Objective To analyze the current status of sleep quality and cognitive flexibility among railway construction workers in a plateau region, providing a scientific basis for enhancing their physical and mental health and work efficiency in the high -altitude environment.

Methods From July to August 2022, a convenience sampling method was used to conduct questionnaire surveys of 339 railway construction workers in a plateau area, with the Cognitive Flexibility Inventory (CFI) and the Pittsburgh Sleep Quality Index(PSQI). Multiple linear stepwise regression models were employed to analyze the factors influencing sleep quality.

Results A total of 339 valid questionnaires were collected with a valid response rate of 94.5%. The mean score for cognitive flexibility of the workers was (61.43 ±10.87) points, and the mean score for sleep quality was (5.32 ±3.39) points, while 111 (32.7%) of them had sleep disturbances. Higher educational levels were associated with higher levels of cognitive flexibility (P < 0.05). Workers residing at altitudes < 2 500 meters demonstrated higher cognitive flexibility than those ≥ 2 500 meters (P < 0.05). The total PSQI score (r = 0.16), as well as scores for subjective sleep quality (r = 0.23), sleep latency(r = 0.15), sleep efficiency (r = -0.12), nocturnal sleep disturbances (r = 0.15), and daytime dysfunction (r = 0.29), were correlated with the controllability dimension of cognitive flexibility (all P < 0.05). No significant correlations were found between the selectivity dimension of cognitive flexibility and either of the sleep quality dimensions(all P > 0.05). Multiple linear stepwise regression analysis showed that each one-level increase in self -reported deterioration of physical health was associated with a 0.968 -point increase in sleep quality score (P < 0.01); each one -level increase in perceived worsening of plateau living experience was associated with a 0.772 -point increase in sleep quality score(P < 0.01); and each one-level increase in educational level was associated with a 0.501- point increase in sleep quality score(P < 0.01).

Conclusions The sleep quality and cognitive flexibility of railway construction workers in plateau regions were negatively influenced by various factors and should not be overlooked. Improving sleep quality and enhancing cognitive flexibility in this population would be crucial for promoting individual mental health, work efficiency, and adaptability.