The Impact of Shift Work, Stress, and Depression on Poor Sleep Quality Among Healthcare Workers: A Meta-Analysis
Keywords:
shift work, stress, depression, sleep quality, healthcare workersAbstract
Poor sleep quality is a major risk factor for healthcare workers. Research suggests that psychological and occupational issues such as depression, stress, and shift work are major contributing factors. The purpose of this meta-analysis is to ascertain how shift work, stress, and depression affect healthcare professionals' risk of experiencing poor sleep quality. Based on the PICO framework, this meta-analysis included nine cross-sectional studies from Ethiopia, Turkey, Thailand, Somalia, and Saudi Arabia. Population: healthcare workers, with a total sample size of 6,135. Intervention: shift work, stress, and depression. Comparison: no shift work, no stress, and no depression. Outcome: poor sleep quality. The databases used included Google Scholar and PubMed. The inclusion criteria were full-text articles with observational study design using multivariate analysis that attaches aOR values and is published from 2019-2025. The keywords used in the primary data search were "Sleep quality" AND "Healthcare workers" OR "Health personnel" OR "Medical staff" AND "Cross-sectional study" AND "aOR" OR "Adjusted odds ratio". Statistical analysis was performed using a fixed-effects model to combine odds ratios in RevMan 5.3 software. The meta-analysis found that shift work significantly increases the odds of poor sleep quality (aOR= 1.42; CI 95%= 1.32 to 1.53; p< 0.001). High stress was associated with more than double the odds of poor sleep (aOR= 2.02; CI 95%= 1.46 to 2.79; p< 0.001). The most substantial effect was observed for depression, which nearly tripled the odds (aOR= 2.61; CI95%= 1.92 to 3.54; p< 0.001). Funnel plot indicated slight publication bias on shift work effect estimate. Shift work, stress, and depression were all significant and strong predictors of poor sleep quality among healthcare workers, with depression showing the strongest association. These findings suggest that healthcare institutions should implement better shift schedules, create mental health support programs, and add sleep health checks for their staff.
References
Abate, H., Letta, S., Worku, T., Tesfaye, D., Amare, E., & Mechal, A. (2023). Shiftwork sleep disorder and associated factors among nurses working at public hospitals in Harari Regional state and Dire Dawa Administration, Eastern Ethiopia: a cross-sectional study. BMC Nursing, 22(1), 1–9. https://doi.org/10.1186/s12912-023-01257-1
Alghamdi, L. A., Alsubhi, L. S., Alghamdi, R. M., Aljahdaly, N. M., Barashid, M. M., Wazira, L. A., Batawi, G. A.,
Manzar, M. D., Alshumrani, R. A., Alhejaili, F. F., & Wali, S. O. (2024). Prevalence of poor sleep quality among physicians and nurses in a tertiary health care center. Journal of Taibah University Medical Sciences, 19(3), 473–481. https://doi.org/10.1016/j.jtumed.2024.03.003
Alshahrani, N. Z., Alarifi, A. M., Alotaibi, W. S., Alsayed, A. A., Alwasm, K. S. L., Alhunti, A. A., AlDahleh, L. A.,
Alshahrani, M. M. A., Albeshry, A. M., & Aljunaid, M. A. (2024). Prevalence and Correlates of Poor Sleep Quality Among Psychiatry Physicians in Saudi Arabia: A Cross-Sectional Study. Health Science Reports, 7(11), 1–13. https://doi.org/10.1002/hsr2.70170
Getu, A. A., Tesfaye, W., Yeshaw, Y., & Addis, Y. (2022). Sleep Deprivation among Health-Care Workers: A
Cross-sectional Study at the University of Gondar Comprehensive Specialized Hospital. 1–16. https://doi.org/10.21203/rs.3.rs-1516915/v1
Güngördü, N., Kurtul, S., & Erdoğan, M. S. (2023). Evaluation of Sleep Quality, Work Stress and Related Factors in ps://doi.org/10.23749/mdl.v114i3.14033
Mohamud, R. Y. H., Mohamed, N. A., Abdi, A. A., Osman, I. M., Ali, A. N., Doğan, S., Mohamud, S. M., & Orhan, Z. (2025). Prevalence and Associated Factors of Poor Sleep Quality Among Nurses in a Tertiary Care Hospital: A Cross-Sectional Study. Risk Management and Healthcare Policy, 18(February), 975–986. https://doi.org/10.2147/RMHP.S511543
Segon, T., Kerebih, H., Gashawu, F., Tesfaye, B., Nakie, G., & Anbesaw, T. (2022). Sleep quality and associated factors among nurses working at comprehensive specialized hospitals in Northwest, Ethiopia. Frontiers in Psychiatry, 13(August), 1–10. https://doi.org/10.3389/fpsyt.2022.931588
Sirinara, P., Hanprathet, N., Pongpirul, K., & Jiamjarasrangsi, W. (2019). Impact of shift work on sleep quality among staff. Chulalongkorn Medical Journal, 63(4), 221–227. https://doi.org/10.14456/clmj.2019.14
Tsegay, Y., Arefayne, N. R., Fentie, D. Y., Workie, M. M., Tegegne, B. A., & Berhe, Y. W. (2023). Assessment of sleep quality and its factors among clinicians working in critical care units and operation theaters at North West Ethiopia, 2022: a multicenter cross-sectional study. Annals of Medicine & Surgery, 85(8), 3870–3879. https://doi.org/10.1097/ms9.0000000000001071
