Poor sleep, insomnia symptoms associated with emotional exhaustion in healthcare workers

A study examining sleep disorders and burnout in healthcare workers found that poor sleep was associated with a 2.45-fold increased likelihood of increased emotional exhaustion, while insomnia symptoms were associated with a 2.56-fold increased likelihood of the same.

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Healthcare worker burnout is a widespread problem, affecting up to 60% of professionals in the field, according to a study published in JAMA Network Open. While factors such as staffing levels and administrative tasks contribute to burnout, individual behavioral and psychosocial factors also play a significant role.

Sleep disturbance, which is associated with a variety of negative consequences, including fatigue, decreased self-esteem, and decreased empathy, was the main factor assessed. That’s why researchers investigated the relationship between sleep and burnout in emergency medicine health workers.

The study conducted a cross-sectional analysis of emergency department (ED) healthcare workers in a large urban medical center. The participants, a total of 126 people, completed an online questionnaire covering demographics, sleep patterns and burnout symptoms.

Sleep quality and insomnia symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), respectively. Burnout symptoms were assessed using the shortened Maslach Burnout Inventory–9, focusing on emotional exhaustion, depersonalization, and reduced personal accomplishment. Statistical analyzes were adjusted for age, gender, race and ethnicity, and depressive symptoms, all known factors associated with sleep.

A total of 126 participants with a mean age of 40.9 years were included. Among the participants, 79 were women, representing 62.7% of the sample.

The results show that poor sleep quality and insomnia symptoms are prevalent among the study population. Poor sleep was positively associated with increased levels of depersonalization and emotional exhaustion. Insomnia symptoms were also associated with higher depersonalization and emotional exhaustion scores.

The researchers observed specific associations between sleep quality, insomnia symptoms, and dimensions of burnout. The PSQI score indicating sleep quality was found to be positively correlated with depersonalization (r = 0.27) and emotional exhaustion (r= 0.23).

However, there was no significant correlation between PSQI score and reduced personal achievement (r= −0.12). Similarly, the ISI score reflecting insomnia symptoms showed a positive relationship with depersonalization (r= 0.26) and emotional exhaustion (r= 0.30), while no significant correlation was found with reduced personal achievement (r= −0.04).

The study further explored the impact of poor sleep quality and insomnia symptoms on burnout. Results showed that people with poor sleep quality, as opposed to good sleep quality, were 2.45 times more likely to experience increased emotional exhaustion (OR, 2.45; 95% CI, 1.02-5.89 ).

Participants with insomnia symptoms were 2.56 times more likely to exhibit increased emotional exhaustion than those without insomnia symptoms (OR, 2.56; 95% CI, 1.11-5.93). However, neither poor sleep quality nor insomnia symptoms were significantly associated with increased depersonalization or decreased personal achievement.

“The present findings add to the evidence linking sleep to burnout,” the researchers conclude. “Future work should examine whether individual-level sleep interventions moderate the impact of organizational and system-level approaches (eg, increased staffing, reduced workload, and circadian-based scheduling) on ​​burnout.”


Schechter A, Firew T, Miranda M, et al. Sleep disturbance and burnout in emergency department health care workers. JAMA Netw Open.2023;6(11):e2341910. doi:10.1001/jamanetworkopen.2023.41910

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