Prevalence of sleep disturbance and associated factors among nurses in Chinese tertiary public hospitals: a national cross-sectional study

Background: Sleep disturbance is a critical occupational health issue among nurses, jeopardizing their well-being and patient safety. Identifying its prevalence and modifiable factors is essential for developing effective interventions. Objectives: This study aimed to determine the national prevalence of sleep disturbance and explore associated demographic, occupational, and behavioral factors among Chinese nurses. Methods: In this nationwide cross-sectional study, we analyzed baseline data from the Nurses' Mental Health Study (NMHS), a primary database established and maintained by the authors. A total of 132,910 nurses from 67 tertiary public hospitals in China were included between December 2023 and January 2024. Data were collected electronically via a structured questionnaire. Chi-square tests and binary logistic regression were used to identify factors associated with sleep disturbances. Results: The overall prevalence of sleep disturbances was 24.1%. Difficulty initiating sleep (13.3%), difficulty maintaining sleep (15.5%), and early morning awakening (15.4%) were most common, with higher rates in critical care, emergency, pediatrics, and obstetrics. Factors associated with increased odds of sleep disturbance included age (30-39 years), female sex, intermediate professional title, lower education, longer working experience, night shift work, smoking, alcohol use, and physical inactivity. Conclusion: Sleep disturbance is prevalent among Chinese nurses and associated with scheduling patterns and health behaviors. To mitigate risk, healthcare organizations should optimize shift schedules, enhance support for high-risk nurses, and allocate resources to high-burden clinical departments. Nurses are also encouraged to adopt healthier lifestyles to improve sleep quality and occupational safety. Clinical trial registration: Identifier ChiCTR2300072142.