# The sleep quality and influencing factors among midwives in China: a cross-sectional study

**Authors:** Dongning He, Jinling Zhang, Mingxin Zhu, Yangxue Meng, Na Li, Guoyu Wang, Biru Luo

PMC · DOI: 10.3389/fpubh.2025.1581508 · 2025-07-07

## TL;DR

This study found that most midwives in China have poor sleep quality, influenced by work and personal factors, and suggests changes to improve their sleep and work performance.

## Contribution

The study provides empirical evidence on sleep quality and its influencing factors among midwives in China.

## Key findings

- 71.9% of midwives reported poor sleep quality with a PSQI score above 7.
- Health status, hospital type, and work mode were significant factors affecting sleep quality.
- Work pressure and the need for sleep assistance were linked to poorer sleep outcomes.

## Abstract

This study aimed to assess sleep quality and identify influencing factors among midwives in mainland China, providing a reference for obstetric managers to develop strategies that enhance sleep health among midwives.

The study was conducted from January to December 2023 across 566 hospitals in mainland China. A total of 1,948 midwives participated. A self-designed questionnaire was used to collect socio-demographic information and participants' perceived factors influencing their sleep quality. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and regression analysis was performed to identify the factors influencing sleep quality.

The median Pittsburgh Sleep Quality Index score was 9, with 71.9% (n = 1,400) of midwives reporting poor sleep quality (cutoff score >7). Additionally, 12.4% of midwives required medication to assist with sleep. Statistically significant differences (P < 0.05) in scores were observed across variables such as years of experience as a midwife, health status, hospital type, work mode, ability to leave work on time, and sleep assistance situation. Regression analysis indicated that health status, hospital type, work mode, ability to leave work on time, the need for sleep assistance, and perceived work pressure were significant factors influencing sleep quality among midwives.

The overall sleep quality of Chinese midwives is poor, influenced by both work-related and individual factors. Obstetric managers should allocate clinical staff and resources efficiently. This can be achieved by adjusting shift rotations, reducing overtime, and implementing other measures to create an environment that supports better sleep quality among midwives, enhancing their work performance and ensuring maternal and neonatal safety.

## Full-text entities

- **Diseases:** infections (MESH:D007239), diabetes (MESH:D003920), injuries (MESH:D014947), Insufficient sleep (MESH:D012892), breathing difficulties (MESH:D004417), obesity (MESH:D009765), poor sleep quality (MESH:D012893), burnout (MESH:D002055), dizziness (MESH:D004244), anxiety (MESH:D001007), poor (MESH:D009123), daytime dysfunction (MESH:D006970), amniotic fluid embolism (MESH:D004619), emotional disturbances (MESH:D014832), insomnia (MESH:D007319), fatigue (MESH:D005221), psychiatric disorders (MESH:D001523), anxiety disorders (MESH:D001008), placental abruption (MESH:D000037), metabolic diseases (MESH:D008659), cardiovascular diseases (MESH:D002318), difficulty concentrating (MESH:C567712), needlestick injuries (MESH:D016602), impaired cognitive function (MESH:D003072), depression (MESH:D003866), postpartum hemorrhage (MESH:D006473)
- **Chemicals:** sleep medicine (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12277148