Open AccessArticle Prevalence and Factors Associated with Insomnia Among Healthcare Workers in Kazakhstan During the COVID-19 Pandemic: A Cross-Sectional Study 1 Department of Clinical Disciplines, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan 2 Department of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan 3 Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA 4 Higher School of Psychology, Turan University, Almaty 050013, Kazakhstan 5 Department of Communication Skills, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan 6 Florida Department of Health in Miami-Dade County, Miami, FL 33125, USA 7 School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan 8 B. Atchabarov Scientific-Research Institute of Fundamental and Applied Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan 9 Department of Biostatistics and Foundations of Scientific Research, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan 10 Department of Research Management, JSC Research Institute of Cardiology and Internal Diseases, Almaty 050012, Kazakhstan add Show full affiliation list remove Hide full affiliation list * Authors to whom correspondence should be addressed. Medicina 2026, 62(6), 1094; https://doi.org/10.3390/medicina62061094 (registering DOI) Submission received: 29 April 2026 / Revised: 26 May 2026 / Accepted: 3 June 2026 / Published: 4 June 2026 Abstract Background and Objectives: Healthcare workers (HCWs) involved in the COVID-19 response are at increased risk of mental health disturbances, including sleep disorders. This study aimed to assess the prevalence and predictors of insomnia among HCWs in Almaty, Kazakhstan. Materials and Methods: A cross-sectional study was conducted between 11 and 26 September 2021, including 553 HCWs. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI). The primary binary outcome was defined as an ISI score ≥ 10, while ISI ≥ 15 was used descriptively to indicate moderate-to-severe insomnia symptoms. Associations were evaluated using chi-square tests and multivariable logistic regression models. Statistical significance was set at p 1 year (AOR = 2.28, 95% CI: 1.33–3.89) were significantly associated with increased odds of insomnia. Conclusions: Insomnia symptoms were common among surveyed HCWs during the COVID-19 pandemic and were associated with selected demographic and occupational characteristics, including professional role, education level, and duration of work with COVID-19 patients. These findings highlight the need for targeted mental health interventions and structural support systems for HCWs in Kazakhstan. Keywords: COVID-19; healthcare worker; medical worker; insomnia; mental health 2. Materials and Methods 2.1. Study Design This cross-sectional study was conducted between 11 and 26 September 2021, using an online survey to collect quantitative data from healthcare workers. The inclusion criteria included any healthcare professional working in hospitals or healthcare facilities designated as treatment centers for COVID-19 patients. Relevant services at these facilities encompassed medical evaluations for at-risk individuals, intensive care units, inpatient units, and other medical services specifically designed for the care of COVID-19 patients. Direct work with COVID-19 patients was not treated as an eligibility criterion. 2.2. Study Population For participant selection, the prevalence of insomnia among healthcare workers during the COVID-19 pandemic was estimated to be 0.43 [ 17]. Based on this prevalence, a required sample size of 334 was calculated with a margin of error (d) of 0.05, from a population of 3218 [ 18]. The study used a non-probability convenience sampling strategy, and data were collected using SurveyMonkey.com software (SurveyMonkey Inc., San Mateo, CA, USA). Therefore, the study sample should be interpreted as a respondent sample of HCWs who were reachable and willing to participate in an online survey, rather than as a probability-based representative sample of all HCWs in Kazakhstan. All participants were provided with detailed information about the study’s objectives, methods, and consent forms. The study was conducted in accordance with the Declaration of Helsinki. The study protocol received ethical approval from the Institutional Review Board of Kazakh National Medical University in Almaty, Kazakhstan (approval number: 8/114). Written informed consent was obtained from all participants prior to participation. 2.3. Study Instruments The study employed a structured questionnaire to gather information on demographic characteristics, work details, and perceived support from administration and colleagues. Current/recent insomnia symptoms were assessed using the Insomnia Severity Index (ISI), a seven-item instrument that evaluates the perceived severity and impact of insomnia symptoms. The ISI asks participants to rate the severity of difficulties with sleep onset, sleep maintenance, and early morning awakening; satisfaction with the current sleep pattern; the extent to which sleep problems interfere with daytime functioning; how noticeable the sleep problem is to others; and the level of distress or worry caused by the sleep problem. Each item is scored from 0 to 4, yielding a total score ranging from 0 to 28, with higher scores indicating more severe insomnia symptoms. For the primary analysis, insomnia symptoms were defined a priori as an ISI score ≥ 10, consistent with the threshold used to identify probable insomnia cases [ 19]. The internal consistency of the ISI in the present sample was high, with a Cronbach’s alpha of 0.87. 2.4. Statistical Data Analysis Methods Data analysis was performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). Descriptive statistics were used to summarize the characteristics of healthcare workers and their mental health outcomes. The primary dependent variable was binary insomnia status, defined as ISI 10 years 173 (31.28) Occupation Administrative/Healthcare 29 (5.24) Physician 412 (74.50) Nurse 112 (20.25) City of residence Other 202 (36.53) Almaty 351 (63.47) Duration of work with COVID-19 patients ≤1 year 146 (26.40) >1 year 247 (44.67) No experience 160 (28.93) Presence of challenges when working with COVID-19 patients None 363 (65.64) Some challenges present 190 (34.36) 1—Percentages may not sum to 100% due to missing values. Table 2. Sleep Quality Outcomes. Table 2. Sleep Quality Outcomes. Outcome Frequency (%) 1Insomnia status based on the predefined ISI ≥ 10 threshold ISI 10 years 1.760 1.010–3.066 0.046 1.563 0.525–4.653 0.423 Specialty (Ref. category: Administrative/Healthcare) Physician 2.428 0.789–7.471 0.122 4.919 1.253–19.303 0.022 Nurse 2.206 0.670–7.262 0.193 1.929 0.469–7.940 0.363 Place of Work (Ref. category: other) Almaty 1.020 0.685–1.518 0.923 0.893 0.579–1.378 0.611 Work Experience (Ref. category: Did not work) ≤1 year 1.902 1.096–3.300 0.022 1.883 1.045–3.394 0.035 >1 year 2.407 1.470–3.940 0.0005 2.277 1.334–3.887 0.003 Problem with COVID (Ref. category: none) Some challenges 1.452 0.976–2.161 0.065 1.130 0.728–1.753 0.586 Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. © 2026 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Share and Cite MDPI and ACS Style Aryntayeva, N.; Shonbay, K.; Koru-Sengul, T.; Bagiyarova, F.; Aimbetova, G.; Zhang, G.; Umbetkulova, S.; Zhumagaliuly, A.; Baisugurova, V.; Karibayeva, I. Prevalence and Factors Associated with Insomnia Among Healthcare Workers in Kazakhstan During the COVID-19 Pandemic: A Cross-Sectional Study. Medicina 2026, 62, 1094. https://doi.org/10.3390/medicina62061094 AMA Style Aryntayeva N, Shonbay K, Koru-Sengul T, Bagiyarova F, Aimbetova G, Zhang G, Umbetkulova S, Zhumagaliuly A, Baisugurova V, Karibayeva I. Prevalence and Factors Associated with Insomnia Among Healthcare Workers in Kazakhstan During the COVID-19 Pandemic: A Cross-Sectional Study. Medicina. 2026; 62(6):1094. https://doi.org/10.3390/medicina62061094 Chicago/Turabian Style Aryntayeva, Nurila, Kuanysh Shonbay, Tulay Koru-Sengul, Fatima Bagiyarova, Gulshara Aimbetova, Guoyan Zhang, Saltanat Umbetkulova, Abzal Zhumagaliuly, Venera Baisugurova, and Indira Karibayeva. 2026. "Prevalence and Factors Associated with Insomnia Among Healthcare Workers in Kazakhstan During the COVID-19 Pandemic: A Cross-Sectional Study" Medicina 62, no. 6: 1094. https://doi.org/10.3390/medicina62061094 APA Style Aryntayeva, N., Shonbay, K., Koru-Sengul, T., Bagiyarova, F., Aimbetova, G., Zhang, G., Umbetkulova, S., Zhumagaliuly, A., Baisugurova, V., & Karibayeva, I. (2026). Prevalence and Factors Associated with Insomnia Among Healthcare Workers in Kazakhstan During the COVID-19 Pandemic: A Cross-Sectional Study. Medicina, 62(6), 1094. https://doi.org/10.3390/medicina62061094 Article Metrics Article metric data becomes available approximately 24 hours after publication online.
