Nurses face significant risks of excessive daytime sleepiness (EDS), which adversely affects workplace safety and productivity. Yet, the extent of EDS in this workforce remains inadequately characterized.

The aims of this systematic review were to assess the pooled prevalence of EDS among nurses.

We systematically searched PubMed, Embase, Scopus, and ISI Web of Science for observational studies reporting the prevalence of EDS, as measured by the Epworth Sleepiness Scale (ESS), from database inception to May 1, 2024, with no language restrictions. Study quality was evaluated using JBI's critical appraisal tool. Pooled estimates were calculated through random-effects meta-analysis, with subgroup and meta-regression analyses assessing associations between EDS prevalence and study-level factors. Linear regression modeling was used to assess time trends. This study was registered with PROSPERO (CRD42024535109).

We included 36 unique studies encompassing 2677 nurses from 20 countries. EDS occurred in 14.0%-55.6% of nurses. The results of the meta-analysis showed a pooled prevalence of EDS of 32.2% (95% confidence interval [CI]: 28.5-36.1; I2 = 92.6). Prevalence estimate did not vary substantially in terms of study-level data (i.e., region, country income, pre/post covid era, hospital type, proportion of female nurse, average nursing experience, or proportion of married nurses). The prevalence of EDS in nurses has remained unchanged over time.

This meta-analysis identifies a high global prevalence of EDS among nurses, affecting nearly one-third of this workforce. The findings underscore the urgent need for targeted interventions to mitigate EDS across diverse geographic and economic contexts.

This study highlights the pervasive issue of EDS among nurses worldwide, necessitating comprehensive strategies to address this challenge across all regions, income levels, hospital settings, and demographic groups.

Work-family conflicts and daytime sleepiness are related to the risk of suicide. At present, no study has investigated the relationship between nurses' work-family behavioral role conflict and suicide risk. Moreover, it has not been confirmed whether, considering the effect of daytime sleepiness on suicide risk, daytime sleepiness mediates the effect of work-family behavioral role conflict and suicide risk.

To explore the pathway relationships among nurses' work-family behavioral role conflict, daytime sleepiness, and suicide risk.

Convenience and purposive sampling methods were used to select 750 nurses from six provinces, including Jiangxi, Sichuan, and Shanxi. The work-family behavioral role conflict scale, the Chinese adult daytime sleepiness scale, and the suicide behavior questionnaire were used for the survey. The data were statistically analyzed via SPSS 25.0 software, Pearson correlation analysis was used to explore the correlations between the variables, the PROCESS 4.0 program was used for the mediation effect analysis, and the mediation effect model was tested via the bootstrap method.

Nurses' work-family behavioral role conflict and daytime sleepiness were positively correlated with suicide risk (r = 734, 0.717). Work-family behavioral role conflict positively predicted suicide risk (β = 0.118), and daytime sleepiness positively predicted suicide risk (β = 0.152). Daytime sleepiness partially mediated the role of nurses' work-family behavioral role conflict and suicide risk, with a mediation effect value of 0.046 and a mediation effect accounting for 38.98%.

The results of the Pearson correlation analysis and mediation effect analysis revealed that nurses' work-family behavioral role conflict has a direct effect on suicide risk and indirectly affects suicide risk through daytime drowsiness symptoms.

Whether hours on shift might impact adaptation to night shift work is still controversial.

We conducted a pooled analysis of two studies, including 170 hospital nurses working night shifts, 116 from a United Kingdom study working 12-hour rotating shifts, and 54 from Italy working 8-hour shifts. Both studies used the Epworth Sleepiness Scale (ESS) to detect sleepiness during routine daytime activities as an indicator of fatigue. We compared the prevalence of daytime sleepiness, as indicated by an ESS score≥11, resulting from either shift work schedule. We used logistic regression to calculate the risk of daytime sleepiness associated with 12-hour vs. 8-hour nightshifts, adjusting by age, sex, and parenting children aged≤4.

When comparing similar work circumstances, nightshifts prolonged to 12 hours did not increase the risk of daytime sleepiness compared to 8 hours (OR=0.9, 95% CI 0.32, 2.59).

Our results suggest that 12-hour rotating nightshifts with additional rest days and 8-hour rotating shift schedules do not differ in their impact on daytime sleepiness. Further research is warranted on what strategies might effectively contrast fatigue, circadian misalignment, and the related metabolic changes leading to adverse health outcomes, including cancer.

We investigated the relationship between shift work and excessive daytime sleepiness (EDS) among participants in the Japan Nurses' Health Study (JNHS). Responses of 9,728 female nurses to the 6th follow-up questionnaire were cross-sectionally analyzed. EDS was defined as an Epworth Sleepiness Scale score ≥11. EDS-associated factors were evaluated using Poisson regression analysis after adjustment for multiple confounders. Of the participants (mean age, 52.2 ± 8.0 yr), 28.7% were engaged in shift work, and the overall prevalence of EDS was 24.6%. EDS-associated factors were investigated separately in women aged <40 yr (n=250), 40-59 yr (n=7,467), and ≥60 yr (n=2,011). Current engagement in shift work (prevalence ratio: 1.92 [95% confidence interval: 1.20-3.06], compared with no experience of shift work) and obesity (2.08 [1.11-3.88] for BMI ≥30 and 1.39 [1.02-1.90] for BMI of 25.0-30.0, compared with BMI of 18.5-25.0) showed an independent association with EDS in women aged ≥60 yr. The effect of shift work on EDS in female nurses differed by age, as shift work and obesity contributed to EDS only in older participants. Shift work should be assigned after full consideration of age, sleep, and health status to minimize medical errors.

This study examines the associations between working night shifts and various outcomes, including sleep patterns, healthcare workers' sleep quality, and physical, mental, and social well-being. A descriptive cross-sectional study was conducted, where the findings revealed that night shift healthcare workers experienced poor sleep quality and pattern. In addition, night shift healthcare workers were more likely to express their intent to leave, the impact of work on their social lives, and a low level of job satisfaction. Healthcare workers showed moderate anxiety and mild depression levels. Lower job satisfaction correlated with higher anxiety and depression levels among healthcare workers, while the negative impact of working hours on social life was associated with increased anxiety and depression. Organizations should consider establishing comprehensive wellness initiatives covering work-life balance, stress management strategies, and mental health resources.

Objectives: To gain a comprehensive understanding of the occupational hazards encountered by home health care nurses in Japan and to elucidate the reality of harm they incur, the hazardous situations, and the protective measures taken.

Methods:A questionnaire survey of managers of home health care nursing agencies in Japan was conducted, and 355 valid responses were obtained. The survey questions concerned the occupational hazards experienced by home health care nursing staff. The occupational hazards were classified into 6 categories, and responses were obtained regarding harm, hazardous situations, and protective measures in each category.

Results: The types of harm that occurred at highest rates during the previous 3 years were emotional abuse by the patient or their family members, lower back pain resulting from improper posture while providing care, sexual harassment by the patients and their family members, automobile accidents while traveling to home care sites, and allergic reactions to the environment at home care sites. Some hazardous situations were caused by the unique environments of home care sites.

Conclusions: In order to prevent the occurrence of harm, the development of risk assessment tools, educational initiatives to increase awareness of occupational hazards, and consideration of the financial and technical support that will enable the use of assistive devices in the practice of nursing techniques were considered necessary. The development of effective guidelines and manuals specific to the occupational hazards encountered by home health care nurses is an important challenge.

The response of sleep depth to CPAP in patients with OSA is unpredictable. The odds-ratio-product (ORP) is a continuous index of sleep depth and wake propensity that distinguishes different sleep depths within sleep stages, and different levels of vigilance during stage wake. When expressed as fractions of time spent in different ORP deciles, nine distinctive patterns are found. Only three of these are associated with OSA. We sought to determine whether sleep depth improves on CPAP exclusively in patients with these three ORP patterns.

ORP was measured during the diagnostic and therapeutic components of 576 split-night polysomnographic (PSG) studies. ORP architecture in the diagnostic section was classified into one of the nine possible ORP patterns and the changes in sleep architecture were determined on CPAP for each of these patterns. ORP architecture was similarly determined in the first half of 760 full-night diagnostic PSG studies and the changes in the second half were measured to control for differences in sleep architecture between the early and late portions of sleep time in the absence of CPAP.

Frequency of the three ORP patterns increased progressively with the apnea-hypopnea index. Sleep depth improved significantly on CPAP only in the three ORP patterns associated with OSA. Changes in CPAP in the other six patterns, or in full diagnostic PSG studies, were insignificant or paradoxical.

ORP architecture types can identify patients in whom OSA adversely affects sleep and whose sleep is expected to improve on CPAP therapy.

This study aimed to measure the spectral power differences in the brain rhythms among a group of hospital doctors before and after an overnight on-call duty. Thirty-two healthy doctors who performed regular on-call duty in a tertiary hospital in Sarawak, Malaysia were voluntarily recruited into this study. All participants were interviewed to collect relevant background information, followed by a self-administered questionnaire using Chalder Fatigue Scale and electroencephalogram test before and after an overnight on-call duty. The average overnight sleep duration during the on-call period was 2.2 hours (p<0.001, significantly shorter than usual sleep duration) among the participants. The mean (SD) Chalder Fatigue Scale score of the participants were 10.8 (5.3) before on-call and 18.4 (6.6) after on-call (p-value < 0.001). The theta rhythm showed significant increase in spectral power globally after an overnight on-call duty, especially when measured at eye closure. In contrast, the alpha and beta rhythms showed reduction in spectral power, significantly at temporal region, at eye closure, following an overnight on-call duty. These effects are more statistically significant when we derived the respective relative theta, alpha, and beta values. The finding of this study could be useful for development of electroencephalogram screening tool to detect mental fatigue.

An increasing body of evidence suggests that fatigue among healthcare staff is widespread, owing to a combination of high work intensity, long daytime hours and night-shift working. This has been linked to poorer outcomes for patients and longer inpatient stays, and to increased risks of work-related accidents, errors and injuries for practitioners. These include needlestick injuries and motor vehicle accidents, and other impacts on practitioner health, ranging from cancer, mental health problems, metabolic disorders to coronary disease. Other 24-hour safety-critical industries have fatigue policies that acknowledge the risks of staff fatigue and provide a system to manage it and mitigate harm, but these are still lacking within healthcare. This review explains the basic physiology behind fatigue and outlines its impacts on healthcare practitioners' clinical practice and wellbeing. It proposes methods to minimise these effects for individuals, organisations and the wider UK health service.

As shift workers, nurses are at an increased risk of drowsy driving because of long hours at work and/or short sleep periods between shifts.

In this study, a descriptive cross-sectional cohort design was used to examine the prevalence of drowsy driving among nurses.

An electronic survey was sent to 7,217 nurses of which 2,205 (30.5%) completed the survey. Thirty percent (672 nurses) reported having dozed off while driving during their commute to work. In addition, 44.6% (976) of nurses disclosed feeling unsafe or uncomfortable during their commute due to drowsiness or fatigue.

As shift workers, nurses are subject to drowsy driving and its untoward effects. Healthcare leaders and nurse executives are in a position to evaluate and explore fatigue mitigation strategies such as napping, as this may prove to be beneficial in supporting nurse well-being and public safety.

Burnout and work satisfaction have been shown to be associated with risk of commuting crashes and drowsy driving. Although health care workers (HCWs) were found to have high burnout, no study has yet examined the relationship between burnout and commuting crashes in this occupational group.

The objective of this study was to examine the relationships between burnout, commuting crashes and drowsy driving among HCWs.

A cross-sectional study was conducted among 291 HCWs in a tertiary hospital, using an online survey focusing on burnout subscales, work satisfaction, commuting crashes, and drowsy driving to and from work.

One third of the sample population reported commuting crashes that led to physical, mental, and quality-of-life harms in more than half of them. Burnout was not associated with commuting crashes; however, it was associated with increased drowsy driving. Nurses reported on more physical, emotional, and quality-of-life harms, and administrative staff reported on more physical harm. Low work satisfaction was significantly associated with higher severity of reported mental harm (p = 0.01).

Burnout and commuting crashes are more common among physician and nurses, compared to other HCWs. Work satisfaction and sense of personal accomplishment can reduce the negative outcomes of commuting crashes and may contribute to recovery of HCWs after commuting crashes.