Association of Cognitive Abilities with Patterns and Quality of Sleep in Nurses Working in Public and Private Tertiary Care Hospitals: A Cross-sectional Study in Pakistan

Healthcare workers, especially the nurses are one of the most overworked individuals of the society. Huge working hours can affect the quality and patterns of sleep, which in-turn can affect the cognitive abilities of these workers. The primary aim of this study was to determine and evaluate the impact of sleep quality and sleep patterns on cognitive abilities of nurses in tertiary care hospitals. The secondary objective was to ascertain differences in cognition and sleep quality of different shift nurses of public and private tertiary care hospitals. This cross-sectional study was conducted on 360 nurses across six tertiary care hospitals in Peshawar, Pakistan. Sleep quality was assessed using the Sleep Quality Scale (SQS) scale. Sleep patterns were analyzed using a self-administered questionnaire. Cognitive abilities were quantified using the Mini-Mental State Examination (MMSE). Statistical tests included were the Mann-Whitney U, Kruskal Wallis, and Spearmans correlation test. Out of the 360 nurses, 54.2% of them were females, with a median age of 27.7 +/- 5.6 years. The median SQS and MMSE were 41 {+/-} 91, and 23 {+/-} 30. Significant differences between public and private hospitals were noted in work hours, night sleep time, and nap duration (p<.05). For shift nurses, it included work hours, and MMSE (p<.05). Sleep pattern factors associated were nap duration ({rho} =0.12), and frequency of sleep cycle ({rho} =-0.24). Moreover, there was a negative correlation between SQS and MMSE ({rho} =-0.024). This study concludes that sleep quality directly influences the cognitive functioning of nurses. Among the sleep patterns, nap duration and frequency of sleep cycle were associated with cognitive abilities. Additionally, significant differences in the distribution of work hours, night sleep time, and day shift frequency were observed.