{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:36:00Z","timestamp":1787160960452,"version":"build-2736575974"},"reference-count":54,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Nursing"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Shift work disorder and insufficient sleep are prevalent among nurses, leading to fatigue, reduced well-being, and potential safety concerns. The increasing use of wearable sleep-tracking devices presents an opportunity to evaluate nurses\u2019 sleep quality objectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The primary objective was to evaluate the feasibility of wearable-based sleep monitoring and to obtain preliminary evidence of agreement with validated actigraphy among nurses. The secondary objective was to describe nurses\u2019 sleep characteristics and to examine exploratory associations between sociodemographic characteristics, shift patterns, sleep hygiene, and sleep parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 2-phase feasibility observational cohort study was conducted in a tertiary hospital in Singapore. In phase 1, 5 nurses concurrently wore a consumer-grade, wrist-worn Apple Watch Series 10 and a validated actigraph (GENEActiv; ActivInsights Ltd) for 2 weeks. Preliminary agreement between the Apple Watch and GENEActiv was examined using intraclass correlation coefficients. Feasibility was determined through wear-time compliance and data completeness. In phase 2, 50 nurses working rotating or single shifts completed demographic and work-related questionnaires and the Sleep Hygiene Index. Multiple linear regression analyses were performed to examine exploratory associations between selected covariates and sleep parameters, with adjustment for age, sex, BMI, parental status, workplace, total length of service, and sleep hygiene.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Apple Watch showed preliminary evidence of agreement with GENEActiv for total sleep time, in-bed wake time, and sleep efficiency (intraclass correlation coefficients of 0.95, 0.72, and 0.69, respectively), with high wear compliance and minimal missing data, supporting its feasibility for sleep monitoring. Mean total sleep time was 381 (SD 55) minutes, and mean sleep efficiency was 94.77% (SD 4.11%). Shift nurses reported poorer sleep hygiene than nonshift nurses; however, shift work status was not independently associated with sleep outcomes after adjustment. Higher BMI was associated with shorter total sleep time (unstandardized coefficient\n                      <jats:italic>B<\/jats:italic>\n                      =\u22123.76 min\/kg\/m\u00b2;\n                      <jats:italic>P<\/jats:italic>\n                      =.01), reduced rapid eye movement sleep (unstandardized coefficient\n                      <jats:italic>B<\/jats:italic>\n                      =\u22121.18 min;\n                      <jats:italic>P<\/jats:italic>\n                      =.03), shorter core sleep (unstandardized coefficient\n                      <jats:italic>B<\/jats:italic>\n                      =\u22122.72 min;\n                      <jats:italic>P<\/jats:italic>\n                      =.02), and reduced time in bed (unstandardized coefficient\n                      <jats:italic>B<\/jats:italic>\n                      =\u22124.05 min;\n                      <jats:italic\/>\n                      =.008). Age was negatively associated with deep sleep duration, with older age associated with less deep sleep (unstandardized coefficient\n                      <jats:italic>B<\/jats:italic>\n                      =\u22121.00 min\/y;\n                      <jats:italic\/>\n                      =.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Apple Watch\u2013based monitoring was feasible and showed preliminary agreement with actigraphy. Nurses slept less than recommended, and BMI and age were associated with sleep outcomes in exploratory analyses. These findings support larger studies and workplace strategies to improve sleep opportunity and healthy sleep behaviors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/96912","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:45:06Z","timestamp":1784249106000},"page":"e96912-e96912","source":"Crossref","is-referenced-by-count":0,"title":["Validation and Feasibility of a Consumer-Grade Wearable Sleep Monitoring Device and an Exploratory Evaluation of Sleep Characteristics and Associated Factors Among Nurses: Observational Cohort Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9559-0909","authenticated-orcid":false,"given":"Siew Hoon","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-5068","authenticated-orcid":false,"given":"Fazila","family":"Aloweni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4541-1687","authenticated-orcid":false,"given":"Phyllis","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-7012","authenticated-orcid":false,"given":"Shin Yuh","family":"Ang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1136\/bmjqs-2021-014375","article-title":"National improvements in resident physician-reported patient safety after limiting first-year resident physicians\u2019 extended duration work shifts: a pooled analysis of prospective cohort studies","volume":"32","author":"Weaver","journal-title":"BMJ Qual Saf"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","DOI":"10.1002\/1348-9585.12262","article-title":"Meta-analysis of differences in sleep quality based on actigraphs between day and night shift workers and the moderating effect of age","volume":"63","author":"Chang","journal-title":"J Occup Health"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s40675-017-0071-6","article-title":"Shift work: disrupted circadian rhythms and sleep\u2014implications for health and well-being","volume":"3","author":"James","journal-title":"Curr Sleep Med Rep"},{"issue":"5","key":"R4","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1378\/chest.14-0970","article-title":"International classification of sleep disorders-third edition: highlights and modifications","volume":"146","author":"Sateia","journal-title":"Chest"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2020.110343","article-title":"Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: a systematic review and meta-analysis","volume":"141","author":"Al Maqbali","journal-title":"J Psychosom Res"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12872","article-title":"Exploring the associations between shift work disorder, depression, anxiety and sick leave taken amongst nurses","volume":"29","author":"Booker","journal-title":"J Sleep Res"},{"issue":"3","key":"R7","doi-asserted-by":"publisher","first-page":"247","DOI":"10.33808\/clinexphealthsci.639710","article-title":"Examining sleep quality and job satisfaction of critical care nurses","volume":"10","author":"Dogan","journal-title":"Clin Exp Health Sci"},{"issue":"6","key":"R8","doi-asserted-by":"publisher","first-page":"732","DOI":"10.2486\/indhealth.2018-0258","article-title":"Relationship between job satisfaction and sleep quality of female shift-working nurses: using shift type as moderator variable","volume":"57","author":"Chang","journal-title":"Ind Health"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4641","article-title":"Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large US cohorts of female nurses","volume":"363","author":"Shan","journal-title":"BMJ"},{"issue":"12","key":"R10","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56120680","article-title":"Relationship between night shifts and risk of breast cancer among nurses: a systematic review","volume":"56","author":"Fagundo-Rivera","journal-title":"Medicina (Kaunas)"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","first-page":"86","DOI":"10.2486\/indhealth.2020-0191","article-title":"My job impacts my sleep: signs and symptoms of insomnia among healthcare workers","volume":"59","author":"Lee","journal-title":"Ind Health"},{"issue":"21","key":"R12","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192113986","article-title":"Which shiftwork pattern is the strongest predictor for poor sleep quality in nurses?","volume":"19","author":"Wangsan","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1177\/1099800417695483","article-title":"Sleep quality associated with different work schedules: a longitudinal study of nursing staff","volume":"19","author":"Niu","journal-title":"Biol Res Nurs"},{"issue":"9","key":"R14","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15092038","article-title":"Effects of clockwise and counterclockwise job shift work rotation on sleep and work-life balance on hospital nurses","volume":"15","author":"Shiffer","journal-title":"Int J Environ Res Public Health"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Lichstein KL Morin CM , editors. Treatment of Late-Life Insomnia. SAGE Publications; 2000. [doi: 10.4135\/9781452225555]","DOI":"10.4135\/9781452225555"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"134","DOI":"10.5958\/j.0974-0155.7.4.020","article-title":"Sleep hygiene and good sleep habits: a review","volume":"7","author":"Prasad","journal-title":"Indian J Sleep Med"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Thorpy M . International Classification of Sleep Disorders. In: Sleep Disorders Medicine: Basic Science, Technical Considerations and Clinical Aspects. Springer; 2017:475-484. [doi: 10.1007\/978-1-4939-6578-6_27]","DOI":"10.1007\/978-1-4939-6578-6_27"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsz228","article-title":"The role of sleep hygiene in the risk of Shift Work Disorder in nurses","volume":"43","author":"Booker","journal-title":"Sleep"},{"issue":"6","key":"R19","doi-asserted-by":"publisher","first-page":"546","DOI":"10.5762\/KAIS.2016.17.6.546","article-title":"The influence of stress response, physical activity, and sleep hygiene on sleep quality of shift work nurses","volume":"17","author":"Jeong","journal-title":"J Korea Acad Ind Coop Soc"},{"issue":"5","key":"R20","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.14143","article-title":"A systematic review of the performance of actigraphy in measuring sleep stages","volume":"33","author":"Yuan","journal-title":"J Sleep Res"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2017.12.002","article-title":"Feeling validated yet? A scoping review of the use of consumer-targeted wearable and mobile technology to measure and improve sleep","volume":"40","author":"Baron","journal-title":"Sleep Med Rev"},{"issue":"16","key":"R22","doi-asserted-by":"publisher","DOI":"10.3390\/s22166317","article-title":"A validation of six wearable devices for estimating sleep, heart rate and heart rate variability in healthy adults","volume":"22","author":"Miller","journal-title":"Sensors (Basel)"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.19020.1","article-title":"Sleep monitoring with the Apple Watch: comparison to a clinically validated actigraph","volume":"8","author":"Roomkham","journal-title":"F1000Res"},{"issue":"2","key":"R24","doi-asserted-by":"publisher","first-page":"171","DOI":"10.5014\/ajot.2013.006270","article-title":"Nuts and bolts of conducting feasibility studies","volume":"67","author":"Tickle-Degnen","journal-title":"Am J Occup Ther"},{"issue":"5","key":"R25","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaa291","article-title":"Performance of seven consumer sleep-tracking devices compared with polysomnography","volume":"44","author":"Chinoy","journal-title":"Sleep"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-025-01675-9","article-title":"Sample size justification in feasibility studies: moving beyond published guidance","volume":"11","author":"Montgomery","journal-title":"Pilot Feasibility Stud"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-025-03326-y","article-title":"Moderately strong intraclass correlations between actigraphic and polysomnographic total sleep time and sleep efficiency in older adults with sleep disturbance","volume":"29","author":"Rahimi","journal-title":"Sleep Breath"},{"key":"R28","unstructured":"Track your sleep with Apple Watch. Apple Support. 2026. URL: https:\/\/support.apple.com\/en-sg\/guide\/watch\/apd830528336\/watchos [Accessed 25-07-2026]"},{"key":"R29","unstructured":"Public health research, raw data accelerometer. ActivInsights. 2026. URL: https:\/\/activinsights.com\/remote-monitoring-wearables\/geneactiv-raw-data-accelerometer-public-health-research [Accessed 25-07-2026]"},{"key":"R30","unstructured":"Actigraphy Sleep Toolkit. 2025. URL: https:\/\/sleeptoolkit.activinsights.net [Accessed 25-07-2026]"},{"issue":"3","key":"R31","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s10865-006-9047-6","article-title":"Assessment of sleep hygiene using the Sleep Hygiene Index","volume":"29","author":"Mastin","journal-title":"J Behav Med"},{"issue":"4","key":"R32","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1037\/1040-3590.6.4.284","article-title":"Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology","volume":"6","author":"Cicchetti","journal-title":"Psychol Assess"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","DOI":"10.3390\/s24020635","article-title":"Evaluating accuracy in five commercial sleep-tracking devices compared to research-grade actigraphy and polysomnography","volume":"24","author":"Kainec","journal-title":"Sensors (Basel)"},{"key":"R34","doi-asserted-by":"crossref","unstructured":"Jaworski DJ Park EJ . Apple Watch sleep and physiological tracking compared to clinically validated actigraphy, ballistocardiography and polysomnography. Presented at: 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC); Jul 24-27, 2023; Sydney, Australia. [doi: 10.1109\/EMBC40787.2023.10340725]","DOI":"10.1109\/EMBC40787.2023.10340725"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph23010064","article-title":"Sleep quality in shift-working nurses: subjective and objective evaluation","volume":"23","author":"Dujmi\u0107","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1080\/07420528.2021.2005082","article-title":"Influence of shift work on rest-activity rhythms, sleep quality, and fatigue of female nurses","volume":"39","author":"Chang","journal-title":"Chronobiol Int"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1177\/23779608241267079","article-title":"Utility of a wearable tracker to assess sleep quality in nurses and their spouses: a prospective cohort study","volume":"11","author":"Ishinuki","journal-title":"SAGE Open Nurs"},{"issue":"7","key":"R38","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1249\/MSS.0000000000001947","article-title":"Wearable sleep technology in clinical and research settings","volume":"51","author":"de Zambotti","journal-title":"Med Sci Sports Exerc"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"Eldridge","journal-title":"BMJ"},{"issue":"2","key":"R40","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1177\/1090198104263660","article-title":"Health promotion by social cognitive means","volume":"31","author":"Bandura","journal-title":"Health Educ Behav"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104468","article-title":"A scoping review of sleep education and training for nurses","volume":"142","author":"Hittle","journal-title":"Int J Nurs Stud"},{"issue":"10 (Suppl. 2)","key":"R42","doi-asserted-by":"publisher","first-page":"S218","DOI":"10.1139\/apnm-2020-0034","article-title":"Sleep duration and health in adults: an overview of systematic reviews","volume":"45","author":"Chaput","journal-title":"Appl Physiol Nutr Metab"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1187382","article-title":"Effectiveness of sleep interventions for rotating night shift workers: a systematic review and meta-analysis","volume":"11","author":"Jeon","journal-title":"Front Public Health"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02557-w","article-title":"Factors influencing sleep quality among nurses in tertiary hospitals in Kelantan, Malaysia: a cross-sectional study","volume":"23","author":"Supian","journal-title":"BMC Nurs"},{"issue":"6","key":"R45","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1080\/15402002.2019.1677233","article-title":"Prevalence of poor sleep quality in nursing staff: a meta-analysis of observational studies","volume":"18","author":"Zeng","journal-title":"Behav Sleep Med"},{"issue":"1","key":"R46","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-020-01374-4","article-title":"Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: a cross-sectional study","volume":"18","author":"Dong","journal-title":"Health Qual Life Outcomes"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-023-01693-z","article-title":"Sleep quality and fatigue among nurses working in high-acuity clinical settings in Saudi Arabia: a cross-sectional study","volume":"23","author":"Alameri","journal-title":"BMC Nurs"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.579938","article-title":"Nurses and Night Shifts: Poor Sleep Quality Exacerbates Psychomotor Performance","volume":"14","author":"Di Muzio","journal-title":"Front Neurosci"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S511543","article-title":"Prevalence and associated factors of poor sleep quality among nurses in a tertiary care hospital: a cross-sectional study","volume":"18","author":"Haji Mohamud","journal-title":"Risk Manag Healthc Policy"},{"issue":"5","key":"R50","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10050954","article-title":"Relation between Burnout and Sleep Problems in Nurses: A Systematic Review with Meta-Analysis","volume":"10","author":"Membrive-Jim\u00e9nez","journal-title":"Healthcare (Basel)"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1401044","article-title":"Correlations between empathy fatigue, occupational identity, and sleep quality in nursing staff: a cross-sectional study","volume":"12","author":"Zhao","journal-title":"Front Public Health"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1506061","article-title":"Determinants of sleep quality and their impact on health outcomes: a cross-sectional study on night-shift nurses","volume":"15","author":"Xiao","journal-title":"Front Psychiatry"},{"issue":"2","key":"R53","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.jsmc.2022.02.007","article-title":"Sleep in normal aging","volume":"17","author":"Li","journal-title":"Sleep Med Clin"},{"issue":"9","key":"R54","doi-asserted-by":"publisher","first-page":"2648","DOI":"10.1038\/s41591-024-03155-8","article-title":"Sleep patterns and risk of chronic disease as measured by long-term monitoring with commercial wearable devices in the All of Us Research Program","volume":"30","author":"Zheng","journal-title":"Nat Med"}],"container-title":["JMIR Nursing"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:38:53Z","timestamp":1787157533000},"score":1,"resource":{"primary":{"URL":"https:\/\/nursing.jmir.org\/2026\/1\/e96912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":54,"URL":"https:\/\/doi.org\/10.2196\/96912","relation":{},"ISSN":["2562-7600"],"issn-type":[{"value":"2562-7600","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"article-number":"v9i2e96912"}}