EFFECT OF ONLINE MINDFULNESS-BASED BRIEF INTERVENTION ON SLEEP QUALITY AMONG SHIFT-WORKING NURSES: A NARRATIVE REVIEW

Authors

  • Wuttipong Saisuwan Wattanapat Hospital, Ao Nang, Krabi, Thailand

DOI:

https://doi.org/10.46827/ejprs.v6i1.257

Keywords:

mindfulness-based intervention, online intervention, sleep quality, shift work, nurses, Pittsburgh Sleep Quality Index, circadian rhythm, digital health

Abstract

Background: Shift-working nurses face significant disruption to circadian rhythms and sleep architecture, resulting in high rates of shift work disorder (SWD) and impaired sleep quality. Online mindfulness-based brief interventions (MBIs) offer an accessible, scalable, and cost-effective approach to address these occupational sleep challenges. However, the evidence base remains heterogeneous and requires systematic synthesis. Objectives: To review the current evidence on the effectiveness of online mindfulness-based brief interventions in improving sleep quality among shift-working nurses, and to examine proposed biological and psychological mechanisms. Methods: A narrative review of peer-reviewed literature was conducted using PubMed, EMBASE, Scopus, CINAHL, and PsycINFO databases. Studies published from 2010 to 2024 reporting the effects of online or app-based mindfulness interventions on sleep outcomes in nurses or shift workers were included. Results: Evidence from randomized controlled trials and systematic reviews demonstrates that online MBIs significantly improve PSQI global scores, reduce insomnia severity, decrease pre-sleep arousal, and attenuate hyperarousal in nurse populations. Brief digital formats (10-30 min/session) are effective and well-tolerated. Mechanistic pathways include modulation of the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system regulation, and reduced cognitive hyperarousal. Conclusions: Online mindfulness-based brief interventions are a promising, evidence-based strategy to improve sleep quality among shift-working nurses. Implementation considerations include session brevity, smartphone delivery, and integration with occupational health programs.

Author Biography

  • Wuttipong Saisuwan, Wattanapat Hospital, Ao Nang, Krabi, Thailand

    Dr. Wuttipong Saisuwan is a physician at Wattanapat Hospital, Ao Nang, Krabi, Thailand. He completed his medical degree (MD) and has developed a clinical focus on Health Promotion Centre. His clinical interest in mindfulness-based interventions emerged from direct observation of the sleep difficulties and burnout experienced by nursing staff working rotating and night shift schedules at his institution. Dr. Saisuwan is committed to integrating evidence-based behavioral and lifestyle approaches into the occupational wellness programs at Wattanapat Hospital, with a particular emphasis on accessible, technology-delivered interventions suitable for the demanding schedules of shift-working clinical staff.

    Email: doctorwuttipong@gmail.com

References

Flo E, Pallesen S, Magerøy N, Moen BE, Grønli J, Nordhus IH, Bjorvatn B. Shift work disorder in nurses—assessment, prevalence and related health problems. PLoS One. 2012;7(4):e33981. PMID: 22485153; PMCID: PMC3317447. https://doi.org/10.1371/journal.pone.0033981

Harrington JM. Health effects of shift work and extended hours of work. Occup Environ Med. 2001;58(1):68-72. https://doi.org/10.1136/oem.58.1.68

Li Y, Lv X, Li R, Wang Y, Guan X, Li L, et al. Predictors of shift work sleep disorder among nurses during the COVID-19 pandemic: A multicenter cross-sectional study. Front Public Health. 2021;9:785518. PMID: 34926396; PMCID: PMC8674423. https://doi.org/10.3389/fpubh.2021.785518

Pallesen S, Bjorvatn B, Waage S, Harris A, Sagoe D. Prevalence of shift work disorder: A systematic review and meta-analysis. Front Psychol. 2021;12:638252. PMID: 33833721; PMCID: PMC8021760. https://doi.org/10.3389/fpsyg.2021.638252

Baek J, Ki J, Ryu J, Choi-Kwon S. Relationship between occupational stress, sleep disturbance, and presenteeism of shiftwork nurses. J Nurs Scholarsh. 2022;54(5):631-638. PMID: 35048504. https://doi.org/10.1111/jnu.12766

Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Rev ed. New York: Bantam Books; 2013. Retrieved from https://psycnet.apa.org/record/2006-04192-000

Gong H, Ni CX, Liu YZ, Zhang Y, Su WJ, Lian YJ, Peng W, Jiang CL. Mindfulness meditation for insomnia: A meta-analysis of randomized controlled trials. J Psychosom Res. 2016;89:1-6. PMID: 27663102. https://doi.org/10.1016/j.jpsychores.2016.07.016

Zhang Q, Zhao H, Zheng Y. Effectiveness of mindfulness-based stress reduction (MBSR) on symptom variables and health-related quality of life in breast cancer patients—a systematic review and meta-analysis. Support Care Cancer. 2019;27(3):771-781. https://doi.org/10.1007/s00520-018-4570-x

Pallesen S, Bjorvatn B, Waage S, Harris A, Sagoe D. Prevalence of shift work disorder: A systematic review and meta-analysis. Front Psychol. 2021;12:638252. PMID: 33833721; PMCID: PMC8021760. https://doi.org/10.3389/fpsyg.2021.638252

Havula K, Härmä M, Ropponen A, Puttonen S. Quantifying cumulative circadian disruption from shift work and associations with health outcomes in a large cohort of nurses. Sleep. 2026;49(1):zsaf301. https://doi.org/10.1093/sleep/zsaf301

Sack RL, Auckley D, Auger RR, et al. Circadian rhythm sleep disorders: Part II, Advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. Sleep. 2007;30(11):1484-1501. https://doi.org/10.1093/sleep/30.11.1484

American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien, IL: AASM; 2014. Retrieved from https://aasm.org/clinical-resources/international-classification-sleep-disorders/

Ong JC, Ulmer CS, Manber R. Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia. Behav Res Ther. 2012;50(11):651-660. PMID: 22975073; PMCID: PMC3466342. https://doi.org/10.1016/j.brat.2012.08.001

Sánchez-García M, Pérez-Yus MC, Denia-Pérez Y, et al. Mindfulness-Based Interventions and the Hypothalamic-Pituitary-Adrenal Axis: A Systematic Review. Medicina (Kaunas). 2024;60(6):115. PMID: 39597311; PMCID: PMC11587421. https://doi.org/10.3390/neurolint16060115

Lumma AL, Kok BE, Singer T. Is meditation always relaxing? Investigating heart rate, heart rate variability, experienced effort and likeability during training of three types of meditation. Int J Psychophysiol. 2015;97(1):38-45. https://doi.org/10.1016/j.ijpsycho.2015.04.017 PMID: 26002797.

Aguilar-Raab C, Jarczok MN, Warth M, et al. Effects of a mindfulness-based intervention on mindfulness, stress, salivary alpha-amylase and cortisol in everyday life. Psychophysiology. 2021;58(10):e13937. PMID: 34056741. https://doi.org/10.1111/psyp.13937

Jaiswal S, Purpura SR, Manchanda JK, et al. Design and Implementation of a Brief Digital Mindfulness and Compassion Training App for Health Care Professionals: Cluster Randomized Controlled Trial. JMIR Ment Health. 2024;11:e49467. [PMCID: PMC10845023] https://doi.org/10.2196/49467

Huberty JL, Espel-Huynh HM, Neher TL, Puzia ME. Systematic review and meta-analysis of effects of standalone digital mindfulness-based interventions on sleep in adults. npj Digit Med. 2025. https://doi.org/10.1038/s41746-025-02120-0

Baek G, Cha C, Lee M, Cho A. Online Mindfulness-Based Interventions for Healthcare Professionals: A Scoping Review. Workplace Health Saf. 2024;72(8):385-396. https://doi.org/10.1177/21650799241254554

Taylor H, Cavanagh K, Field AP, Strauss C. Health Care Workers' Need for Headspace: Findings from a Multisite Definitive Randomized Controlled Trial of an Unguided Digital Mindfulness-Based Self-help App to Reduce Healthcare Worker Stress. JMIR Mhealth Uhealth. 2022;10(8):e31744. [PMCID: PMC9459942]. https://doi.org/10.2196/31744

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [PMID: 2748771]. https://doi.org/10.1016/0165-1781(89)90047-4

Moghadam M, Doosti R, Rahmanian V. Factorial structure and psychometric properties of the Pittsburgh Sleep Quality Index in non-professional caregivers. Int J Environ Res Public Health. 2022;20(1):126. [PMCID: PMC9819073]. https://doi.org/10.3390/healthcare11010067

Al-Hammouri MM, Rababah JA, Aldalaykeh M, Shahrour G. A brief mindfulness-based intervention, sleep quality, sleep duration, and fatigue among nurses: A randomized controlled trial. J Clin Psychol. 2024;80(5):1067-1078. doi:10.1002/jclp.23677 [PMID: 38458149]. https://doi.org/10.1002/jclp.23677

Alkhawaldeh JM, Masa'deh R, Alkhawaldeh AM, et al. The effect of a mindfulness intervention (MI) on sleep disturbance (SD) among nurses. Sci Rep. 2024;14:5234. [PMCID: PMC10907617]. https://doi.org/10.1038/s41598-024-55748-5

Zhang Y, Li W, Chen L, et al. Effectiveness of mindfulness-based interventions on burnout, resilience and sleep quality among nurses: a systematic review and meta-analysis of randomized controlled trials. BMC Nurs. 2025. [PMCID: PMC12210539]. https://doi.org/10.1186/s12912-025-03101-0

Moore C, Kelly S, Melnyk BM. The use of mHealth apps to improve hospital nurses' mental health and well-being: A systematic review. Worldviews Evid Based Nurs. 2024;21(2):110-119. [PMID: 38491775]. https://doi.org/10.1111/wvn.12716

Fazia T, Bubbico F, Nova A, et al. Beneficial Effects of an Online Mindfulness-Based Intervention on Sleep Quality in Italian Poor Sleepers during the COVID-19 Pandemic: A Randomized Trial. Int J Environ Res Public Health. 2023;20(3):2724. [PMCID: PMC9914977]. https://doi.org/10.3390/ijerph20032724

Downloads

Published

2026-05-04

Issue

Section

Articles