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Sleep Quality in Shift-Working Nurses: Subjective and Objective Evaluation.
Željka Dujmić1,2,3, Štefica Mikšić1, Ivana Barać1
1Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
International Journal of Environmental Research and Public Health
|January 28, 2026
Summary
Rotating shift work significantly impairs nurses' sleep quality, despite subjective reports. Objective smartwatch data revealed poorer sleep duration and stages in rotating shift nurses compared to day shift nurses.
Area of Science:
- Nursing research
- Sleep science
- Chronobiology
Background:
- Rotating shift work is known to disrupt circadian rhythms and sleep quality in nurses.
- Previous studies highlight the negative impact of shift work on healthcare professionals' well-being.
- Understanding the nuances of sleep quality in nurses is crucial for improving occupational health.
Purpose of the Study:
- To compare subjective and objective sleep quality in nurses.
- To investigate differences in sleep quality related to rotating shift work versus day shifts.
- To assess the validity of subjective sleep ratings against objective measures.
Main Methods:
- Prospective, observational, cross-sectional study conducted in Croatia in 2025.
- 140 nurses participated, assessed using the Pittsburgh Sleep Quality Index (PSQI) and FitBit Charge 3 smartwatches.
- Sleep was monitored objectively over an eight-day period.
Main Results:
- Subjectively, most nurses reported good or very good sleep quality.
- Objectively, all nurses were classified as poor sleepers (PSQI > 5).
- Nurses on day shifts exhibited significantly better sleep scores, longer total sleep duration, and improved sleep stage durations compared to rotating shift nurses.
Conclusions:
- Subjective sleep ratings in nurses may not accurately reflect objective sleep quality.
- Rotating shift work is associated with objectively poorer sleep quality, including reduced duration and altered sleep stages.
- Objective sleep monitoring is essential for a comprehensive understanding of shift work's impact on nurses' sleep.
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