Sleep Quality in Shift-Working Nurses: Subjective and Objective Evaluation

It is well-known that rotating shift work disrupts the circadian rhythm and sleep quality in nurses. With this study, we aimed to compare subjectively and objectively measured sleep quality in nurses, specifically focusing on any differences that arose in relation to shift work.

This prospective, observational, cross-sectional study was conducted in 2025 in Croatia; a total of 140 nurses participated. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and FitBit Charge 3 smartwatch, which monitored sleep over an eight-day period.

Most nurses rated their sleep as good or very good, but according to the PSQI questionnaire, all participants were classified as poor sleepers (PSQI > 5). Objective smartwatch measurements showed that nurses working only day shifts had higher sleep scores (median 77, IQR 75-80 vs. 73, IQR 68-76; p < 0.001), significantly longer total sleep duration (median 6.4, IQR 6.3-7.1 vs. 5.5, IQR 5.2-6.2 h; p < 0.001), and longer durations of all sleep stages compared with those working rotating shifts.

Most nurses subjectively rated their sleep as good or very good; however, according to the PSQI questionnaire results, all were classified as poor sleepers, with no significant difference related to shift work. Objective measurements using the smartwatch indicated that rotating shift work is associated with significantly poorer sleep quality.