Morningness-Eveningness Chronotypes, Sleep Quality, and Sleepiness Among Nurses

Mohammad Hajaghazadeh1, Vahid Zamanzadeh2, Marjan Ghofrani2, Samira Orujlu2, *
1 Department of Occupational health, Health Faculty, Urmia University of Medical Sciences, Urmia, Iran
2 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

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© 2019 Hajaghazadeh et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran; Tel: +98-9141651694; E-mail:



Poor sleep quality and sleepiness is a common problem in nurses. The morningness-eveningness preference of nurses may affect their sleep quality.


The objectives of this study were (1) to describe the quality of sleep in a group of hospital nurses and (2) to analyze the effect of shift work and morningness-eveningness on the sleep quality of nurses.


In this cross-sectional study, 120 nurses completed the survey in a university hospital in Iran. The study tools were Pittsburgh Sleep Quality Questionnaire (PSQI), Epworth Sleepiness Scale (ESS), and Morningness-Eveningness Questionnaire (MEQ). Nurses with PSQI>5 and ESS≥10 were considered having poor sleep quality and excessive daytime sleepiness. Nurses were subdivided into morning-, intermediate- and evening-types according to MEQ. Data were analyzed by chi-square, Mann–Whitney U-test, logistic regression, and analysis of covariance (ANCOVA) tests.


The mean (±SD) of PSQI and ESS was 6.88(2.18) and 9.5(±3.9), respectively. About 74% of nurses reported poor sleep quality, and near 40% of the nurses had excessive daytime sleepiness. Sixty percent of nurses were intermediate-type, and the remaining was morning (24.2%) and evening (15.8%) types. The sleep quality and daytime sleepiness had a significant relation with shift work. The mean PSQI was significantly different between shift work and non-shift work nurses. The mean PSQI of three main chronotypes was statistically different.


Poor sleep quality was prevalent in the nurses and was significantly associated with shift work and chronotype. The sleep preference of nurses would be considered as an important factor in the assignment of shift work by hospital managers.

Keywords: Sleep disorders, Chronotype, Nurses, Hospitals, Sleepiness, Adult.