Sleep quality: An evolutionary concept analysis

Nurs Forum. 2022 Jan;57(1):144-151. doi: 10.1111/nuf.12659. Epub 2021 Oct 5.


Aim: To clarify the meaning of the concept sleep quality.

Background: Sleep loss and sleep quality are global health concerns. Poor sleep quality has significant adverse health outcomes. A clarification of the term is necessary to inform patients and healthcare providers, promote consistent theoretical and operational definitions in research, and develop prevention and treatment strategies.

Design: Concept analysis.

Data sources: Scientific literature from electronic databases (CINAHL, PsycINFO, PubMED, Web of Science, and JSTOR) and definitions from online dictionaries.

Review methods: Rodgers' Evolutionary method was applied to guide the concept analysis to identify and determine the attributes, antecedents, and consequences.

Results: Sleep quality is defined as an individual's self-satisfaction with all aspects of the sleep experience. Sleep quality has four attributes: sleep efficiency, sleep latency, sleep duration, and wake after sleep onset. Antecedents include physiological (e.g., age, circadian rhythm, body mass index, NREM, REM), psychological (e.g., stress, anxiety, depression), and environmental factors (e.g., room temperature, television/device use), and family/social commitments. Good sleep quality has positive effects such as feeling rested, normal reflexes, and positive relationships. Poor sleep quality consequences include fatigue, irritability, daytime dysfunction, slowed responses, and increased caffeine/alcohol intake.

Conclusions: Sleep quality is essential, and poor sleep quality contributes to disease and poor health outcomes. Given the extensive consequences of poor sleep quality, nurses and clinicians are vital in instructing the importance of good sleep.

Keywords: circadian rhythm; concept analysis; insomnia; shift work; sleep; sleep disturbance; sleep hygiene; sleep impairment; sleep quality.

MeSH terms

  • Anxiety
  • Anxiety Disorders
  • Concept Formation
  • Health Personnel
  • Humans
  • Sleep Quality*
  • Sleep*