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Practice Matters

In pursuit of a good night’s rest

Good sleep quality is essential for overall health and well-being. The Centers for Disease Control and Prevention (CDC), via the Sleep Foundation, recommends that adults get 7 to 9 hours of sleep each night. This is especially important for RNs and other healthcare professionals who work long or rotating shifts

Nurses’ unique sleep challenges

Nurses face unique challenges when it comes to healthy sleep each night. For this reason, the American Nurses Association (ANA) has designated rest as one of the five domains essential for health in the Healthy Nurse, Healthy Nation™ Grand Challenge.

The benefits of healthy sleep include heightened alertness, improved mood, increased energy, enhanced concentration, more stamina, greater motivation, better judgment, and improved learning. Conversely, according to the National Institutes of Health, the sleep-deprived are susceptible to obesity, cardiovascular disease, hypertension, diabetes, and mood disorders. For shift-working nurses, significant sleep loss, known as shiftwork sleep disorder (SWSD), can increase errors and reduce job performance, as well as jeopardize patient safety and negatively impact healthcare costs.

ANA recommendations

In April 2015, ANA, recognizing that nurses need assistance in combating fatigue and SWSD, issued a position statement with recommendations, advising nurses and their employers to “collaborate to employ evidence-based strategies to reduce the risks of nurse fatigue and sleepiness associated with shiftwork and long work hours.” Recommendations for nurses include getting regular and restful sleep, improving personal health, taking scheduled meals and breaks, following established policies, and using existing systems to report accidents and near misses. Recommendations for employers include eliminating mandatory overtime, instituting a system for reporting accidents and near misses, scheduling shifts according to evidence-based recommendations, and providing transportation for nurses too tired to drive home.

Sleep quality may be helped by improving and maintaining healthy sleep habits. If sleep problems persist to the extent that they interfere with normal function, consider seeking a professional evaluation. The CDC recommends keeping a diary of sleep habits for 10 days to discuss during the visit. An example of a sleep diary can be found online.

To improve your sleep, ANA recommends the following:


Avoid nicotine.

Keep a consistent bedtime routine.

Avoid alcohol and caffeine before bedtime.

Engage in relaxing activities before bedtime such as prayer, a warm bath, calming music, or reading.

Get comfortable with a supportive mattress and adequate pillows.

Ensure your room is dark, quiet (unless you prefer soft music or white noise), and offers a cool but comfortable temperature.

If you’re anxiety-prone, keep a pad of paper to write down worries, then let them go until morning.

Neither starve nor stuff yourself before bedtime.

Exercise earlier in the day to promote better sleep.

Sleep: Don’t take it for granted

Healthy sleep appears to be a simple commodity, but it shouldn’t be taken for granted if nurses are to function at peak condition to care for their patients. If you think you have a sleep disorder, don’t hesitate to seek professional help. For support in maintaining a healthy lifestyle that includes quality sleep, connect with other nurses in the Healthy Nurse, Healthy Nation Grand Challenge.

Ruth Francis is a senior policy advisor in Nursing Practice and Work Environment at ANA.

Selected references

American Nurses Association. Addressing nurse fatigue to promote safety and health: Joint responsibilities of registered nurses and employers to reduce risks. September 10, 2014.

American Nurses Association. Healthy sleep.

Centers for Disease Control and Prevention. How much sleep do I need? March 2, 2017.

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