Background: Nursing staff are on the front line of providing healthcare that addresses patients' needs. Sleep quality is highly related to work performance and quality of life among nurses.Aims: This study aimed to examine the influence of sociodemographic variables, menopause syndrome, and health-promoting behaviors on sleep quality in a sample of middle-aged nurses in China. Methods: A cross-sectional design was employed. A consecutive sample of 424 nurses was recruited from a university-affiliated hospital in Bengbu, China. Self-reported, structured questionnaires, including sociodemographic surveys, the Kupperman Menopausal Index, the Health Promoting Lifestyle Profile II, and the Pittsburgh Sleep Quality Index, were administered between October 2018 and July 2019. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Results: Study participants had a mean sleep quality level of 5.30 points (SD = 3.16), indicating potential sleep problems. The results of regression models showed that menopause syndrome and spiritual growth were important predictors of sleep quality for premenopause, perimenopause, and postmenopause groups. Conclusion: Middle-aged nurses with more severe menopause syndrome and less spiritual growth might experience worse sleep quality. Relevance to clinical practice: This study highlights important factors influencing the level of sleep quality in Chinese middle-aged nurses. Identifying the factors that are associated with sleep quality may help with the development of proper interventions.