Prevalence and Risk Factors of Shift Work Sleep Disorder Among Healthcare Workers in a Tertiary Hospital in India

Introduction: Shift work, particularly night shifts, disrupts the natural circadian rhythm and homeostatic regulation of sleep, leading to significant health consequences. One of the key disorders associated with shift work is Shift Work Sleep Disorder (SWSD), characterized by excessive sleepiness during work hours and insomnia when attempting to sleep during the day. Healthcare workers are particularly vulnerable due to their demanding and often unpredictable work schedules. The prevalence of SWSD and associated risk factors among healthcare workers in India remains underexplored. This study aimed to assess the prevalence of SWSD symptoms among hospital staff and identify occupational and demographic risk factors contributing to sleep disturbances and fatigue.

Methods: This cross-sectional study was conducted at a private teaching tertiary hospital in Bangalore from September to December, 2024. A total of 318 hospital staff were recruited using stratified random sampling from various departments, including nursing, housekeeping, hospital aides, nursing aides, and laboratory technicians. The inclusion criteria required participants to be under 60 years old and to have worked at least seven night shifts in the past month. Data were collected through structured interviews using standardized tools, including the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. Data was entered in Microsoft Excel and analyzed using SPSS V.21. Descriptive data was represented as frequency and percentages. Chi square test was used to study association between insomnia, fatigue and daytime sleepiness with demographic and work-related characteristics.

Results: Among the 318 participants, 91.2% were female and the majority (54.7%) were between 21–25 years of age. Insomnia symptoms were reported by 39.9% of workers, while clinical insomnia (moderate to severe) was identified in 4.7%. Fatigue symptoms, measured by the FACIT Fatigue Scale, were present in 4.7%, with nursing aides (19.6%) reporting the highest levels of fatigue. Excessive daytime sleepiness (EDS), as measured by the ESS, was observed in 19.8% of participants, with 2.8% requiring medical attention due to severe sleepiness. Several occupational factors were significantly associated with fatigue and excessive daytime sleepiness, including working more than 8 hours per shift, frequent night shifts (more than twice per month), and prolonged 12-hour shifts without sufficient rest periods (p < 0.05). However, insomnia symptoms were not significantly associated with socio-demographic factors such as place of residence, marital status or mode of transport.

Conclusion: A significant proportion of healthcare workers experience insomnia, fatigue and excessive daytime sleepiness all of which can impact their health and job performance. The findings underscore the urgent need for workplace interventions to address shift work-related sleep disorders, including modifying work schedules, ensuring adequate rest breaks, and providing sleep health education. Implementing these changes could improve staff well-being, job efficiency and patient safety in healthcare settings.

Publication History

Article published online:
08 October 2025