More than half of secondary school teachers in the state of Selangor had poor sleep quality!

Teachers form a significant proportion of the workforce. According to the Ministry of Education, Malaysia, teachers are among the largest professional group of the country’s workforce. Teaching is viewed as a demanding and stressful profession. Teachers are burden with a high load of administrative duties in addition to teaching, as well as increasing academic demands from both students and parents. Teachers also face constant challenges of having to update their teaching methodologies, and some may seek to upgrade their qualifications through specialization courses. All the above factors may affect their sleep duration as well as sleep quality.

Sleep duration is easily measured but it may not be as comprehensive as the duration of sleep does not indicate the quality of sleep. One can have an adequate duration of sleep which is of poor quality. Sleep quality is one of the important factors for maintaining good physical and mental health. Sleep quality is also related with metabolic syndrome, poor glucose metabolism and poor control of blood pressure; contributing to higher risks of cardiovascular diseases, poor mental health and poor quality of life.

As there are limited studies conducted on sleep quality, especially among school teachers, a study was carried out to estimate the prevalence and determine the associated factors of poor sleep quality among secondary school teachers in the state of Selangor, Malaysia. This is a part of the CLUSTer teachers cohort study.

The study was conducted in two phases. Phase I tested the reliability of the Pittsburgh Sleep Quality Index in the Malay language (M-PSQI), whereas Phase II determined the prevalence and factors associated with poor sleep quality. Participants were recruited using multistage sampling. A self-administered questionnaire was used to collect data on socio-demographic and teaching characteristics, comorbidities and characteristics of sleep. The M-PSQI was used to measure sleep quality. The Depression Anxiety Stress Scale-21 was used to measure mental health status.
A total of 1871 secondary school teachers were recruited. The participants were majority females (87.4%), Malays (86.4%) and married (89%). The mean global score of M-PSQI was 5.45 (95% CI: 3.80-7.09). The prevalence of poor sleep quality was 61% (95% CI 53.9-66.7%). Only 21% of them had sleep duration of seven hours and more.

Total teaching hours/day, depression and stress were significantly associated with poor sleep quality in the univariate analysis, while only stress (OR 1.04; 95% CI 1.02-1.05%) remained significant in the multivariate analyses. Stress faced by teachers may arise from the high demand for students’ excellent academic performance from parents and school management. Work overload and repetitive tasks were also associated with poor sleep quality.

Although the prevalence of poor sleep quality was high among our participants, the majority of them rated their overall sleep quality as fairly good and very good. This discrepancy may imply that poor sleep quality was prevalent without their knowledge and no precautionary measures were taken. Their ignorance of sleep problem should be addressed promptly as it may affect their physical and mental health as well as the quality of life. Teachers’ poor mental health and poor sleep quality can impact on the school instructional system which may influence the students’ academic performance. Therefore, it is recommended that teachers be screened for sleep quality and mental health routinely.

The above study was carried out by Dr Nor Asma Musa, a DrPH candidate under the supervision of Associate Professor Moy Foong Ming and Professor Wong Li Ping. The manuscript is published in the Journal of Industrial Health.

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