Nurses' sleep duration and quality have declined significantly over four decades.

A meta-regression model adjusted results for age, sex, geographic region, shift type (day, night, rotating), and how sleep was measured (self-reported or actigraphy). Sleep duration declined significantly by 28.7 minutes over the study period (95% CI: 26.2–33.1 minutes; effect size 0.43), while global PSQI scores increased by 1.6 points (95% CI: 1.47–1.77; effect size 0.49)—higher PSQI scores indicate worse sleep quality. The researchers attribute these declines to intensified workplace demands in nursing over recent decades. One limitation is reliance on mixed measurement methods across studies, though the model adjusted for this variation. The findings raise concerns about nurse fatigue, clinical performance, burnout, and workplace accidents.

The effect sizes (0.43 for duration, 0.49 for quality) are moderate by epidemiologic standards, indicating a real but not enormous shift—roughly equivalent to losing 30 minutes of sleep per night and a meaningful worsening of sleep architecture and continuity. The decline accelerated in more recent decades: nurses surveyed after 2010 showed larger deficits than those studied in the 1980s–90s. Subgroup analyses by shift type are particularly relevant: night-shift and rotating-shift nurses consistently reported worse sleep than day-shift workers, though the temporal trend persisted across all shift patterns. The PSQI increase of 1.6 points reflects both reduced sleep duration and increased fragmentation, difficulty falling asleep, and daytime dysfunction. The mechanism likely involves circadian misalignment (especially for night-shift work), psychological stress, understaffing, and longer shifts. Geographic variation was significant: nurses in high-income countries and certain regions (e.g., North America, Europe) showed steeper declines than those in some lower-income settings, possibly reflecting different workplace policies and shift patterns.