The indirect association of subjective work performance with sleep quality and wellbeing among high-stress workers in Japan: a cross-sectional study

In today’s fast-paced and demanding working society, promoting wellbeing has become increasingly important. While sleep quality is widely recognized as a critical determinant of wellbeing, the specific pathways linking the two remain underexplored, particularly in high-stress occupational settings. Understanding these associations may enable the development of more effective strategies for promoting wellbeing in this population. Recently, work performance (presenteeism) has garnered attention for its potential intermediary role, as it may play a pivotal role in supporting employees’ wellbeing. At the same time, work performance itself is known to be closely related to sleep disturbances. However, the mediating effect has not been thoroughly examined. This study aimed to investigate whether presenteeism serves as a link in the association between sleep quality and wellbeing in a working population. A total of 129 high-stress office workers in Japan participated in this observational study. Sleep quality, presenteeism, and wellbeing were assessed using validated measures, and mediation analysis was conducted using the PROCESS macro with bootstrap samples to estimate indirect associations. Results revealed associations between sleep quality and presenteeism ( r = − 0.306, p < 0.01), as well as between sleep quality and wellbeing ( r = − 0.213, p < 0.01), indicating that poorer sleep (i.e., higher PSQI scores) was linked to both higher presenteeism (lower performance) and reduced wellbeing. Furthermore, presenteeism was found to statistically mediate the association between sleep quality and wellbeing. Even after adjusting for multiple covariates (age, sex, years of service, weekly working hours, occupational position, smoking status, and alcohol consumption), a significant indirect association was observed (Estimate = −0.446, 95% CI [−0.919, −0.072]). These findings suggest that the importance of work performance as a potential intermediary factor between sleep and wellbeing among high-stress workers. This study provides novel insights into the occupational mechanisms associated with sleep quality and wellbeing and highlights the importance of addressing presenteeism as a critical intervention target in occupational health.