Occupational and Physiological Predictors of Burnout Among Healthcare Workers: The Combined Role of Night Shifts and Sleep Apnea Risk Using Structural Equation Modeling.

Background: High levels of burnout are common among healthcare workers (HCWs), particularly those who work night shifts. Burnout symptoms may be linked with obstructive sleep apnea (OSA), a frequent but often underdiagnosed condition. The association between shift work, risk of sleep apnea and burnout among HCWs was studied. Methods: A cross-sectional study was conducted on 400 HCWs (200-night shift, 200-day shift) aged 25-60 years working in different healthcare facilities. Participants completed demographic and occupational questionnaires, the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the STOP-Bang questionnaire for risk of sleep apnea. Burnout was defined by MBI-HSS thresholds. Statistical analyzes Chi-square and t-tests, Pearson correlations, and multiple logistic regression were performed. A path analysis with structural equation modeling was used to test for mediation effects of sleep apnea. Results: Night shift workers reported a significantly higher prevalence of burnout (28.5% vs. day shift; p<0.001) with higher emotional exhaustion (30.2 vs. 23.4), depersonalization (12.7 vs. 8.9) and lower personal accomplishment (31.6 vs. 36.3). The proportion of night shift workers was higher at intermediate (39.5%) and high risk (27%) of sleep apnea. Higher prevalence of burnout was related to sleep apnea risk, particularly in night shift workers with high-risk scores (76%). Logistic regression analysis revealed that night shifts, higher BMI, being a nurse and intermediate/high STOP-Bang scores were significant predictors of burnout (p<0.05). Interaction analysis revealed the combined effect of night shifts and sleep apnea on the risk of burnout (AOR = 9.54 for high-risk night shift workers). Correlations also confirmed strong associations between burnout dimensions and both the frequency of night shift and STOP-Bang scores. Conclusion: Independent and synergistic associations of night shift work and increased risk of sleep apnea with higher levels of burnout in healthcare professionals These findings emphasize the need for specific measures addressing sleep disorders and shift scheduling to mitigate risk of burnout in this vulnerable population.