Background A chronic state of imbalance between effort and reward can affect sleep quality. However, few studies have explored the relationship between variables in the work-related stress (the effort-reward imbalance model, ERI model) and sleep quality in community health workers in mainland China. We investigated the relationship between ERI and sleep quality in community health workers. Methods This cross-sectional study was conducted from September to November 2018 and involved 249 registered doctors and 223 registered nurses. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep problems status of the participants. The ERI questionnaire was administered to evaluate job-related stress. Multivariate logistic regression was performed to evaluate the factors related to sleep quality. Results The ERI ratio of the 472 health workers was 1.17 ± 0.22, and 273 health workers (57.84%) had PSQI scores > 7.There were statistically significant differences in the effort scores, overcommitment scores and ERI ratio between the health workers with and without sleep problems. The ERI ratio was an independent risk factor for sleep quality; sleep quality, race, type of work, shift work,job title, and personal monthly income were related to the ERI ratio among community health workers. Conclusions We found that sleep problems were prevalent, work effort was greater than reward and a positive correlation between effort-reward and sleep quality among community health workers in China. Managers should focus on the factors that influence sleep problems among community health workers, balance the efforts and rewards of work, and reduce the incidence of sleep problems.

Background: A chronic state of imbalance between effort and reward can affect sleep quality. However, few studies have explored the relationship between variables in the ERI model and sleep quality in community health workers in mainland China. We investigated the relationship between effort–reward imbalance and sleep quality in community health workers. Methods: This cross-sectional study was conducted from September to November 2018 and involved 249 registered doctors and 223 registered nurses. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep disorder status of participants. The Effort-Reward Imbalance (ERI) questionnaire was administered to evaluate job-related stress. Multivariate logistic regression was performed to evaluate the factors related to sleep quality. Results: The ERI ratio of 472 health workers was 1.17 ± 0.22, and 273 health workers (57.84%) had PSQI scores >7. There were statistically significant differences in effort scores, overcommitment scores and the total ERI ratio between the health workers with sleep disorders and those without sleep disorders. The ERI ratio was an independent risk factor for sleep quality; age, education, type of work, shift work, and job title were related to the ERI ratio. Conclusions: This study found that sleep disorders were prevalent, work effort was greater than reward and a positive correlation between effort-reward and sleep quality among the health workers community in China. Managers should pay attention to the factors that influence sleep disorders among community health workers, balance the efforts and rewards of work, and reduce the incidence of sleep disorders.