Sleep quality among employees in long-term care centers: The contribution of the work environment

Poor quality of sleep and disruption of sleep/wake patterns are common problems among nursing staff. Sleep disruption has been related to shift work, gender and age, but other possible predictors in the work environment have been largely ignored. This is a cross-sectional study of employees' working conditions and sleep quality.Self-administered questionnaires were collected with employees in 18 nursing homes located in Maryland and New England Area between January, 2007 and November, 2008. Working conditions assessed include physical conditions (physical demands, safety climate, violence at work), and psychological conditions (psychological demands, social support, perceived respect from management, and decision-making opportunities). Employee sleep quality was significantly associated with physical demands, safety climate, violence at work, psychological demands, social support, and perceived respect from management. An index of workplace stressors included all six associated factors was built with dichotomizing them at the median value to standardize the weighting. Sleep quality was more associated with physical working conditions than with psychological working conditions. Generalized linear regression model showed an 8% (95% CI=5%-12%, p<0.001) decrease in sleep quality for each stressful exposure, after adjustment for age, gender, race, and night shift work. This study suggests that effective workplace intervention programs must address work organization features in order to improve employee sleep quality.