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A staggering number of nurses may suffer from insomnia and about one in eight admit to taking medication to help them stay awake during the day, a new study finds.

The findings, presented at SLEEP 2019, the 33rd annual meeting of the Associated Professional Sleep Societies, add to a growing list of studies that sound the alarm on the condition of health care practitioners forced to work long, stressful shifts. This latest work reveals that 31% of nurses show symptoms consistent with chronic insomnia. The same amount also show signs of shift work disorder, which happens when one’s work shift coincides with the time they’d normally be asleep.

“We were surprised by the number of nurses potentially suffering from common sleep disorders, most notably, chronic insomnia and shift work disorder,” says lead author Dr. Francis Christian, a second-year fellow at the University of Oklahoma Health Sciences Center in Oklahoma City, in a statement.

Perhaps even more frightening is that 13% of nurses rely on medication to help keep them awake, and 4.5% battle excessive daytime sleepiness. In addition, more than a quarter (27%) take sleeping medication before bed, while nearly half (49%) typically log about 6.6 hours of sleep each night — less than the recommended seven hours.

The study also found that 18.5% of nurses have a moderate-to-severe risk for obstructive sleep apnea.

Results were conceived from an online survey of 1,165 nurses working at a medical center. Respondents answered questions about their sleep schedules, symptoms they experience, and medications they use.

“Nurses are at increased risk for circadian rhythm sleep-wake disorders such as shift work disorder,” says Christian, who notes that nearly 100,000 deaths occur each year in U.S. hospitals as a result of medical errors. “Recognition needs to take place so that we can screen appropriately and make scheduling modifications to help alleviate the burden of shift work disorder among nurses.”