Sleep Quality and Mental Health in Healthcare Workers During COVID-19

The COVID-19 pandemic placed unprecedented demands on healthcare workers worldwide, with long shifts, high patient turnover and persistent risk of infection. Such conditions have exacerbated poor sleep quality—characterised by reduced duration, fragmentation and difficulty initiating sleep—and contributed to a rise in psychological distress including anxiety, depression and post-traumatic stress symptoms. Sleep disturbance and mental health are closely interlinked: disrupted sleep impairs emotional regulation, while heightened stress and trauma further fragment sleep architecture. Studies in diverse settings have documented that frontline nurses and physicians facing COVID-19 patients frequently report insomnia symptoms, daytime fatigue and reliance on sedatives. These disturbances have been associated with elevated levels of anxiety and depression, compromises in cognitive performance and increased risk of medical errors. Individual factors such as younger age, female gender and less professional experience have been linked to greater susceptibility, while organisational elements—including extended work hours, inadequate rest facilities and limited psychosocial support—further exacerbate risk. Conversely, higher psychological resilience and targeted interventions, for example structured rest breaks, cognitive behavioural strategies for insomnia and peer support programmes, have demonstrated potential to mitigate sleep and mental health burdens. The global significance of these findings lies not only in safeguarding the wellbeing of healthcare professionals but also in sustaining the resilience of health systems through improved patient safety and reduced staff turnover.

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Sleep Quality and Mental Health in Healthcare Workers During COVID-19 publication trend

The graph below shows the total number of articles in sleep quality and mental health in healthcare workers during covid-19 across all publications each year (not limited to Nature Index journals).

Technical terms

Pittsburgh Sleep Quality Index (PSQI): A standardised self-report questionnaire measuring various dimensions of sleep quality over a one-month interval, including duration, latency and disturbances.

Insomnia Severity Index (ISI): A brief instrument for assessing the severity and impact of insomnia symptoms, including difficulty initiating or maintaining sleep and related daytime impairment.

Athens Insomnia Scale (AIS): A diagnostic tool evaluating the presence and intensity of insomnia based on sleep induction, awakenings, total sleep duration and next-day functioning.

Psychological Resilience: The capacity to maintain or regain mental health despite exposure to adversity, including adaptive coping strategies and stress regulation.

References

1. The prevalence of sleep disturbances among physicians and nurses facing the COVID-19 patients: a systematic review and meta-analysis. Globalization and Health (2020).
2. Life Habits of Healthcare Professionals during the Third Wave of COVID-19: A Cross-Sectional Study in a Spanish Hospital. International Journal of Environmental Research and Public Health (2023).
3. Prevalence and associated factors of insomnia symptoms after ending China’s dynamic zero-COVID policy: a cross-sectional survey of frontline nursing staff in Chinese hospitals. Frontiers in Public Health (2024).