Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses

Int Arch Occup Environ Health. 2012 Nov;85(8):877-84. doi: 10.1007/s00420-011-0730-8. Epub 2011 Dec 30.


Purpose: To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan.

Methods: This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6-10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12).

Results: Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57-3.28; and OR, 1.91; 95% CI, 1.39-2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts.

Conclusion: Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Confidence Intervals
  • Fatigue / etiology
  • Female
  • Health Surveys
  • Humans
  • Mental Health*
  • Middle Aged
  • Nursing / organization & administration*
  • Occupational Health
  • Odds Ratio
  • Personnel Staffing and Scheduling
  • Sleep*
  • Taiwan
  • Work Schedule Tolerance*
  • Young Adult