The burden of insomnia among public health sector nurses in KwaZulu-Natal, South Africa

Abstract

Background: Insomnia is defined as poor quantity or quality of sleep resulting in impaired daytime functioning and distress. Insomnia has been found to occur at higher rates in health care workers and has been associated with physiological dysfunction, illness and distress as well as many socio-demographic and lifestyle-related factors.

Aim: This study aims to establish the burden of insomnia and its associated socio-demographic, lifestyle and occupation-related factors among nurses.

Setting: Nurses employed in the public sector in Kwazulu-Natal Province South Africa comprised the study group. A cross-sectional descriptive online survey was conducted.

Methods: Nurses were invited to participate in an online survey from September to December 2023. The survey comprised a socio-demographic questionnaire and three instruments: the Sleep Condition Indicator, the Single Item Measure of Burnout and the Sleep-Hygiene Index (SHI).

Results: Of the 235 participants surveyed, 41.7% screened positive for insomnia and had significantly lower frequencies of good sleep-hygiene practices on the SHI. After controlling for socio-demographic, clinical and work-related covariates, a psychiatric history adjusted odds ratio [aOR]: 5.52; CI:1.06–28.66) and poor sleep hygiene (aOR: 1.07; CI: 1.02–1.13) displayed significant association with insomnia. All levels of work-related stress were significantly associated with insomnia (p < 0.01), with total burnout having a 10.3-fold increased association.

Conclusion: The study highlights the concerning burden of insomnia and its association with burnout, poor sleep hygiene and a psychiatric comorbidity, among nurses.

Contribution: Given that the risk factors associated with insomnia identified in our study (i.e. poor sleep hygiene, burnout and psychiatric illness) are all potentially modifiable, our findings may serve as a reference for future health-promotion initiatives, aimed at health care professionals, such as health education, screening and mindfulness and wellness programmes.