Individual differences in sleep-wake habits and sleep quality among nursing home employees

Background: Nursing home employees work long or irregular shifts, resulting in abnormal sleep-wake patterns, decreased sleep quantity and quality. Epidemiologic studies of health effects require accurate characterization of sleep-wake patterns and sleep quality, in relation to work schedules and family responsibilities. The extent of individual variability has rarely been described.

Methods: Questionnaires were collected from employees in 24 nursing homes. Sleep-wake patterns were assessed from the number of sleep periods per day. Sleep duration, quality, insufficiency, and interference with daily functioning were collected. 

Results: Among 2,642 employees, 28% reported getting sleep at two or more different times, and poor quality; 40% reported short duration and sleep insufficiency; and 62% reported sleep interference with daily functioning. Getting sleep at two or more different times was more prevalent in black and other “minority” groups, and among employees who worked night shifts, or had children or dependents. Short sleep duration was more prevalent among younger employees working night or rotating shifts, and those responsible for children or dependents. Poor sleep quality and sleep insufficiency were associated with younger age, female, white, non-Hispanic, working night or rotating shifts, and having children or dependents. Sleep interference with daily functioning was more frequently reported among younger, female, single, white employees, and those working night or rotating shifts, or having children or dependents.

Conclusions: Sleep-wake habits and quality were distributed differently among nursing home employees. Job and family characteristics need to be taken into account when developing interventions to reduce "sleep disparities" and promote employees' sleep health.