Sleep Quality among Nurses during the First Year of Coronavirus Disease 2019


  • Wafa Ibrahim Alharbi Family Medicine Resident, National Guard Hospital Program, Almadinah Almunawwarah, Saudi Arabia
  • Amani Mahrus Department of Family and Community Medicine, Prince Mohammed Ben Abdulaziz Hospital, Almadinah Almunawwarah, Saudi Arabia
  • Shadia Elsayed Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, Saudi Arabia; Department of Oral and Maxillofacial Surgery, Al-Azhar University, Cairo, Egypt
  • Albraa B. Alolayan Department of Oral and Maxillofacial Surgery, Taibah University, Almadinah Almunawwarah, Saudi Arabia



Sleep disturbance, Pittsburgh, Sleep Quality Index, Nurses


BACKGROUND: Nurses represent the largest section of the health-care workforce, and lack of sleep has an adverse influence on them, particularly during pandemics such as coronavirus disease 2019 (COVID-19). It causes not only health problem but also poor work results and an increased risk of medical errors.

AIM: The goal of the study was to determine the prevalence of poor sleep quality among nurses during COVID-19 outbreaks.

MATERIALS AND METHODS: A cross-sectional analysis was conducted among a group of nurses in the Al-Madinah region of Saudi Arabia at the National Guard Health Affairs in 2020 (1st year of the COVID-19 crisis). Data were collected using a validated questionnaire with two sections: Sociodemographic data such as age, nationality, family status, gender, and the Pittsburgh Sleep Quality Index.

RESULTS: There were 238 nurses in the report. 37.8% of them were found to be between the ages of 31 and 35, while 24.4% were under the age of 30. The nurses were mostly female (84%). Sleep latency, sleep disruption, overall subjective sleep quality, and sleep length were the most widely identified sleep problems. Sixty-six percent of the nurses said they had a poor night’s sleep. None of the demographic variables analyzed had a significant relationship with overall sleep quality.

CONCLUSION: Majority of nurses working at the National Guard Health Affairs and primary health-care centers in Al-Medina, Saudi Arabia, experience poor sleep quality, during the 1st year of COVID-19 crisis regardless of their demographic characteristics.


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Elsayed SA, Abu-Hammad O, Alolayan AB, Eldeen YS, Dar- Odeh N. Fallacies and facts around COVID-19: The multifaceted infection. J Craniofac Surg. 2020;31(6):e643-4. PMid:32649559

Elsayed SA, Abu-Hammad O, Alolayan AB, Althagafi N, Ayed Y, Eldeen YS, et al. Getting to know SARS-CoV-2: Towards a better understanding of the factors influencing transmission. Pesqui Bras Odontopediatr Clin Integr. 2020;20:1-7.

Dar-Odeh N, Elsayed S, Babkair H, Abu-Hammad S, Althagafi N, Bahabri R, et al. What the dental practitioner needs to know about pharmaco-therapeutic modalities of COVID-19 treatment: A review. J Dent Sci. 2020;16(3):806-16. PMid:33230404

Horesh D, Brown AD. Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities. Psychol Trauma. 2020;12(4):331-5. PMid:32271070

Wondie T, Molla A, Mulat H, Damene W, Bekele M, Madoro D, et al. Magnitude and correlates of sleep quality among undergraduate medical students in Ethiopia: Cross sectional study. Sleep Sci Pract. 2021;5:7.

Cho H, Pavek K, Steege L. Workplace verbal abuse, nurse-reported quality of care and patient safety outcomes among early-career hospital nurses. J Nurs Manag. 2020;28(6):1250-8. PMid:32564407

McLeod S. Maslow’s Hierarchy of Needs Simply Psychology; 2007. Available from:

Edwards J. The Importance of Quality Sleep how it Affects Your Health. Volunteer Protection Programs Particip Associate Inc,; 2019. Available from:

Gaba DM, Howard SK. Fatigue among clinicians and the safety of patients. N Engl J Med. 2002;347(16):1249-55. PMid:12393823

Rogers AE. The effects of fatigue and sleepiness on nurse performance and patient safety. In: Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality US; 2008. p. 1-38.

Shao MF, Chou YC, Yeh MY, Tzeng WC. Sleep quality and quality of life in female shift-working nurses. J Adv Nurs. 2010;66(7):1565-72. PMid:20492021

Alqarni AB, Alzahrani NJ, Alsofyani MA. The interaction between sleep quality and academic performance among the medical students in Taif university. Egypt J Hosp Med. 2018;70:2202-8.

Ibrahim NK, Badawi FA, Mansouri YM, Ainousa AM, Jambi SK, et al. Sleep quality among medical students at king Abdulaziz university: A cross-sectional study. J Community Med Health Educ. 2017;7:561.

Olawale O, Taiwo O, Hesham A. Quality of sleep and well-being of health workers in Najran, Saudi Arabia. Indian J Psychiatry. 2017;59(3):347-51. IndianJPsychiatry_241_16 PMid:29085095

Chien PL, Su HF, Hsieh PC, Siao RY, Ling PY, Jou HJ. Sleep quality among female hospital staff nurses. Sleep Disord. 2013;2013:283490.

McDowall K, Murphy E, Anderson K. The impact of shift work on sleep quality among nurses. Occup Med (Lond). 2017;67(8):621-5. PMid:29040745

Aliyu I, Ibrahim ZF, Teslim LO, Okhiwu H, Peter ID, Michael GC. Sleep quality among nurses in a tertiary hospital in North-West Nigeria. Niger Postgrad Med J. 2017;24(3):168-73. PMid:29082906

Park E, Lee HY, Park CS. Association between sleep quality and nurse productivity among Korean clinical nurses. J Nurs Manag. 2018;26(8):1051-8. PMid:29855101

Surani S, Murphy J, Shah A. Sleepy nurses: Are we willing to accept the challenge today? Nurs Adm Q. 2007;31(2):146-51. PMid:17413508

Malik AA, Bakarman MA, Butt NS. Construct validity and factor structure of the Pittsburgh Sleep Quality Index (PSQI) among physicians in Jeddah, Kingdom of Saudi Arabia. Pakistan J Stat Oper Res. 2018;14:935-43.

Mahfouz MS, Ali SA, Bahari AY, Ajeebi RE, Sabei HJ, Somaily SY, et al. Association between sleep quality and physical activity in Saudi Arabian university students. Nat Sci Sleep. 2020;12:775-82. PMid:33117013

AlSaif HI. Prevalence of and risk factors for poor sleep quality among residents in training in KSA. J Taibah Univ Med Sci. 2019;14(1):52-9. PMid:31435390

Dong H, Zhang Q, Zhu C, Lv Q. Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: A cross-sectional study. Health Qual Life Outcomes. 2020;18:1-9.

Dong H, Zhang Q, Sun Z, Sang F, Xu Y. Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. BMC Psychiatry. 2017;17(1):241. PMid:28673267

Kolo E, Ahmed A, Hamisu A, Ajiya A, Akhiwu B. Sleep health of healthcare workers in Kano, Nigeria. Niger J Clin Pract. 2017;20(4):479-83. PMid:28406131

Ghalichi L, Pournik O, Ghaffari M, Vingard E. Sleep quality among health care workers. Arch Iran Med. 2013;16(2):100-3. PMid:23360632

Sher L. COVID-19, anxiety, sleep disturbances and suicide. Sleep Med. 2020;70:124. PMid:32408252

de Silva ES, Ono BH, Souza JC. Sleep and immunity in times of COVID-19. Rev Assoc Med Bras. 2020;66(Suppl 2):143-7. PMid:32965373

Deng J, Zhou F, Hou W, Silver Z, Wong CY, Chang O, et al. The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: A meta-analysis. Ann N Y Acad Sci. 2021;1486(1):90-111. PMid:33009668

Marelli S, Castelnuovo A, Somma A, Castronovo V, Mombelli S, Bottoni D, et al. Impact of COVID-19 lockdown on sleep quality in university students and administration staff. J Neurol. 2021;268(1):8-15. PMid:32654065

Salehi K, Alhani F, Sadegh-Niat K, Mahmoudifar Y, Rouhi N. Quality of sleep and related factors among imam khomeini hospital staff nurses. IJN. 2010;23:18-25.

Stimpfel AW, Fatehi F, Kovner C. Nurses’ sleep, work hours, and patient care quality, and safety. Sleep Health. 2020;6(3):314-20. PMid:31838021

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. PSQI article.pdf. Psychiatry Res. 1998;28(2):193-213. PMid:2748771

De Martino MM, Abreu AC, dos Barbosa MF, Teixeira JE. The relationship between shift work and sleep patterns in nurses. Cien Saude Colet 2013;18(3):763-8. PMid:23546203

Flo E, Pallesen S, Magerøy N, Moen BE, Grønli J, Nordhus IH, et al. Shift work disorder in nurses--assessment, prevalence and related health problems. PLoS One. 2012;7(4):e33981. PMid:22485153

Lin PC, Chen CH, Pan SM, Pan CH, Chen CJ, Chen YM, et al. Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses. Int Arch Occup Environ Health. 2012;85(8):877-84. PMid:22207296

Roodbandi AS, Feyzi V, Khanjani N, Moghadam SR, Bafghi MS, Moghadasi M, et al. Sleep quality and sleepiness: A comparison between nurses with and without shift work, and university employees. Int J Occup Hyg. 2017;8:8.

Sveinsdóttir H. Self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction of female nurses working different combination of shifts. Scand J Caring Sci. 2006;20(2):229-37. PMid:16756530

Bagheri H, Shahabi Z, Ebrahimi H, Alaeenejad F. The association between quality of sleep and health-related quality of life in nurses. Tums Hayat. 2007;12:13-20.

Najimi A, Goudarzi AM, Sharifirad G. Causes of job stress in nurses: A cross-sectional study. Iran J Nurs Midwifery Res. 2012;17(4):301-5. PMid:23833631

Sepehrmanesh Z, Mousavi G, Saberi H, Saei R. Sleep quality and related factors among the nurses of the hospital of Kashan university of medical sciences, Iran YR 2017/1/1. Int Arch Heal Sci. 2017;4:17-21.

Christian FG, Muppavarapu K, Aston C, Bauer C, Doshi V. 0630 sleep health of nursing staff in an academic medical center: Results of a survey study. Sleep. 2019;42:A251-1.

Fitzgerald T, Vietri J. Residual effects of sleep medications are commonly reported and associated with impaired patient-reported outcomes among insomnia patients in the United States. Sleep Disord. 2015;2015:607148. PMid:26783470

Gómez-García T, Ruzafa-Martínez M, Fuentelsaz-Gallego C, Madrid JA, Rol MA, Martínez-Madrid MJ, et al. Nurses’ sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts. BMJ Open. 2016;6:e012073.

Poceta JS. Zolpidem ingestion, automatisms, and sleep driving: A clinical and legal case series. J Clin Sleep Med. 2011;7(6):632-8. PMid:22171202

Roth AJ, McCall WV, Liguori A. Cognitive, psychomotor and polysomnographic effects of trazodone in primary insomniacs. J Sleep Res. 2011;20(4):552-8. PMid:21623982

Korompeli A, Chara T, Chrysoula L, Sourtzi P. Sleep disturbance in nursing personnel working shifts. Nurs Forum. 2013;48(1):45-53. PMid:23379395

Zhang L, Sun DM, Li CB, Tao MF. Influencing factors for sleep quality among shift-working nurses: A cross-sectional study in china using 3-factor Pittsburgh sleep quality index. Asian Nurs Res (Korean Soc Nurs Sci). 2016;10(4):277-82. PMid:28057314

Chan MF. Factors associated with perceived sleep quality of nurses working on rotating shifts. J Clin Nurs. 2009;18(2):285- 93. PMid:19120755

Kageyama T, Nishikido N, Kobayashi T, Oga J, Kawashima M. Cross-sectional survey on risk factors for insomnia in Japanese female hospital nurses working rapidly rotating shift systems. J Hum Ergol (Tokyo). 2001;30(1-2):149-54. PMid:14564874




How to Cite

Alharbi WI, Mahrus A, Elsayed S, Alolayan AB. Sleep Quality among Nurses during the First Year of Coronavirus Disease 2019. Open Access Maced J Med Sci [Internet]. 2021 Oct. 3 [cited 2022 Jan. 28];9(G):128-34. Available from:



Nursing in Internal Medicine