Temporal Dynamics of Daily Sleep, Mood, and Cognition in NHS Shift Workers: A Digital Experience Sampling (ESM) Study
- 1Canterbury Christ Church University
Abstract
BackgroundSleep, mood, and affective states are mutually connected. There is a paucity of studies, however, that have considered bidirectional relationships between daily sleep-affective dyads in naturalistic settings, particularly for shift workers.
ObjectiveTo evaluate the dynamic and temporal interplay of daily smartphone-based self- reported sleep measurements, dimensions of affective experience and cognitive processing in UK shift working nurses.
MethodsThe EClocker Study prospectively monitored 102 National Health Service (NHS) nurses (aged 25-61 years, 83.3% female) working standard (day shift) and non-standard (fast rotating shifts) schedules over a two-week period. Smartphone-based Experience Sampling Methodology (ESM) recorded daily sleep, mood, momentary affect and cognitive attentional functioning. Self-reported burnout, emotional dysregulation, emotion reactivity and affective dimensions (positive and negative) were also collected.
FindingsOverall, NHS nurses reported a high prevalence of depressive symptoms, stress, burnout and sleep-circadian rhythm disturbances. Generalised Additive Modelling (GAMs) revealed that NHS nurses higher perceived sleep quality predicted better next- day mood state, while better daytime mood was associated with reduced sleep onset latency, such that participants reported falling asleep faster. In contrast, daytime mood or affect (positive and negative) had no substantial, direct impact on nurses subjective sleep parameters (sleep quality, sleep duration, sleep efficiency). Exposure to fast rotating night shifts across the two-week study was associated with more frequent response errors on a Choice Reaction Time (CRT) cognitive task, while daytime somnolence did not adversely influence nurses momentary reaction time speeds or attentional function.
ConclusionsClinically relevant sleep impairments, insomnia-related symptoms, elevated stress, and poor mood were pervasive in a sample of UK NHS nurses, regardless of shift type. Sleep quality impacted next-day mood and daytime mood impacted sleep latency, while rotating shifts led to an increase in cognitive errors. Recognising the impact of shiftwork and designing interventions to promote better sleep quality offer potential to enhance mood and performance in healthcare professionals.
Clinical implicationsWe need to implement and evaluate interventions that regularise sleep patterns and promote sleep quality to alleviate mood symptoms among frontline NHS shift workers.
Related
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BibTeX
@misc{hickman2026temporal,
title = {{Temporal Dynamics of Daily Sleep, Mood, and Cognition in NHS Shift Workers: A Digital Experience Sampling (ESM) Study}},
author = {R. Hickman and D. W. Joyce and N. Gray and A. Hampshire and P. J. Hellyer and Z. Cai and S. Shergill and T. C. D'Oliveira},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.27.26361516},
url = {https://www.medrxiv.org/content/10.64898/2026.08.27.26361516v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Temporal Dynamics of Daily Sleep, Mood, and Cognition in NHS Shift Workers: A Digital Experience Sampling (ESM) Study
AU - R. Hickman
AU - D. W. Joyce
AU - N. Gray
AU - A. Hampshire
AU - P. J. Hellyer
AU - Z. Cai
AU - S. Shergill
AU - T. C. D'Oliveira
PY - 2026
DA - 2026/08/27
PB - medRxiv
DO - 10.64898/2026.08.27.26361516
UR - https://www.medrxiv.org/content/10.64898/2026.08.27.26361516v1
AB - BackgroundSleep, mood, and affective states are mutually connected. There is a paucity of studies, however, that have considered bidirectional relationships between daily sleep-affective dyads in naturalistic settings, particularly for shift workers. ObjectiveTo evaluate the dynamic and temporal interplay of daily smartphone-based self- reported sleep measurements, dimensions of affective experience and cognitive processing in UK shift working nurses. MethodsThe EClocker Study prospectively monitored 102 National Health Service (NHS) nurses (aged 25-61 years, 83.3% female) working standard (day shift) and non-standard (fast rotating shifts) schedules over a two-week period. Smartphone-based Experience Sampling Methodology (ESM) recorded daily sleep, mood, momentary affect and cognitive attentional functioning. Self-reported burnout, emotional dysregulation, emotion reactivity and affective dimensions (positive and negative) were also collected. FindingsOverall, NHS nurses reported a high prevalence of depressive symptoms, stress, burnout and sleep-circadian rhythm disturbances. Generalised Additive Modelling (GAMs) revealed that NHS nurses higher perceived sleep quality predicted better next- day mood state, while better daytime mood was associated with reduced sleep onset latency, such that participants reported falling asleep faster. In contrast, daytime mood or affect (positive and negative) had no substantial, direct impact on nurses subjective sleep parameters (sleep quality, sleep duration, sleep efficiency). Exposure to fast rotating night shifts across the two-week study was associated with more frequent response errors on a Choice Reaction Time (CRT) cognitive task, while daytime somnolence did not adversely influence nurses momentary reaction time speeds or attentional function. ConclusionsClinically relevant sleep impairments, insomnia-related symptoms, elevated stress, and poor mood were pervasive in a sample of UK NHS nurses, regardless of shift type. Sleep quality impacted next-day mood and daytime mood impacted sleep latency, while rotating shifts led to an increase in cognitive errors. Recognising the impact of shiftwork and designing interventions to promote better sleep quality offer potential to enhance mood and performance in healthcare professionals. Clinical implicationsWe need to implement and evaluate interventions that regularise sleep patterns and promote sleep quality to alleviate mood symptoms among frontline NHS shift workers.
ER -