Abstract
•One in every six expatriate nurses exhibited inadequate sleep (<5 h/day).•13% of expatriate nurses had severe depressive symptoms.•There was a dose–response relationship between sleep hours and depression.
There is limited data on sleep and its impact on mental health among expatriate nurses in Saudi Arabia. This study aimed to assess the association between sleep duration and symptoms of depression among expatriate nurses.
Nurses in government healthcare facilities in Al-Qassim, Saudi Arabia responded to an electronic survey (n = 977) on demography, lifestyle, job features, and symptoms of depression (Depression Anxiety Stress Scale 21). Binary and multinomial logistic regression, respectively, assessed the adjusted associations of daily sleep hours (≤5, 6–7, ≥8) with having any (no, yes) or degree of symptoms (no, mild to moderate, and severe to extremely severe).
There was a dose–response relationship between sleep hours and depressive symptoms (any as well as degree) (p-values for trend <0.05). For nurses who slept 6–7 h, the odds ratio (OR) of having any symptoms of depression was 1.6 (95% CI: 1.2 – 2.2), ‘mild to moderate’ symptoms 1.5 (95% CI: 1.1 – 2.2), and ‘severe to extremely severe’ symptoms 1.9 (95% CI: 1.1 – 3.4). For nurses who slept ≤5 h, the OR of having any symptoms was 2.1 (95% CI: 1.4–3.3), ‘mild to moderate’ symptoms 1.7 (95% CI: 1.0–2.6), and ‘severe to extremely severe’ symptoms 4.2 (95% CI: 2.2–8.1) (reference group ≥ 8 h).
The sleep data pertained to duration only and not to sleep quality.
There was a strong association between sleep duration and symptoms of depression among expatriate nurses.