Associations Between Night Shifts and Comorbid Depressive–Anxiety Symptoms Among Chinese Nurses: Indirect Associations via Sleep Quality and Duration

In this cross-sectional study, a higher frequency of night shifts was significantly associated with poorer mental health outcomes among Chinese nurses, with sleep quality serving as a statistical mediator. These findings suggest that optimizing shift scheduling, enhancing institutional support for sleep recovery, and integrating sleep quality monitoring into occupational health policies may be effective strategies to promote nurse well-being. This study provides empirical evidence to inform nursing management practices and health workforce policy.