Abstract
PURPOSE: The purpose of this study was to investigate the trajectories of sleep disturbance among school teachers in China, the factors that influencing these trajectories, and their association with mental health outcomes. METHODS: The participants in this study were 3,634 teachers from Shenzhen city, China, with 21.2% of them being males and a mean age of 34.69 years. The survey was conducted in three waves between April 2021 and June 2022, and assessed sleep disturbance, neuroticism, resilience, negative life events, depression, anxiety, and demographic variables. Latent Growth Mixture Modeling (LGMM) was used to identify different latent trajectory classes of sleep disturbance. Multivariable logistic regression was then employed within the best-fitting LGMM to examine the associations between trajectory membership with both predictors and mental health outcomes. RESULTS: The prevalence of sleep disturbance among school teachers in the three surveys was 19.0%, 16.6%, and 18.8%, respectively. Four trajectories of sleep disturbance were identified within one year: no/low (73.3%), persistent (16.2%), new-onset (5.3%), and remission (5.2%). Higher neuroticism and lower resilience were associated with increased risks of persistent or new-onset sleep disturbance. A greater number of negative life events was a potential risk factor for new-onset sleep disturbance, whereas younger age protected against persistent sleep disturbance. Additionally, teachers in the persistent and new-onset trajectories were more likely to report depression and anxiety. CONCLUSIONS: Although most teachers' sleep disturbance remains mild or resolved over time, a subset of teachers, particularly those with the aforementioned risk factors, experience persistent or new-onset sleep disturbance. Therefore, targeted interventions for these teachers are warranted.