Relationship between sleep-wake patterns, occupational stress and sickness absence among nurses

Individual sleep-wake characteristics play an important role in daily functioning and adaptation to shift work. They are associated with alertness, sleep quality, cognitive performance, concentration, and the ability to cope with occupational demands. High levels of occupational stress and chronic fatigue have also been identified as factors associated with sickness absence among nursing staff.

The aim of the study was to assess the relationship between sleep-wake characteristics, occupational stress, and the use of sick leave in a group of practicing nurses.

The study included 588 male and female nurses employed in three hospitals in the Podkarpackie Voivodeship. A diagnostic survey method was employed, utilizing the Subjective Work Assessment Questionnaire (SWAQ), the Sleep-Wake Pattern Assessment Questionnaire (SWPAQ), and a proprietary questionnaire covering socio-demographic and work-related data. Statistical analysis was performed using non-parametric tests and linear regression.

The SWPAQ scores were generally centered around the midpoint of the scale, indicating no clear predominance of any particular self-reported sleep-wake characteristic.The analysis revealed statistically significant differences in the use of sick leave depending on age (p = 0.0072), marital status (p = 0.0038), having a second job (p = 0.0093), and working overtime (p = 0.0048). As Anytime Wakeability increased, the level of perceived stress decreased. The study found that being male was an independent predictor of higher stress levels. In the multivariate model, men scored on average 16.2 points higher on the stress scale than women. However, it is worth emphasizing that the observed relationship should not be interpreted as the effect of gender alone, but rather as a result of interactions between many coexisting factors, including psychological conditions.

Higher levels of work-related stress were associated with a greater tendency to fall asleep at any time of the day, and with a reduced ability to stay awake. Independent factors associated with higher stress levels included: being male, working a two-shift system, and working overtime. Higher levels of work-related stress were significantly associated with more frequent use of sick leave. Furthermore, a higher frequency of taking sick leave was associated with older age, higher levels of work-related stress, and taking on additional work.