{
  "abstract": "BackgroundShiftwork disrupts natural sleep-wake cycles, alters light exposure patterns, and contributes to circadian misalignment. Detrimental health consequences associated with shift work include elevated risk for metabolic disorders, cardiovascular disease, cancer and all-cause mortality. Healthcare workers have one of the highest rates of shift work exposure, yet there are relatively few non-pharmacological interventions (with good evidence) developed to improve sleep outcomes in this population.\n\nObjectiveA pre-post pilot interventional study assessed the acceptability and perceived effectiveness of commercial noise-masking earbuds on improving subjective sleep characteristics among National Health Service (NHS) healthcare staff working fast rotating shifts.\n\nMethodsNoise-masking sleep earbuds (Kokoon NightBuds) were worn for a pilot six-week intervention by twenty-seven NHS nurses (aged 26-43 years, 88.9% female) working fast rotating shifts from the EClocker Study. Sensors inside the earbuds were paired with a smartphone app to monitor sleep. An audio library in the smartphone app delivered personalised relaxation exercises and sleep techniques drawn from cognitive behavioural therapy for insomnia (CBT-I). A pre-post two-week monitoring period with daily smartphone-based Experience Sampling Methods (ESM) captured perceived daily sleep patterns. Acceptability and perceived effectiveness of the earbuds in promoting better sleep outcomes was assessed.\n\nResultsUse of the noise-masking sleep earbuds over a six-week period was associated with positive sleep improvement trends and elicited promising acceptability. Almost two thirds of NHS fast rotating shift nurses (63%) subjectively reported reductions in general sleep disturbance symptoms (PSQI Global), one in four experienced perceived sleep quality improvements (SQ; 25.9%), one in five reported sleeping longer (TST; 22.2%), and a third perceived falling asleep faster (SOL; 33.3%), had better sleep efficiency (SE; 33.3%) and improved daytime dysfunction (33.3%) (PSQI subcomponent scores). Sleep diaries (CSD) collected daily using smartphone-based ESM also demonstrated small improvements post-sleep earbud use; nurses reported sleeping an average 18 minutes longer (TST) and fell asleep more easily, on average 11 minutes faster (SOL). Sleep earbuds were generally well tolerated; 56% of nurses reported the earbuds as (somewhat to very) helpful, 52% reported (somewhat to strongly) falling asleep more easily (SOL), 44% felt (somewhat to strongly) their sleep quality was improved (SQ) and 30% agreed (somewhat to strongly) they slept longer (TST) and had less disturbed sleep.\n\nConclusionsTo our knowledge, this is the first study in Europe to pilot noise-masking earbuds as a potential non-pharmacological aid to improve sleep-wake behaviours or mitigate fatigue for healthcare staff. Preliminary results showed promising acceptability and (small) perceived sleep improvement trends following a targeted six-week earbud intervention in NHS fast rotating shift nurses.",
  "abstract_shown": true,
  "affiliations": [
    "Canterbury Christ Church University"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "R. Hickman"
    },
    {
      "name": "D. W. Joyce"
    },
    {
      "name": "N. Gray"
    },
    {
      "name": "S. Shergill"
    },
    {
      "affs": [
        0
      ],
      "name": "T. C. D'Oliveira"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1jp0mh18mgafn.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.28.26361673",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.28.26361673v1.full",
  "id": "1jp0mh18mgafn",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.28.26361673v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "3205|Sleep and Work-Related Fatigue"
    ]
  ],
  "openalex": "W7204915475",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.28.26361673v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1jp0mh18mgafn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:30Z",
      "native_id": "10.64898/2026.08.28.26361673",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.28.26361673v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Sleep Intervention for NHS Healthcare Shift Workers: A Pilot Study of Noise-Masking Earbuds",
  "title_text": "Sleep Intervention for NHS Healthcare Shift Workers: A Pilot Study of Noise-Masking Earbuds",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:30Z",
  "url": "https://research.draconitic.com/paper/1jp0mh18mgafn",
  "venue": "medRxiv",
  "versions": []
}