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Lack of sleep linked to rise in nurse depression during COVID-19

US study finds nurses had sleep difficulties worrying about work-related issues

Employers urged to ensure healthy working patterns after US study found many nurses had trouble sleeping during the first six months of the pandemic

Employers have been urged to address workplace stress and ensure healthy working patterns after a study found many nurses had trouble sleeping during the pandemic.

The study – led by New York University’s Rory Meyers College of Nursing – found more than half of nurses had difficulty sleeping during the first six months of the crisis, increasing their odds of experiencing anxiety

Employers urged to ensure healthy working patterns after US study found many nurses had trouble sleeping during the first six months of the pandemic

Employers have been urged to address workplace stress after a US study found many nurses had trouble sleeping during the pandemic
Picture: iStock

Employers have been urged to address workplace stress and ensure healthy working patterns after a study found many nurses had trouble sleeping during the pandemic.

The study – led by New York University’s Rory Meyers College of Nursing – found more than half of nurses had difficulty sleeping during the first six months of the crisis, increasing their odds of experiencing anxiety and depression.

Working long hours and switching between day and night shifts led to less sleep

Nurses described how they were kept awake worrying about work and issues, such as staffing shortages, being redeployed to a COVID unit, lack of personal protective equipment and numerous patient deaths.

Changes in work patterns – such as working extra hours or abruptly switching between day and night shifts – also led to nurses getting less sleep.

Steps employers can take include providing training on stress management and referring staff for mental health support, the researchers said.

They should also ensure nurses have enough time off and protect them from excessive hours and shift patterns that quickly shift between day and night.

Shifts should be as short and as stable as possible, says sleep expert

Sleep expert from the University of Surrey’s Sleep Research Centre Steven Lockley said shift patterns were key in ensuring nurses get enough sleep.

‘Shifts should be as short as possible, especially overnight, and as stable as possible without dramatic swings in timing,’ he told Nursing Standard.

‘The number of night shifts in a row should be limited to two or three and morning shifts should not immediately follow evening shifts.’

Professor Lockley’s sleep tips for nurses

  • Go to bed for at least 7.5 to 8 hours to get the recommended minimum of 7 hours’ sleep per night and ideally longer
  • Do not use electronic devices for 1 to 3 hours before sleep, in bed or if you wake up overnight
  • Be careful with your caffeine intake – little and often is best. Ideally stop consuming it 6 hours before you want to go to bed when working nights and 9 hours when working days/evenings

Pandemic worsened problems for nurses at risk of higher rates of depression

The study featured a survey of 629 US nurses and interviews with 34 nurses in the summer of 2020.

More than one in five – 22% – of those surveyed experienced depression, 52% experienced anxiety, while 55% experienced insomnia. Sleeping for five hours or less before a shift increased the odds of depression, anxiety and insomnia.

Lead author Amy Witkoski Stimpfel said: ‘Nurses are already at risk for higher rates of depression and insufficient sleep compared to other professions. The pandemic seems to have further exacerbated these issues to the detriment of nurses’ well-being.’

Stress and anxiety affects nursing care

A separate study by the University of British Columbia in Canada suggests anxiety, depression, PTSD and burnout among nurses can harm patient care.

Researchers asked more than 10,000 nurses about their mental health and to rate the quality of care at their workplace.

The more severe the mental health symptoms reported by nurses, the more likely they were to rate quality of care as poor.

Source: The Association between Mental Health Symptoms and Quality and Safety of Patient Care before and during COVID-19 among Canadian Nurses (Healthcare 2022)


Find out more

Journal of Occupational and Environment Medicine (2022) Individual and Work Factors Associated with Psychosocial Health of Registered Nurses During the COVID-19 Pandemic


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