Stress and insomnia severity in relation to sleep quality among shift-working nursing staff: a cross-sectional study

Introduction Sleep is an integral component of normal functioning, enabling rest and physiological recovery. Due to the nature of shift work, nursing staff are particularly vulnerable to disruptions of circadian rhythms. Shift work may substantially contribute to poorer sleep quality, the development of insomnia, and increased perceived stress levels. Disruption of the biological sleep rhythm may result in impaired normal functioning. The consequences may include not only deterioration of health but also impaired awareness and concentration, thereby significantly affecting the level and quality of care provided to patients. Despite the growing body of research, there remains a lack of comprehensive analyses simultaneously assessing the broad spectrum of relationships between sleep, insomnia, and stress among nursing staff. The aim of the study was to assess the relationship between perceived stress levels and the severity of insomnia symptoms and sleep quality among nursing staff working in a shift system. Methods The study was conducted using a diagnostic survey method and had a cross-sectional design. The respondents were nursing staff employed in the departments of the Fryderyk Chopin University Clinical Hospital in Rzeszów. An original questionnaire and standardized research instruments were used: the Perceived Stress Scale (PSS-10), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). The statistical analysis included descriptive statistics, correlation analysis, and multiple linear regression using the stepwise method. Results Among the study group of 247 nursing staff members working in a shift system, sleep disturbances and insomnia symptoms were common. Poor sleep quality was identified in 76.1% of respondents, while 81.4% of participants obtained an ISI score of ≥8 points, indicating the presence of insomnia symptoms of at least subthreshold severity. Higher perceived stress scores were associated with greater severity of insomnia symptoms and poorer sleep quality. The strongest association was observed between insomnia symptom severity and sleep quality. Multivariable analysis confirmed significant associations between insomnia symptom severity, perceived stress, and sleep quality. Conclusion Sleep problems were common among the shift-working nursing staff included in the study. Perceived stress was significantly associated with insomnia symptom severity and poorer sleep quality. The findings support the importance of early identification of sleep problems and consideration of stress management in initiatives aimed at supporting the wellbeing of shift-working nursing staff.