Prevalence of Insomnia and Daytime Sleepiness among Healthcare Professionals: A Cross-sectional Study
Keywords:
Health Personnel;Sleep Initiation and Maintenance Disorders;Sleep Hygiene; Surveillance of the Workers Health;Occupational Health.
Abstract
Objectives: To analyse the prevalence of insomnia and daytime sleepiness among healthcare professionals working at a tertiary-level hospital in Barcelona.
Methods: An observational, descriptive, cross-sectional study was conducted using an anonymous survey administered to healthcare professionals at Hospital Clínic of Barcelona between January and April 2025. The Insomnia Severity Index (ISI; range 0–28) and the Epworth Sleepiness Scale (ESS; range 0–24) were applied, together with sociodemographic variables (age, sex, work shift, and professional category). Frequencies were calculated and comparisons between groups were performed.
Results: A total of 154 complete questionnaires were analysed. The sample was predominantly female (81.8%), with the most frequent age group being 41–50 years (33.8%). The overall prevalence of insomnia was 83.8% (45.5% mild, 33.8% moderate, and 4.5% severe). Insomnia prevalence was higher among men than women (89.3% vs 82.5%), although this difference was not statistically significant (p=0.381). Insomnia was more frequent in participants aged <50 years compared with those aged ≥50 years (88.6% vs 77.3%;p=0.058), with no significant differences according to work shift. Pathological daytime sleepiness was observed in 41.6% of participants and was slightly more frequent in women (42.9% vs 35.7%;p=0.488). Daytime sleepiness was more prevalent among participants aged ≥50 years (45.5% vs 38.6%), with significantly higher mean ESS scores (10.23 ± 4.24 vs 8.76 ± 4.94;p=0.025).
Conclusions: This study reveals a high prevalence of insomnia and daytime sleepiness among healthcare professionals, reinforcing the need to implement specific strategies for the detection, prevention, and promotion of sleep health within the hospital setting.
References
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25. Maganto-Fraile A, Alcañiz-Martín F, de Priso-Sañudo S, Mayoral-Buendía A. Características del sueño en trabajadores sanitarios de hospitales de Madrid Sur. Med Segur Trab. [Internet]. 2023 [Cited 2025 oct 5];69(270):12–27. doi:10.4321/s0465-546x2023000100003
26. Stimpfel AW, Fatehi F, Kovner C. Nurses' sleep, work hours, and patient care quality and safety. Sleep Health. [Internet]. 2020 [Cited 2025 oct 5];6(3):314–20. doi:10.1016/j.sleh.2019.11.001
27. Jehan S, Zizi F, Pandi-Perumal SR, Wall S, Auguste E, Myers AK, et al. Shift work and sleep: Medical implications and management. Sleep Med Disord Int J. [Internet]. 2017 [Cited 2025 oct 5];1(2):1–8. doi:10.15406/smdij.2017.01.00008
28. Mober SMA, et al. The impact of shift work on nurses’ well-being and patient care excellence in inpatient settings. Br J Nurs Stud. [Internet]. 2024 [Cited 2025 oct 5]; 4(2):95–105. doi:10.32996/bjns.2024.4.2.11
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32. Mayers AG, Grabau EA, Campbell C, Baldwin DS. Subjective sleep, depression, and anxiety: interrelationships in a non-clinical sample. Hum Psychopharmacol. [Internet]. 2009 [Cited 2025 oct 5]; 24(6):495–501. doi:10.1002/hup.1041
33. Bell J, Curtis K, Page S. Fatigue in nurses and medication administration errors: A scoping review. J Clin Nurs. [Internet]. 2023 [Cited 2025 oct 5]; 32(13–14):2871–81. doi: 10.1111/jocn.16620
34. Moreno-Casbas MT, et al. Percepción sobre la calidad de los cuidados, entorno laboral y características del sueño de las enfermeras del Sistema Nacional de Salud. Enferm Clin. [Internet]. 2018 [Cited 2025 oct 5];28(4):210–7. doi:10.1016/j.enfcli.2018.01.001
35. Yu X, et al. Shift work sleep disorder in nurses: A concept analysis. BMC Nurs. [Internet] 2025 [Cited 2025 oct 5];24:99. doi:10.1186/s12912-024-02651-z
36. Instituto Nacional de Seguridad y Salud en el Trabajo (INSST). Trabajo a turnos y nocturno: riesgos para la seguridad y la salud. [Internet]. 2019 [Cited 2025 oct 5]. Disponible: https://www.insst.es
37. Castillo-Guerra B, Guiance-Gómez LM, Méndez-Pérez C, Pérez-Aguilera AF. Impacto de los turnos de trabajo en la calidad del sueño del personal de enfermería en dos hospitales de tercer nivel de canarias. Med Segur Trab [Internet]. 2022 [Cited 2025 oct 5];68(267):105-117. doi:10.4321/s0465-546x202200020003
38. Rodríguez González-Moro MT, Gallego-Gómez JI, Vera Catalán T., López López ML, Marín Sánchez MC, Simonelli-Muñoz AJ. Somnolencia diurna excesiva e higiene del sueño en adultos trabajadores en España. Anales Sis San Navarra [Internet]. 2018 [Cited 2025 oct 5];41(3):329-338. doi:10.23938/assn.0378
39. Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int [Internet]. 2012 [Cited 2025 oct 5];29(2):211–219. doi:10.3109/07420528.2011.645752
40. Silva RMD, Zeitoune RCG, Beck CLC, Martino MMFD, Prestes FC, Loro MM. Chronotype and work shift in nursing workers of university hospitals. Rev Bras Enferm [Internet]. 2017 [Cited 2025 oct 5];70(5):958–964. doi:10.1590/0034-7167-2016-0542
2. Lim DC, Najafi A, Afifi L, Bassetti CLA, Buysse DJ, Han F, Högl B, Melaku YA, Morin CM, Pack AI, Poyares D, Somers VK, Eastwood PR, Zee PC, Jackson CL; World Sleep Society Global Sleep Health Taskforce. The need to promote sleep health in public health agendas across the globe. Lancet Public Health. [Internet]. 2023 [Cited 2025 oct 5];8(10):e820-6. doi:10.1016/s2468-2667(23)00182-2
3. Grandner MA, Chaput JP. Sleep and health. Sleep Health. [Internet]. 2021 [Cited 2025 oct 5];7(6):629-631. doi: 10.1016/j.smrv.2021.101556
4. AlDabal L, BaHammam AS. Metabolic, endocrine, and immune consequences of sleep deprivation. Commun Biol. [Internet]. 2020 [Cited 2025 oct 5];24(3):91. doi: 10.1038/s42003-020-0892-6
5. International Agency for Research on Cancer (IARC). Night Shift Work (IARC Monographs, Volume 124). Lyon: IARC; 2020. Disponible en: https://monographs.iarc.who.int/news-events/volume-124-night-shift-work-2/
6. International Labour Organization. Guide to developing balanced working time arrangements. Geneva: ILO; 2019. Disponible en: https://www.ilo.org/media/402936/download
7. Vanttola P, Puttonen S, Karhula K, Oksanen T, Härmä M. Prevalence of shift work disorder among hospital personnel: a cross-sectional study using objective working hour data. J Sleep Res. [Internet]. 2020 [Cited 2025 oct 5];29(3):e12906. doi:10.1111/jsr.12906
8. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. [Internet]. 1989 [Cited 2025 oct 5];28(2):193–213. doi:10.1016/0165-1781(89)90047-4
9. Mayers AG, Grabau EA, Campbell C, Baldwin DS. Subjective sleep, depression, and anxiety: interrelationships in a non-clinical sample. Hum Psychopharmacol [Internet]. 2009 [Cited 2025 oct 5];24(6):495–501. doi:10.1002/hup.1041
10. Organización Mundial de la Salud. Clasificación Internacional de Enfermedades 11ª edición (CIE-11). Ginebra: OMS; 2019.
11. Ferre Navarrete F, Vilches Aguirre Y. Diagnóstico y tratamiento del insomnio. Medicine [Internet]. 2012 [Cited 2025 oct 5];11(23):1406-11. doi:10.1016/S0304-5412(12)70483-3
12. Sarrais F, Castro-Manglano P. El insomnio. An Sist Sanit Navar. [Internet]. 2007 [Cited 2025 oct 5];30(Supl 1):27-42. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272007000200011&lng=es.
13. Gandhi KD, Mansukhani MP, Silber MH, Kolla BP. Excessive daytime sleepiness: A clinical review. Mayo Clin Proc. [Internet]. 2021 [Cited 2025 oct 5];96(5):1288-301. doi:10.1016/j.mayocp.2020.08.033
14. Liu Y, Zhang Q, Jiang F, Zhong H, Huang L, Zhang Y, et al. Association between sleep disturbance and mental health of healthcare workers: a systematic review and meta-analysis. Front Psychiatry. [Internet]. 2022 [Cited 2025 oct 5];13:919176. doi: 10.3389/fpsyt.2022.919176
15. Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U, et al. Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord. [Internet]. 2011 [Cited 2025 oct 5];135(1–3):10-9. doi:10.1016/j.jad.2011.01.011
16. Ye S, Sui L, Zeng X, Dong Z, Liao Z, Qu C. Association between gastrointestinal disorders and sleep-related problems: the mediating effect of depression. BMC Gastroenterol. [Internet]. 2025 [Cited 2025 oct 5];25:600. doi:10.1186/s12876-025-04180-8
17. AL-hrinat, J, Al-Ansi A.M, Hendi A, Adwan G, Hazaimeh M. The impact of night shift stress and sleep disturbance on nurses quality of life: case in Palestine Red Crescent and Al-Ahli Hospital. BMC Nurs [Internet]. 2024 [Cited 2025 oct 5]; 23,24. doi:10.1186/s12912-023-01673-3
18. Fox J, et al. A mixed-methods systematic review of sleep and patient safety in healthcare workers. Behavioral Sleep Medicine. [Internet] 2025 [Cited 2025 oct 5]; 23(5): 698–714. doi:10.1080/15402002.2025.2522682
19. Demir G, & Karadag G. The Relationship Between Nurses' Sleep Quality and Their Tendency to Commit Medical Errors. Sleep science. [Internet]. 2023 [Cited 2025 oct 5];17(1): 7–15. doi:10.1055/s-0043-1776753
20. Martin CV, Joyce-McCoach J, Peddle M, East CE. Sleep deprivation and medication administration errors in registered nurses-A scoping review. Journal of clinical nursing. [Internet]. 2024 [Cited 2025 oct 5];33(3): 859–873. doi: 10.1111/jocn.16912
21. Sadeghniiat-Haghighi K, Najafi A, Eftekhari S, Tarkhan S. Insomnia and its association with absenteeism: A cross-sectional study among Iranian nursing team. Sleep science. [Internet] 2021 [Cited 2025 oct 5]; 14(4): 305–310. Doi: 10.5935/1984-0063.20200106
22. Fernández-Mendoza J, Rodríguez-Muñoz A, Vela-Bueno A, Olavarrieta-Bernardino S, Calhoun SL, Bixler EO, et al. The Spanish version of the Insomnia Severity Index: a confirmatory factor analysis. Sleep Med. [Internet]. 2012 [Cited 2025 oct 5];13(2):207-13. doi:10.1016/j.sleep.2011.06.019
23. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. [Internet]. 1991 [Cited 2025 oct 5];14(6):540-5. doi:10.1093/sleep/14.6.540
24. Serrano-Ripoll MJ, Zamanillo-Campos R, Castro A, Fiol-deRoque MA, Ricci-Cabello I. Insomnio y calidad del sueño en profesionales sanitarios frente a la COVID-19: una revisión sistemática de la literatura y meta-análisis. Actas Esp Psiquiatr. [Internet] 2021 [Cited 2025 oct 5];49(4):155-179. Disponible en: https://www.actaspsiquiatria.es/repositorio/23-132-ESP-155-179-763306.pdf
25. Maganto-Fraile A, Alcañiz-Martín F, de Priso-Sañudo S, Mayoral-Buendía A. Características del sueño en trabajadores sanitarios de hospitales de Madrid Sur. Med Segur Trab. [Internet]. 2023 [Cited 2025 oct 5];69(270):12–27. doi:10.4321/s0465-546x2023000100003
26. Stimpfel AW, Fatehi F, Kovner C. Nurses' sleep, work hours, and patient care quality and safety. Sleep Health. [Internet]. 2020 [Cited 2025 oct 5];6(3):314–20. doi:10.1016/j.sleh.2019.11.001
27. Jehan S, Zizi F, Pandi-Perumal SR, Wall S, Auguste E, Myers AK, et al. Shift work and sleep: Medical implications and management. Sleep Med Disord Int J. [Internet]. 2017 [Cited 2025 oct 5];1(2):1–8. doi:10.15406/smdij.2017.01.00008
28. Mober SMA, et al. The impact of shift work on nurses’ well-being and patient care excellence in inpatient settings. Br J Nurs Stud. [Internet]. 2024 [Cited 2025 oct 5]; 4(2):95–105. doi:10.32996/bjns.2024.4.2.11
29. Ley 14/2007, de 3 de julio, de Investigación Biomédica. Boletín Oficial del Estado [Internet]. 2007 jul 4 [Cited 2025 oct 5]; (159):28826–28848. Disponible en: https://www.boe.es/buscar/doc.php?id=BOE-A-2007-12945
30. Real Decreto 1090/2015, de 4 de diciembre, por el que se regulan los ensayos clínicos con medicamentos, los Comités de Ética de la Investigación con medicamentos y el Registro Español de Estudios Clínicos. Boletín Oficial del Estado [Internet]. 2015 dic 24 [Cited 2025 oct 5];(307):121923–121960. Disponible en: https://www.boe.es/buscar/doc.php?id=BOE-A-2015-14082
31. Di Simone E, Fabbian F, Giannetta N, Dionisi S, Renzi E, Cappadona R, Di Muzio M, Manfredini R. Risk of medication errors and nurses’ quality of sleep: a national cross-sectional web survey study. Eur Rev Med Pharmacol Sci. [Internet]. 2020 [Cited 2025 oct 5];24(12):7058–7062. doi:10.26355/eurrev_202006_21699
32. Mayers AG, Grabau EA, Campbell C, Baldwin DS. Subjective sleep, depression, and anxiety: interrelationships in a non-clinical sample. Hum Psychopharmacol. [Internet]. 2009 [Cited 2025 oct 5]; 24(6):495–501. doi:10.1002/hup.1041
33. Bell J, Curtis K, Page S. Fatigue in nurses and medication administration errors: A scoping review. J Clin Nurs. [Internet]. 2023 [Cited 2025 oct 5]; 32(13–14):2871–81. doi: 10.1111/jocn.16620
34. Moreno-Casbas MT, et al. Percepción sobre la calidad de los cuidados, entorno laboral y características del sueño de las enfermeras del Sistema Nacional de Salud. Enferm Clin. [Internet]. 2018 [Cited 2025 oct 5];28(4):210–7. doi:10.1016/j.enfcli.2018.01.001
35. Yu X, et al. Shift work sleep disorder in nurses: A concept analysis. BMC Nurs. [Internet] 2025 [Cited 2025 oct 5];24:99. doi:10.1186/s12912-024-02651-z
36. Instituto Nacional de Seguridad y Salud en el Trabajo (INSST). Trabajo a turnos y nocturno: riesgos para la seguridad y la salud. [Internet]. 2019 [Cited 2025 oct 5]. Disponible: https://www.insst.es
37. Castillo-Guerra B, Guiance-Gómez LM, Méndez-Pérez C, Pérez-Aguilera AF. Impacto de los turnos de trabajo en la calidad del sueño del personal de enfermería en dos hospitales de tercer nivel de canarias. Med Segur Trab [Internet]. 2022 [Cited 2025 oct 5];68(267):105-117. doi:10.4321/s0465-546x202200020003
38. Rodríguez González-Moro MT, Gallego-Gómez JI, Vera Catalán T., López López ML, Marín Sánchez MC, Simonelli-Muñoz AJ. Somnolencia diurna excesiva e higiene del sueño en adultos trabajadores en España. Anales Sis San Navarra [Internet]. 2018 [Cited 2025 oct 5];41(3):329-338. doi:10.23938/assn.0378
39. Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int [Internet]. 2012 [Cited 2025 oct 5];29(2):211–219. doi:10.3109/07420528.2011.645752
40. Silva RMD, Zeitoune RCG, Beck CLC, Martino MMFD, Prestes FC, Loro MM. Chronotype and work shift in nursing workers of university hospitals. Rev Bras Enferm [Internet]. 2017 [Cited 2025 oct 5];70(5):958–964. doi:10.1590/0034-7167-2016-0542
Published
2026-03-31
Section
Original Articles
