Exploring association of rotating shift work and sleep quality with abdominal obesity among nurses and paramedical healthcare workers: an analytical cross-sectional study

Shift rotation among healthcare professionals might disrupt healthy sleep patterns and body weight. Abdominal obesity and related health complications may arise due to poor sleep and irregular working hours. The present study investigated the association of rotating shift work and sleep quality with abdominal obesity in healthcare workers at a tertiary care public hospital in Karachi, Pakistan. This analytical cross-sectional study was conducted at Dow University of Health Sciences from December 2024 to May 2025. A total of 279 nurses and paramedical healthcare workers aged 25–55 years were recruited through non-probability consecutive sampling. Data on demographics, occupational factors, anthropometric measurements, and sleep quality were collected using a structured questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Data were analyzed using R Studio. Associations between categorical variables were assessed using the chi-square test, and factors associated with abdominal obesity were examined using univariable and multivariable logistic regression analyses. A p-value ≤ 0.05 was considered statistically significant. Abdominal obesity was observed in 150 (53.8%) participants. Significant associations were found between abdominal obesity and age > 30 years, female gender, work experience > 5 years, marital status, having children, poor sleep quality, and fixed duty schedule in the univariable analysis (all p-values < 0.05). After adjustment for the variables included in the multivariable model, age > 30 years (aOR: 4.83; 95% CI: 2.06–11.33), professional experience > 5 years (aOR: 2.68; 95% CI: 1.23–5.83), and poor sleep quality (aOR: 3.82; 95% CI: 1.86–7.84) were significantly associated with higher prevalence odds of abdominal obesity, whereas male gender was associated with lower prevalence odds of abdominal obesity compared with female gender (aOR: 0.31; 95% CI: 0.16–0.57). No statistically significant associations were observed for number of children, family income, department, professional category, marital status, or duty schedule after adjustment. Abdominal obesity was highly prevalent among healthcare workers. After adjustment for the variables included in the multivariable model, age > 30 years, professional experience > 5 years, and poor sleep quality were significantly associated with higher prevalence odds of abdominal obesity, whereas male gender was associated with lower prevalence odds. No statistically significant association was observed between duty schedule and abdominal obesity after adjustment.