Sleep problems of healthcare workers in tertiary hospital and influencing factors identified through a multilevel analysis: a cross-sectional study in China

Abstract

ObjectivesSleep problems are common among healthcare workers, especially among those who work in tertiary hospitals; however, studies focusing on healthcare workers in tertiary hospitals in China are limited. Therefore, we aimed to examine the prevalence of sleep problems among tertiary hospital employees in China and identify associated factors.DesignCross-sectional questionnaire survey study.SettingThe study was conducted in 317 departments at 33 tertiary hospitals in the Heilongjiang Province, China.ParticipantsThe study included a representative sample of 4007 healthcare workers, including clinicians, medical technicians and office workers, who were selected using a multistage cluster sampling method. Ultimately, 3810 participants completed valid questionnaires, yielding a response rate of 95%.Primary and secondary outcome measuresParticipants completed a structured questionnaire which collected data regarding demographics, sleep problems, employment, chronic pain and health-related behaviours. A two-level logistic regression model was constructed to examine determinants of sleep problems.ResultsWe found that nearly half of the respondents reported experiencing sleep problems. The two-level logistic model suggested a positive association of sleep problems with headache (OR=2.64, 95% CI=2.27 to 3.07), working hours (OR=1.41, 95% CI=1.20 to 1.66) and night shifts (OR=1.43, 95% CI=1.21 to 1.69). In contrast, regular diet (OR=0.44, 95% CI=0.36 to 0.53) and exercise (OR=0.65, 95% CI=0.53 to 0.80) protected the study population against sleep problems.ConclusionsWe found that sleep problems are prominent among tertiary hospital employees in China. The risk factor most strongly associated with sleep problems was headaches. To alleviate sleep problems in this population, medical institutions and health policy makers should establish reasonable working schedules and night-shift work systems, while the healthcare workers themselves should pay attention to their chronic pain problems and engage in regular diet and exercise.

Headaches Due to Personal Protective Equipment During COVID‐19 Pandemic: A Comment

“…We agree that headache reported by healthcare workers may be associated with sleep problems as well as with psychological distress. 5,6 We agree that these factors might have contributed to the headaches in some participants in our study population. However, the prevalence (81%) of de-novo headaches reported by our PPE donning healthcare workers outweighs the considerably lower prevalence of sleep problems and psychological distress.…”

Job-related factors associated with changes in sleep quality among healthcare workers screening for 2019 novel coronavirus infection: a longitudinal study

“…Sleep disorders are important issues in healthcare, particularly in emergency medicine, primary-care physicians, and infectious disease departments [ 7 ]. Sleep disorders have negative consequences for physicians, their patients, and healthcare facilities due to disturbed moods in the medical staff, daytime dysfunction, medical errors, absenteeism, high rates of turnover, and patient dissatisfaction as a result of the effects on quality of care [ 7 , 8 ]. These healthcare specialists are at high risk of sleep disorders because of work overload, high work-related demands, and complex work environments [ 8 ].…”

“…Sleep disorders have negative consequences for physicians, their patients, and healthcare facilities due to disturbed moods in the medical staff, daytime dysfunction, medical errors, absenteeism, high rates of turnover, and patient dissatisfaction as a result of the effects on quality of care [ 7 , 8 ]. These healthcare specialists are at high risk of sleep disorders because of work overload, high work-related demands, and complex work environments [ 8 ]. The 2019-nCoV healthcare workers have an excessive workload and experience high levels of stress and poor working conditions due to the high infectivity and mortality rates of the 2019-nCoV.…”

“…The work involves the screening of patients for 2019-nCoV infection and being responsible for virus specimen collection. Many non-job-related factors (demographics and lifestyle factors) have been shown to be associated with sleep disorders among healthcare workers [ 8 ]. However, there is a lack of consensus regarding the associations of some job-related factors and work schedule (eg, number of years of practice, total work time, work experience related to other infectious diseases, psychological stress regarding illness) with sleep disturbance [ [9] , [10] , [11] ].…”

Headaches, Personal Protective Equipment, and Psychosocial Factors Associated With COVID‐19 Pandemic

“…3 The individual characteristics of workers, in particular anxiety and depression, significantly influence the reporting of headache. 4 Among health care workers, headache is associated with occupational stress 5 and with sleep problems, 6 as well as with anxiety and depression that were significantly increased during the COVID-19 pandemics. 7 This study did not take into account these variables.…”