University of North Texas, Denton, USA.
Oregon State University, Corvallis, USA.
Int J Behav Med. 2022 Oct;29(5):648-658. doi: 10.1007/s12529-021-10048-4. Epub 2022 Jan 5.
Nursing is a demanding occupation characterized by dramatic sleep disruptions. Yet most studies on nurses' sleep treat sleep disturbances as a homogenous construct and do not use daily measures to address recall biases. Using person-centered analyses, we examined heterogeneity in nurses' daily sleep patterns in relation to psychological and physical health.
Nurses (N = 392; 92% female, mean age = 39.54 years) completed 14 daily sleep diaries to assess sleep duration, efficiency, quality, and nightmare severity, as well as measures of psychological functioning and a blood draw to assess inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP). Using recommended fit indices and a 3-step approach, latent profile analysis was used to identify the best-fitting class solution.
The best-fitting solution suggested three classes: (1) "Poor Overall Sleep" (11.2%), (2) "Nightmares Only" (8.4%), (3) "Good Overall Sleep" (80.4%). Compared to nurses in the Good Overall Sleep class, nurses in the Poor Overall Sleep or Nightmares Only classes were more likely to be shift workers and had greater stress, PTSD symptoms, depression, anxiety, and insomnia severity. In multivariate models, every one-unit increase in insomnia severity and IL-6 was associated with a 33% and a 21% increase in the odds of being in the Poor Overall Sleep compared to the Good Overall Sleep class, respectively.
Nurses with more severe and diverse sleep disturbances experience worse health and may be in greatest need of sleep-related and other clinical interventions.
护理是一项要求很高的职业，其特点是睡眠严重中断。然而，大多数关于护士睡眠的研究都将睡眠障碍视为一种同质的结构，并且没有使用日常测量来解决回忆偏差。本研究使用以个体为中心的分析方法，考察了护士日常睡眠模式与心理和身体健康相关的异质性。
共 392 名护士（92%为女性，平均年龄 39.54 岁）完成了 14 天的睡眠日记，以评估睡眠持续时间、效率、质量和噩梦严重程度，以及心理功能测量和血液检查以评估炎症标志物白细胞介素 6（IL-6）和 C 反应蛋白（CRP）。使用推荐的拟合指数和 3 步方法，潜在剖面分析用于确定最佳拟合的类解决方案。
最佳拟合的解决方案表明存在三个类别：（1）“总体睡眠质量差”（11.2%），（2）“仅噩梦”（8.4%），（3）“总体睡眠质量好”（80.4%）。与良好总体睡眠类别中的护士相比，总体睡眠质量差或仅噩梦类别的护士更有可能是轮班工人，并且压力、创伤后应激症状、抑郁、焦虑和失眠严重程度更大。在多变量模型中，与良好总体睡眠类别相比，失眠严重程度和 IL-6 每增加一个单位，与总体睡眠质量差类别的几率分别增加 33%和 21%。
睡眠障碍更严重和多样化的护士健康状况更差，可能最需要睡眠相关和其他临床干预。
