05-2.97). Also, physically active students who spent more than 14 weeks in social isolation demonstrated improved sleep quality (OR 1.99; 95% CI 1.02-3.78) compared to physically inactive individuals. No association was observed for sleep duration. No association was observed between screen time and sleep quality, or sleep duration.

CONCLUSION

During the COVID-19 pandemic, there was considerable worsening of sleep quality, and physical activity was positively associated with improved sleep quality.

Sleep Disturbance and Occupational Fatigue in Emergency Nurses of Public Hospitals in Greece: A Cross-Sectional Study

The emergency department (ED) is a stressful workplace for nurses, due to heavy workload and work shifts, which affect sleep quality, causing occupational fatigue. As a result, nurses burn out and turn over and quality of care is impaired. The aim of this study was to investigate sleep disturbance (SD) and occupational fatigue (OF) in emergency nurses of public hospitals in Greece. This descriptive cross-sectional study was conducted in the ED of tertiary public hospitals in Greece from September 2019 to October 2021, after the approval from the scientific and ethical committee of hospitals and the full informed consent of participants. The Standard Shift work Index (SSI) questionnaire was used, which includes 12 question groups about sleep habits and OF evaluation for shift workers, as nurses. Two hundred and ten ED nurses were recruited for the purpose of the study. In this research their quality of life, sleep completeness, and fatigue levels were studied. A moderate level of SD (total score = 70.54) of nurses was found that was related to marital status, presence of children, and underlying diseases (p = 0.012, p = 0.024, and p = 0.002, respectively). OF was assessed at low levels (score = 27.34) and was mainly related to age, with younger nurses reporting less fatigue compared with older nurses. The effect of work shifts in SD and OF of ED nurses was well documented. ED nurses' OF was correlated with increased SD, age, and marital status. Further research is needed for a better assessment and understanding of the factors that influence SD and OF of ED nurses to plan a strategy to optimize sleep patterns of work shift ED nurses.

Sleep Quality between Nurses and the General Population during the COVID-19 Pandemic in Portugal: What Are the Differences?

Although several studies have described the impact of the COVID-19 pandemic, particularly on sleep quality, there are few studies that, in the same time period and using the same assessment tools, compare sleep quality and mental health status between nurses and the general population. Thus, the aim of this study was to (a) examine whether there were differences between nurses and the general population regarding sleep quality and mental health status during the COVID-19 pandemic and (b) identify which factors may explain sleep quality during the COVID-19 pandemic. To do that, we carried out a cross-sectional study in Portugal. Data were collected using an online survey platform during the first COVID-19 wave, from April to August 2020. Nurses presented poorer sleep quality than the general population, as well as higher anxiety levels. Irritability and worries about the future were two of the factors that might explain those differences. Thus, we can conclude that irritability and worries about the future are dimensions of anxiety that were associated with poor sleep quality during the COVID-19 pandemic. Thus, it would be important to adopt regular anxiety and sleep assessments, particularly for nurses, and to implement strategies to reduce this problem.

"We're Not Going to Be as Prepared": A Qualitative Study of Healthcare Trainees' Experiences after One Year of the COVID-19 Pandemic

The COVID-19 pandemic had significant impacts on the mental health and academic experiences of healthcare trainees. Building on findings from earlier in the pandemic, we explore the impacts on healthcare trainees after a sustained pandemic period of 12-14 months, involving multiple lockdowns, changes in government COVID-19 regulations and the delivery of health education. A qualitative study was conducted between March-May 2021. Participants were 12 healthcare trainees (10 women, 2 men) of medicine, nursing, and midwifery, registered at one of three higher education institutions in the United Kingdom. Interviews were fully transcribed, and data were thematically analysed using a combination of deductive and inductive approaches. We identified three key themes with eight subthemes: (i) academic experiences (adjustment to online learning, loss of clinical experience, confidence in the university), (ii) impacts on wellbeing (psychosocial impacts, physical impacts, pandemic duration and multiple lockdowns), and (iii) support frameworks (university preparedness for increased student support needs, importance of relationship with academic tutors). Findings shed light on the long-lasting and emerging impacts of the pandemic over time. We identify support needs for trainees both during their academic studies, and as they move forwards into professional roles within the healthcare workforce. Recommendations are made for higher education institutions and healthcare employers.

A two-mediator serial mediation chain of the association between social isolation and impaired sleep in old age

Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults. We analyzed data from 1201 adults aged ≥ 50 from Ghana's AgeHeaPsyWel-HeaSeeB study (mean age = 66.14, SD = 11.85, age range = 50-111; women = 63.28%). Measures included the UCLA 3-item Loneliness Scale, modified Berkman-Syme Social Network Index, Sleep Quality Scale, and Mental Distress Questionnaire. We used bootstrapping techniques from Hayes' PROCESS macro program to estimate the hypothesized serial mediation. Social isolation was significantly associated with IS (β = 0.242, p < 0.001). Crucially, social isolation indirectly predicted IS via three significant mediating pathways. Loneliness accounted for 17.6% (β = 0.054, CI = 0.096, 0.016), mental distress accounted for 6.5% (β = 0.020, 95% CI = 0.004, 0.040), and loneliness and mental distress accounted for 32.2% (β = 0.099, 95% CI = 0.065, 0.138) of the overall effect. The total mediating effect was 56.4%. These findings suggest that the social isolation-sleep link is respectively and serially explained by loneliness and mental distress. Social integrative interventions for sleep quality in old age should target mental and emotional well-being.