Sleep problems in shift nurses: A brief review and recommendations at both individual and institutional levels

Abstract

Aims: The purposes of this article are (a) to review briefly the current literature on shift nurses' sleep patterns, sleep quality, and the existing interventions implemented in nursing settings; and (b) to propose solutions that target individual nurses, nurse managers, and health care organisations to improve sleep health in shift nurses.

Background: Sleep problems among shift nurses have been recognized increasingly as a significant issue at both the individual and organisational levels. However, the solutions are not well known.

Design: Narrative review.

Methods: A literature search was conducted using the following databases: CINAHL, PubMed, Embase, and Google Scholar from 1986 to 2016, to include original papers that reported studies on shift nurses' sleep problems and interventions.

Results: Thirteen papers were included in this review, which all indicated associations between shift nurses' sleep problems and current intervention practices. Despite the higher prevalence of sleep problems in shift nurses compared to the general population, current interventional practices only focus on bright-light exposure, nap breaks, shift schedule rearrangement, and behavioural interventions.

Conclusions: To address shift nurses' poor sleep quality, we proposed two levels of approach for consideration-the individual level and the management/institutional level. The recommendations include: improving sleep hygiene; providing a low-stimulation sleep environment; conducting rigorous intervention studies to evaluate the effectiveness of a variety of therapies to deal with shift nurses' sleep disturbances; increasing awareness of sleep health of shift nurses; establishing a flexible rotating work schedule; and putting in place policies such as a 15-30 min nap break, social support, and a suitable working environment.

Implications for nursing management: With better awareness and understanding of shift nurses' sleep behaviours, effective interventions can be employed to improve shift nurses' sleep patterns and sleep quality to promote better emotional and health outcomes.

Keywords: individual; institutional; interventions; shift nurse; sleep pattern; sleep problems.