Prevalence of poor sleep quality and its associated factors in nurses: a multicenter cross-sectional study

Although poor sleep quality has been significantly associated with burnout, medical errors, and patient safety, its prevalence and associated factors among nurses remain underexplored. This study aimed to determine the prevalence of poor sleep quality and identify its associated factors in nurses.

In this multicenter cross-sectional study, convenience sampling was employed to enroll nurses from eight tertiary hospitals across Sichuan Province, China, between October and December 2025. Participants completed a demographic questionnaire, the Pittsburgh Sleep Quality Index, the NASA Task Load Index, and the Self-Regulatory Fatigue Scale. Univariate analysis and binary logistic regression were used to examine the correlates of poor sleep quality.

A total of 1,289 nurses were included, with 813 (63.1%) reporting poor sleep quality. Age (31-45 years: OR = 1.628, 95% CI: 1.200-2.209, p = 0.002; 46-60 years: OR = 2.440, 95% CI: 1.608-3.702, p < 0.001), work unit (pediatric ward: OR = 2.063, 95% CI: 1.407-3.024, p < 0.001; intensive care unit: OR = 3.178, 95% CI: 1.993-5.068, p < 0.001; emergency department: OR = 2.492, 95% CI: 1.664-3.732, p < 0.001), work experience (11-20 years: OR = 1.430, 95% CI: 1.031-1.984, p = 0.032; > 20 years: OR = 2.237, 95% CI: 1.422-3.518, p < 0.001), night shift (OR = 1.857, 95% CI: 1.381-2.498, p < 0.001), workload (OR = 1.223, 95% CI: 1.142-1.261, p < 0.001), and self-regulatory fatigue (OR = 1.346, 95% CI: 1.221-1.384, p < 0.001) were identified as significantly associated factors of poor sleep quality in nurses.

Poor sleep quality was highly prevalent among nurses and was significantly associated with age, work unit, work experience, night shift, workload, and self-regulatory fatigue. These findings highlight the importance of prioritizing high-risk populations, particularly older nurses and those working in high-acuity settings, with lengthy service, and on rotating night schedules. Moreover, comprehensive strategies addressing workplace stressors and individual resilience may help reduce sleep problems.