Nurses and midwives' sleep quality and its associated factors during the early COVID-19 pandemic in Iran

Objectives: Good sleep quality is crucial for medical staff especially nurses and midwives to prevent possible errors and injuries during the providing care. The aim here is to investigate the sleep quality of nurses and midwives during the early corona pandemic and its related factors.

Methods: An online observational and cross-sectional study included 340 medical staff who engaged in the treatment of patients with COVID-19 infection in 2020. Participants completed questionnaires about working characteristics, Pittsburgh Sleep Quality Index (PSQI), and Social Support Indexes (SSI). Pearson's correlation analysis and Multivariate logistic regression identified the interactions between these factors.

Results: The mean PSQI and SSI were 8.4 ± 4.46 and 28.6 ± 13.29, respectively, indicating poor sleep quality and moderate social support. The condition of the participants was serious in terms of sleep efficiency, and sleep disturbance. More than half of the participants reported severe and very serious daytime dysfunction. Poor sleep quality was more common, in nurses than in midwives (OR:0.074, CI; 0.032-0.098, P < 0.001), nurses working in intensive care units than in other wards (OR:1.082, CI; 1.003-4.023, P = 0.005), in people who had long shifts (OR:1.757, CI; 1.123-4.323, P = 0.003), and in people working more than 5 years (OR:4.949, CI; 1.673-6.023, P = 0.028). Social support has a statistically significant relationship with the quality of sleep (OR:0.013, CI; 0.001-0.244, P = 0.004).

Conclusion: The sleep quality of the medical staff has been impaired during the epidemic period, especially among nurses. Targeting staff who are more prone to sleep disturbance, such as nurses with longer work experience, helps us design an optimal strategy to support them through sleep hygiene education.