Characterizing Patterns of Nurses' Daily Sleep Health: a Latent Profile Analysis

Background Nursing is a demanding occupation characterized by dramatic sleep disruptions. Yet most studies on nurses' sleep treat sleep disturbances as a homogenous construct and do not use daily measures to address recall biases. Using person-centered analyses, we examined heterogeneity in nurses' daily sleep patterns in relation to psychological and physical health. Methods Nurses (N = 392; 92% female, mean age = 39.54 years) completed 14 daily sleep diaries to assess sleep duration, efficiency, quality, and nightmare severity, as well as measures of psychological functioning and a blood draw to assess inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP). Using recommended fit indices and a 3-step approach, latent profile analysis was used to identify the best-fitting class solution. Results The best-fitting solution suggested three classes: (1) Poor Overall Sleep (11.2%), (2) Nightmares Only (8.4%), (3) Good Overall Sleep (80.4%). Compared to nurses in the Good Overall Sleep class, nurses in the Poor Overall Sleep or Nightmares Only classes were more likely to be shift workers and had greater stress, PTSD symptoms, depression, anxiety, and insomnia severity. In multivariate models, every one-unit increase in insomnia severity and IL-6 was associated with a 33% and a 21% increase in the odds of being in the Poor Overall Sleep compared to the Good Overall Sleep class, respectively. Conclusion Nurses with more severe and diverse sleep disturbances experience worse health and may be in greatest need of sleep-related and other clinical interventions.

Automated summary

This study examined the daily sleep patterns of nurses in relation to their psychological and physical health. It found that most nurses had good overall sleep, while a minority experienced poor sleep quality and nightmares. Nurses with poor overall sleep or nightmares were more likely to be shift workers and had higher levels of stress, PTSD symptoms, depression, anxiety, and insomnia severity. The severity of insomnia and levels of inflammatory marker IL-6 were associated with an increased likelihood of poor overall sleep.