Frontiers in psychiatry · 2026
Occupational and psychosocial correlates of sleep disturbance among Chinese expatriate employees in Iraq's Maysan oilfields: a cross-sectional study using regression and network analysis.
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Liu Ziming, Li Meihui, Yang Chuanjiang, Zhang Chun'e, Gu Gonglu, Zhang Yiran, Liu Hongye, Du Jing, Fu Yi, Han Shun, Li Qingwei
Аннотация
INTRODUCTION: Chinese expatriate oilfield employees working in Iraq are exposed to multiple occupational and psychosocial stressors, yet evidence on sleep disturbance and its correlates in this workforce remains limited.
METHODS: A cross-sectional survey was conducted among 917 employees. 826 (90.1%) were included after excluding incomplete or invalid responses. Sleep quality and related concern was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the second item of the General Health Questionnaire-12 (GHQ-12). Depression, anxiety, occupational stress, burnout dimensions, Iraq-specific environmental stress, and perceived social support were measured using validated instruments and context-specific questionnaires. Multivariable linear regression and regularized partial correlation network analyses were performed.
RESULTS: The median global PSQI score was 3 (IQR 1-6). Sleep disturbance prevalence was 11.9% (95% CI 9.7%-14.3%) using PSQI > 7 and 25.2% (95% CI 22.3%-28.3%) using PSQI > 5, while 61.3% (95% CI 57.9%-64.7%) reported sleep-related concern on the GHQ-12. In the fully adjusted regression model (adjusted R2 = 0.522), poorer sleep quality was independently associated with higher educational attainment (high school or junior college: β = 0.68, p = 0.012; bachelor degree or above: β = 0.89, p = 0.011), more depressive symptoms (β = 0.25, p < 0.001), higher occupational stress (β = 0.03, p = 0.022), greater emotional exhaustion (β = 0.90, p < 0.001), and greater environmental stress (β = 0.57, p = 0.002). In the global network, PSQI had direct edges with depressive symptoms, anxiety symptoms, emotional exhaustion, and environmental stress and showed moderate centrality (strength = 0.69; expected influence = 0.61), with good stability of strength (CS-coefficient = 0.75). In the component network, subjective sleep quality and daytime dysfunction had the highest centrality among PSQI domains.
CONCLUSION: Although overall self-reported sleep quality was relatively good among Chinese expatriate employees in Iraq, subclinical sleep problems and sleep-related concern were common. Poorer sleep quality was more consistently linked to depressive symptoms, work-related stress and exhaustion, and environmental stressors, while subjective sleep quality and daytime dysfunction emerged as key sleep domains. These findings may help inform priorities for improving sleep health in this expatriate oilfield workforce.
METHODS: A cross-sectional survey was conducted among 917 employees. 826 (90.1%) were included after excluding incomplete or invalid responses. Sleep quality and related concern was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the second item of the General Health Questionnaire-12 (GHQ-12). Depression, anxiety, occupational stress, burnout dimensions, Iraq-specific environmental stress, and perceived social support were measured using validated instruments and context-specific questionnaires. Multivariable linear regression and regularized partial correlation network analyses were performed.
RESULTS: The median global PSQI score was 3 (IQR 1-6). Sleep disturbance prevalence was 11.9% (95% CI 9.7%-14.3%) using PSQI > 7 and 25.2% (95% CI 22.3%-28.3%) using PSQI > 5, while 61.3% (95% CI 57.9%-64.7%) reported sleep-related concern on the GHQ-12. In the fully adjusted regression model (adjusted R2 = 0.522), poorer sleep quality was independently associated with higher educational attainment (high school or junior college: β = 0.68, p = 0.012; bachelor degree or above: β = 0.89, p = 0.011), more depressive symptoms (β = 0.25, p < 0.001), higher occupational stress (β = 0.03, p = 0.022), greater emotional exhaustion (β = 0.90, p < 0.001), and greater environmental stress (β = 0.57, p = 0.002). In the global network, PSQI had direct edges with depressive symptoms, anxiety symptoms, emotional exhaustion, and environmental stress and showed moderate centrality (strength = 0.69; expected influence = 0.61), with good stability of strength (CS-coefficient = 0.75). In the component network, subjective sleep quality and daytime dysfunction had the highest centrality among PSQI domains.
CONCLUSION: Although overall self-reported sleep quality was relatively good among Chinese expatriate employees in Iraq, subclinical sleep problems and sleep-related concern were common. Poorer sleep quality was more consistently linked to depressive symptoms, work-related stress and exhaustion, and environmental stressors, while subjective sleep quality and daytime dysfunction emerged as key sleep domains. These findings may help inform priorities for improving sleep health in this expatriate oilfield workforce.