{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:04:17Z","timestamp":1790661857137,"version":"4.1.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep disturbance is common among occupational populations and may vary by work schedules and psychological burdens. However, evidence among urban operation-supporting occupational groups remains limited. This study aimed to compare the prevalence of sleep disturbance among healthcare, environmental sanitation, and transportation workers in Chongqing, China, and to examine the associations of night shift work, anxiety, and depressive symptoms with sleep disturbance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study was based on the\n                      <jats:italic>Health Literacy Surveillance Project for Key Occupational Groups in Chongqing<\/jats:italic>\n                      (June\u2013September 2022). Overall, 3,667 front-line workers were included. Sleep disturbance was assessed using the\n                      <jats:italic>Chinese Center for Disease Control and Prevention sleep quality scale<\/jats:italic>\n                      . Anxiety and depressive symptoms were assessed using the\n                      <jats:italic>Generalized Anxiety Disorder-7 scale<\/jats:italic>\n                      and the\n                      <jats:italic>Patient Health Questionnaire-9<\/jats:italic>\n                      , respectively. Modified Poisson regression models with robust variance estimation were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Interaction terms were further included to examine occupational group differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of sleep disturbance was 94.1, 85.1, and 92.8% among healthcare, environmental sanitation, and transportation workers, respectively. After adjustment, environmental sanitation workers had a lower prevalence of sleep disturbance than healthcare workers (aPR\u202f=\u202f0.904, 95% CI: 0.862\u20130.947,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), whereas transportation workers showed no significant difference (aPR\u202f=\u202f0.996, 95% CI: 0.956\u20131.037,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.839). Night shift work (aPR\u202f=\u202f1.025, 95% CI: 1.003\u20131.048,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028) and anxiety symptoms (aPR\u202f=\u202f1.094, 95% CI: 1.073\u20131.116,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) were associated with a higher prevalence of sleep disturbance. Depressive symptoms showed no statistical significance in the fully adjusted main model (aPR\u202f=\u202f1.018, 95% CI: 0.999\u20131.038,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.068). The environmental sanitation sector significantly interacted with anxiety symptoms (aPR\u202f=\u202f1.082, 95% CI: 1.030\u20131.136,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), suggesting a stronger anxiety-sleep disturbance association. No significant interactions were observed between occupational group and depressive symptoms or night shift work.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sleep disturbance was prevalent among urban operation-supporting occupational groups. Night shift work and anxiety symptoms were associated with sleep disturbance, with anxiety showing the most stable association. Depressive symptoms showed a weaker, model-dependent association. Sleep and mental health interventions may need to consider occupational context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1935598","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:50:54Z","timestamp":1790661054000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sleep disturbance and its associations with night shift work, anxiety symptoms, and depressive symptoms among urban operation-supporting workers: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yilin","family":"Quan","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengqiong","family":"Chen","sequence":"additional","affiliation":[{"name":"Chongqing Municipal Center for Disease Control and Prevention","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anchao","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengliang","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.2147\/nss.S134864","article-title":"Short- and long-term health consequences of sleep disruption","volume":"9","author":"Medic","year":"2017","journal-title":"Nat Sci Sleep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.sleep.2019.01.047","article-title":"Prevalence of sleep disturbances in Chinese healthcare professionals: a systematic review and meta-analysis","volume":"67","author":"Qiu","year":"2020","journal-title":"Sleep Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"101386","DOI":"10.1016\/j.smrv.2020.101386","article-title":"Safety implications of fatigue and sleep inertia for emergency services personnel","volume":"55","author":"Dawson","year":"2021","journal-title":"Sleep Med Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"105017","DOI":"10.1016\/j.ijnurstu.2025.105017","article-title":"Night and shift work and incidence of physician-diagnosed sleep disorders in nursing staff: a prospective cohort study","volume":"164","author":"Nilsson","year":"2025","journal-title":"Int J Nurs Stud"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"6902","DOI":"10.3390\/ijerph18136902","article-title":"Prevalence of insomnia in various industries and associated demographic factors in night-shift workers using workers' specific health examination data","volume":"18","author":"Lee","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1093\/occmed\/kqg048","article-title":"Health disorders of shift workers","volume":"53","author":"Knutsson","year":"2003","journal-title":"Occup Med (Lond)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1093\/occmed\/kqr001","article-title":"Shift work and chronic disease: the epidemiological evidence","volume":"61","author":"Wang","year":"2011","journal-title":"Occup Med (Lond)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"i5210","DOI":"10.1136\/bmj.i5210","article-title":"Health consequences of shift work and insufficient sleep","volume":"355","author":"Kecklund","year":"2016","journal-title":"BMJ"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"990276","DOI":"10.3389\/fpubh.2022.990276","article-title":"The significant association between quick return and depressive symptoms and sleep disturbances in paid workers: a nationwide survey","volume":"10","author":"Yun","year":"2022","journal-title":"Front Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1093\/sleep\/11.1.17","article-title":"Sleepiness as a consequence of shift work","volume":"11","author":"\u00c5kerstedt","year":"1988","journal-title":"Sleep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.smrv.2018.03.005","article-title":"Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review","volume":"41","author":"Booker","year":"2018","journal-title":"Sleep Med Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1097\/NNA.0b013e3181d0414e","article-title":"Is it time to pull the plug on 12-hour shifts?: part 1. The evidence","volume":"40","author":"Geiger-Brown","year":"2010","journal-title":"J Nurs Adm"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.aap.2004.07.007","article-title":"Fatigue, sleep restriction and driving performance","volume":"37","author":"Philip","year":"2005","journal-title":"Accid Anal Prev"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1164\/rccm.200312-1782OC","article-title":"Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers","volume":"170","author":"Howard","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1136\/bjsports-2020-102587","article-title":"How does occupational physical activity influence health? An umbrella review of 23 health outcomes across 158 observational studies","volume":"54","author":"Cillekens","year":"2020","journal-title":"Br J Sports Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3390\/asi5060108","article-title":"Variation on work demands and sleep disturbances concerning fixed and rotating shifts in the water, sanitation, and waste sector","volume":"5","author":"Dion\u00edsio","year":"2022","journal-title":"Appl Syst Innov"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e0117700","DOI":"10.1371\/journal.pone.0117700","article-title":"Sleep duration and quality among different occupations--China national study","volume":"10","author":"Sun","year":"2015","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"193","DOI":"10.5271\/sjweh.1325","article-title":"Sleep duration and sleep-related problems in different occupations in the Hordaland health study","volume":"35","author":"Ursin","year":"2009","journal-title":"Scand J Work Environ Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"21817","DOI":"10.1038\/s41598-024-72930-x","article-title":"Prevalence and determinants of occupational depression, anxiety, and stress among Ethiopian healthcare workers","volume":"14","author":"Habtu","year":"2024","journal-title":"Sci Rep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.5665\/sleep.2810","article-title":"A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression","volume":"36","author":"Alvaro","year":"2013","journal-title":"Sleep"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1131048","DOI":"10.3389\/fpubh.2023.1131048","article-title":"Job burnout among workers with different shift regularity: interactive factors between sleep, depression, and work environment","volume":"11","author":"Gu","year":"2023","journal-title":"Front Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jad.2011.01.011","article-title":"Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies","volume":"135","author":"Baglioni","year":"2011","journal-title":"J Affect Disord"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"473","DOI":"10.31887\/DCNS.2008.10.4\/plfranzen","article-title":"Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications","volume":"10","author":"Franzen","year":"2008","journal-title":"Dialogues Clin Neurosci"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.janxdis.2015.12.001","article-title":"A systematic review of sleep disturbance in anxiety and related disorders","volume":"37","author":"Cox","year":"2016","journal-title":"J Anxiety Disord"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1038\/s41386-019-0411-y","article-title":"Sleep, insomnia, and depression","volume":"45","author":"Riemann","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.smrv.2014.10.010","article-title":"The effect of the work environment on future sleep disturbances: a systematic review","volume":"23","author":"Linton","year":"2015","journal-title":"Sleep Med Rev"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1093\/occmed\/kqg046","article-title":"Shift work and disturbed sleep\/wakefulness","volume":"53","author":"Akerstedt","year":"2003","journal-title":"Occup Med (Lond)"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1177\/10519815251344543","article-title":"Association between occupational health literacy and generalized anxiety disorder among couriers: a cross-sectional survey based in China","volume":"82","author":"Cai","year":"2025","journal-title":"Work"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.genhosppsych.2014.05.021","article-title":"Reliability and validity of the Chinese version of the patient health questionnaire (PHQ-9) in the general population","volume":"36","author":"Wang","year":"2014","journal-title":"Gen Hosp Psychiatry"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.1177\/10519815241307188","article-title":"Factors influencing sleep quality in healthcare workers: the mediating role of depression and anxiety symptoms","volume":"81","author":"Luo","year":"2025","journal-title":"Work"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.bbi.2020.05.026","article-title":"Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis","volume":"88","author":"Pappa","year":"2020","journal-title":"Brain Behav Immun"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"105273","DOI":"10.1016\/j.ijnurstu.2025.105273","article-title":"The prevalence and risk factors of shift work disorder among nurses: a systematic review and meta-analysis","volume":"174","author":"Zhao","year":"2026","journal-title":"Int J Nurs Stud"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.trf.2024.12.001","article-title":"A systematic review of studies investigating the impact of sleep deprivation on drivers\u2019 physiology and driving performance","volume":"109","author":"Tomson","year":"2025","journal-title":"Transp Res Part F Traffic Psychol Behav"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1177\/10711813251369479","article-title":"Beyond detection: a systematic review of driver passive fatigue prevention and mitigation strategies","volume":"69","author":"Rasouli","year":"2025","journal-title":"Proc Hum Factors Ergon Soc Annu Meet"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1176\/appi.ajp.2018.17111194","article-title":"Physical activity and incident depression: a meta-analysis of prospective cohort studies","volume":"175","author":"Schuch","year":"2018","journal-title":"Am J Psychiatry"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1080\/07420528.2019.1570247","article-title":"The relationship between night work, chronotype, and cardiometabolic risk factors in female hospital employees","volume":"36","author":"Ritonja","year":"2019","journal-title":"Chronobiol Int"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"653","DOI":"10.5664\/jcsm.9642","article-title":"Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies","volume":"18","author":"Wu","year":"2022","journal-title":"J Clin Sleep Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e70172","DOI":"10.1111\/jsr.70172","article-title":"Comparing the health impacts of fixed night and rotating shift work: an umbrella review of meta-analyses","volume":"35","author":"Cho","year":"2026","journal-title":"J Sleep Res"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.smrv.2012.02.002","article-title":"Shift work and the assessment and management of shift work disorder (SWD)","volume":"17","author":"Wright","year":"2013","journal-title":"Sleep Med Rev"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"4505","DOI":"10.3390\/jcm13154505","article-title":"The impact of night work on the sleep and health of medical staff\u2014a review of the latest scientific reports","volume":"13","author":"Czy\u017c-Szypenbejl","year":"2024","journal-title":"J Clin Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e0224259","DOI":"10.1371\/journal.pone.0224259","article-title":"Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study","volume":"14","author":"Garbarino","year":"2019","journal-title":"PLoS One"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"758","DOI":"10.2486\/indhealth.ms1083","article-title":"Effect of brief sleep hygiene education for workers of an information technology company","volume":"48","author":"Kakinuma","year":"2010","journal-title":"Ind Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"2138","DOI":"10.1186\/s12889-022-14599-3","article-title":"Associations of extended work, higher workloads and emotional work demands with sleep disturbance among night-shift workers","volume":"22","author":"Jeon","year":"2022","journal-title":"BMC Public Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e0000531","DOI":"10.1371\/journal.pmen.0000531","article-title":"Sleep and psychiatric disorders: bidirectional interactions and shared neurobiological mechanisms","volume":"2","author":"Hyndych","year":"2026","journal-title":"PLoS Ment Health"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.smrv.2009.04.002","article-title":"The hyperarousal model of insomnia: a review of the concept and its evidence","volume":"14","author":"Riemann","year":"2010","journal-title":"Sleep Med Rev"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1111\/pcn.13551","article-title":"Depression and lifestyle: focusing on nutrition, exercise, and their possible relevance to molecular mechanisms","volume":"77","author":"Kunugi","year":"2023","journal-title":"Psychiatry Clin Neurosci"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1007\/s40263-025-01245-w","article-title":"A 12-week, open-label, multicenter pilot study to evaluate the efficacy and safety of Lemborexant in patients with insomnia comorbid with depressive episodes (SELENADE)","volume":"40","author":"Takaesu","year":"2026","journal-title":"CNS Drugs"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s12916-024-03814-0","article-title":"Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms","volume":"23","author":"Manter","year":"2025","journal-title":"BMC Med"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1935598\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:51:15Z","timestamp":1790661075000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1935598\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":48,"alternative-id":["10.3389\/fpubh.2026.1935598"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1935598","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1935598"}}