Perceived Sleep Insufficiency, Performance and Productivity Among Night-Shift Nurses in Kebbi State, Nigeria: A Cross-Sectional Study

Abstract

Background: Night-shift duty disrupts circadian rhythms and recovery sleep, increasing fatigue and compromising healthcare quality. This study evaluated perceived pre-shift sleep requirements, work performance, productivity, and associated factors among night-shift nurses in public hospitals in Kebbi State, Nigeria. Methods: A cross-sectional survey was conducted among 421 registered nurses working night shifts across public secondary and tertiary hospitals in Kebbi State. Perceived pre-shift sleep requirement, work performance and productivity were assessed using a pretested questionnaire. Performance and productivity scores were dichotomised into normal and poor categories using mean-score thresholds. Data were analysed using frequencies, percentages and chi-square tests of independence. Results: Participants were predominantly female (362/421, 86.0%), younger than 40 years (372/421, 88.4%) and had 1–10 years of service (369/421, 87.6%). Before night duty, 144 (34.2%) reported needing less than six hours of sleep, 227 (53.9%) six to eight hours and 50 (11.9%) more than eight hours. Shorter service duration (1–10 years) was associated with poor performance (76.7% vs 48.1%; χ²(1) = 19.008, p < 0.001) and poor productivity (75.1% vs 59.6%; χ²(1) = 5.542, p = 0.019). Perceived sleep requirement was not associated with performance (χ²(2) = 4.931, p = 0.085) but was associated with productivity (χ²(2) = 49.265, p < 0.001). Conclusion: Perceived performance and productivity difficulties were prevalent among night-shift nurses in Kebbi State and disproportionately affected early-career staff. Healthcare institutions should implement proactive fatigue-risk management systems, including roster optimisation, protected shift rest and non-punitive safety reporting.