Prevalence of Insufficient Sleep and Its Associated Factors Among Working Adults in Malaysia

Abstract

Introduction: Given the scarcity of data on sleep insufficiency in developing countries and its emerging importance in public health, this study aims to provide the prevalence and factors associated with insufficient sleep among working Malaysian adults. Materials and Methods: A total of 11,356 working adults (≥18 years) were recruited from a cross-sectional online health and work survey. Sleep duration was self-reported and was categorised as insufficient sleep (<7 h) and sufficient sleep (≥7 h) based on the National Sleep Guidelines' daily sleep time recommendation for adults. The 10-item Kessler scale was used to assess psychological distress levels (cutoff score ≥20). Bivariate and multivariable regression analyses were performed to examine the factors associated with insufficient sleep. Results: The mean age of the participants was 35.7 years (standard deviation, SD±9.2). There were more female (n=6613; 58.2%) respondents. The mean sleep duration was 6.49 h (SD±1.10). A total of 6212 individuals (54.7%) reported getting <7 h of sleep daily. After adjusting for gender, marital status and educational attainment, older age (odds ratio, OR=2.22, 95% confidence interval, 95% CI: 1.72-2.86), ever smoking (OR=1.38, 95% CI: 1.25-1.53), and high psychological distress (OR=1.33, 95% CI: 1.17-1.53) were found to be associated with insufficient sleep. Factors associated with sleep duration of <7 h per night included having children (OR=1.35, 95% CI: 1.21-1.50), lifestyle factors (OR=1.38, 95% CI: 1.25-1.53), poor sleeping conditions (OR=1.21, 95% CI: 1.07-1.36), and mental health issues (OR=1.32, 95% CI: 1.12-1.54). Discussion and Conclusion: More than half of the participants reported sleep insufficiency. Older age, ever smoking, and high levels of psychological distress were significantly associated with insufficient sleep. Our findings recognise sleep as an emerging public health issue. Smoking cessation programmes and addressing high psychological distress may be beneficial to improve sleep.

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“…Despite this, both chronotypes demonstrated a reduction in total eating window post-intervention. A recent large cross-sectional study among working adults in Malaysia discovered that more than 50% of the respondents sleep less than 7 h/day, which was associated with having children, lifestyle factors, poor sleeping conditions and mental health issues [59]. Hence, strategies to enhance sleep duration might involve education on the importance of adequate sleep and addressing the abovementioned factors.…”

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“…Over the past several decades, beginning in 1985 sleep duration at the population level in the United States (US) began a steep decline. 12 Approximately 75% of adults in the US report insufficient sleep in the prior 30 days, 2 and recent analyses of data collected among working adults in Asia show that average reported sleep duration in an employed population was 6.4 hours, 13 falling short of the recommended 7 to 9 hours for adults. 14,15…”

“…Over the past several decades, beginning in 1985 sleep duration at the population level in the United States (US) began a steep decline. 12 Approximately 75% of adults in the US report insufficient sleep in the prior 30 days, 2 and recent analyses of data collected among working adults in Asia show that average reported sleep duration in an employed population was 6.4 hours, 13 falling short of the recommended 7 to 9 hours for adults. 14,15 While sleep duration is important, sleep health is a multidimensional construct, and additional dimensions of sleep such as timing and satisfaction are important considerations and consequential for daytime alertness.…”