Guangrong Deng, Li Zeng, Fang Wang, Hailong Hou, Li Liu, Yu An, Yifan Lv, Xiuying Hu
SIP, MTI, APT, REBT, and PPEO appeared to be effective non-pharmacological interventions for optimizing nightshift nurses' total sleep score, regulating their sleep duration, and alleviating their depression, anxiety, and fatigue, respectively. Future well-designed studies are warranted to further validate the role of non-pharmacological therapies, particularly SIP and MTI, in regulating sleep among nightshift nurses. However, all findings were based on indirect evidence, which formed a star-shaped network with no closed loops. Therefore, the findings should be considered exploratory and hypothesis-generating, which are intended to provide preliminary guidance for future head-to-head comparative trials rather than establishing definitive clinical evidence. Clinical decisions should be made based on a comprehensive assessment that takes into account local resources, cultural context, and individual preferences of nurses.
PURPOSE: Nightshift nurses commonly suffer from sleep disturbances and occupational stress due to irregular work-sleep rhythms. This Bayesian network meta-analysis (NMA) compared the efficacy of non-pharmacological therapies to identify optimal interventions for improving sleep and reducing occupational stress in night/rotating-shift nurses.
METHODS: Cochrane, Embase, PubMed, Web of Science, and CNKI were searched up to October 24, 2025. Studies were assessed for bias via ROB2. Primary outcomes were total sleep score and sleep duration; secondary outcomes included anxiety, depression, and fatigue scores. Bayesian NMA (R 4.5.2) calculated SMD (95% CrI) and SUCRA for intervention ranking.
RESULTS: Eighteen studies involving 1,572 nurses were included. Sleep intervention program (SIP) appeared to be effective for optimizing total sleep score (SMD -0.80, 95% CrI [-1.2, -0.41]; SUCRA = 80.71%). Mindfulness training intervention (MTI) showed relatively good effectiveness in regulating sleep duration (SMD -1.0, 95% CrI [-1.4, -0.57]; SUCRA = 95.97%). Auricular plaster therapy (APT) appeared to be effective in alleviating depression (SMD -0.60, 95% CrI [-1.0, -0.17]; SUCRA = 84.60%). Rational emotive behavior therapy (REBT) showed superior efficacy for alleviating anxiety (SMD -3.0, 95% CrI [-3.6, -2.4]; SUCRA = 100%). Pure pelargonium essential oil (PPEO) demonstrated relatively good efficacy in relieving fatigue (SMD -0.70, 95% CrI [-1.2, -0.25]; SUCRA = 94.92%).
CONCLUSION: SIP, MTI, APT, REBT, and PPEO appeared to be effective non-pharmacological interventions for optimizing nightshift nurses' total sleep score, regulating their sleep duration, and alleviating their depression, anxiety, and fatigue, respectively. Future well-designed studies are warranted to further validate the role of non-pharmacological therapies, particularly SIP and MTI, in regulating sleep among nightshift nurses. However, all findings were based on indirect evidence, which formed a star-shaped network with no closed loops. Therefore, the findings should be considered exploratory and hypothesis-generating, which are intended to provide preliminary guidance for future head-to-head comparative trials rather than establishing definitive clinical evidence. Clinical decisions should be made based on a comprehensive assessment that takes into account local resources, cultural context, and individual preferences of nurses.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251180760.