Association Between Sleep Quality and Subjective Fatigue in Night-Shift Nurses with Good and Poor Sleep

Abstract

This study aimed to explore the association between sleep quality and subjective fatigue in nurses who performed rotational-shift work. A cross-sectional survey was conducted and included nurses working day and night shifts (n = 35) at Toyama University Hospital in Japan. To examine the influence of sleep quality on subjective fatigue, participants were categorized as poor (n = 23) or good (n = 12) sleepers. They assessed their own sleep status using the St Mary’s Hospital Sleep Questionnaire and subjective fatigue following shift changes (holiday to day shift, day shift to day shift, before night shift, after night shift, and day shift to holiday). Poor sleepers’ State-Trait Anxiety Inventory scores were higher relative to those of good sleepers. Moreover, good sleepers recovered from subjective fatigue after sleep following all shift changes. Poor sleepers’ subjective fatigue also reduced after sleep following ‘before night shift’, ‘after night shift’, and ‘day shift to holiday’ shift changes but not ‘holiday to day shift’ or ‘day shift to day shift’ shift changes. Sleep duration was stable across shift changes in good sleepers, and poor sleepers’ sleep durations were significantly longer following ‘before night shift’, ‘after night shift’, and ‘day shift to holiday’ shift changes relative to those following ‘holiday to day shift’ and ‘day shift to day shift’ shift changes. The results suggested that poor sleepers’ subjective fatigue following ‘before night shift’, ‘after night shift’, and ‘day shift to holiday’ could be reduced by increasing sleep duration, indicating that it is important to ensure sufficient sleep duration to improve all nurses’ sleep quality and reduce poor sleepers’ subjective fatigue. Furthermore, sufficient relaxation at bedtime and the reduction of anxiety are important in maintaining good sleep quality.