Evidence map›Paper›PMID 41299599›Full record

ArticleBMC nursing2025

Prevalence of poor sleep quality among critical care unit nurses: a systematic review and meta-analysis.

Neda Sanaie, Sogand Sarmadi, Akbar Zare-Kaseb

Abstract read
In one paragraph

Article in BMC nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Neda SanaieDepartment of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sogand SarmadiStudent Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0008-2219-0817
Akbar Zare-KasebStudent Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. akbar.zarekaseb@gmail.com.ORCID http://orcid.org/0000-0002-0014-7104

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNurses often suffer from poor sleep due to shift work and stress, affecting their performance and patient safety. Sleep issues like insomnia and sleepiness are common, leading to burnout and cognitive impairment. This study aimed to determine the prevalence of poor sleep quality (primary outcome) and, as secondary outcomes, the prevalence of sleepiness and insomnia severity among nurses in critical care units.

methodA comprehensive search was conducted across the following databases: Web of Science, PubMed, Scopus, Embase, Cochrane Library, and CINAHL. Each database was searched from its inception to February 24, 2025. The keywords "Sleep Quality", "Insomnia", Sleepiness", "Prevalence", "Nurses", "Critical care unit", and their alternatives were searched using MeSH, EMTREE, free-text methods, and expert opinion. A pooled prevalence estimate with a 95% confidence interval (CI) was calculated, and the random-effects model was used to represent the data. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies, and the studies were categorized as having a low, moderate, or high risk of bias. Analysis was performed using STATA version 17 statistical software.

resultsThis review included 25 studies with a total sample size of 3,710 nurses. According to the results of the risk of bias assessments, 24% of studies were rated as having a low risk of bias, and 76% were rated as having a moderate risk. The overall prevalence of poor sleep quality was 69.2% (95% CI: 62.4%-76.1%). Heterogeneity was significantly high (I² = 94.49%), and the Q Cochrane test for heterogeneity was significant (p-value < 0.001), indicating substantial variability between studies. Subgroup analyses by country, continent, risk of bias assessment results, year of publication, and mean age of participants contributed to a reduction in heterogeneity. The mean score for sleep quality was 8.14 (95% CI: 6.51-9.77). Additionally, the pooled prevalence of sleepiness and mild to severe insomnia was 64.5% (95% CI: 56.4%-72.6%) and 63.1% (95% CI: 36.4%-89.7%), respectively.

conclusionsGiven the high prevalence of poor sleep quality, sleepiness, and insomnia among critical care nurses, healthcare managers should implement practical measures such as evidence-based interventions, including behavioral, educational, and policy strategies, to enhance sleep outcomes among critical care nurses and ensure patient safety. IMPLICATIONS FOR CLINICAL PRACTICE: Our study's findings provide policymakers with a more comprehensive understanding of sleep disorders among critical care nurses. PROTOCOL REGISTRATION: PROSPERO registration number (International Prospective Register of Systematic Reviews) CRD420251009448 corresponds to the registered protocol for this systematic review. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Critical care unit nursesInsomniaSleepinessSleep quality

Identifiers

PMID41299599
PMCPMC12659626

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.