Non-pharmacological therapies for sleep and occupational stress regulation among nightshift nurses: a systematic review and Bayesian network meta-analysis based on randomized controlled trials
Abstract
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,…
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