Abstract
<title>Abstract</title> <p>Background Emotional labor, which requires workers to regulate their emotions during customer interactions, is a major occupational stressor negatively affecting mental health and sleep. While workplaces are increasingly adopting emotional labor manuals to mitigate health impacts, empirical evidence on their effectiveness remains limited. In particular, the effect of emotional labor manual availability may vary depending on the organizational environment. This study examined the association between emotional labor manual availability and sleep disorder, and assessed whether organizational environment factors such as supervisor support and rest autonomy modify this association. Methods This is a cross-sectional study using survey data from wage workers. The primary exposure was emotional labor manual availability (having manual/not having manual), and the outcome variable was sleep disorder occurring daily or several times per week (i.e., at least once per week). Weighted logistic regression with complex sample weights estimated odds ratios (ORs) and 95% confidence intervals (CIs). Models were sequentially adjusted for sociodemographic factors, occupational factors, and reward perception. Effect modification by supervisor support, rest autonomy, and gender was assessed using interaction terms. Results Among 24,956 wage workers, no significant overall association was found between emotional labor manual availability and sleep disorder (OR 0.95, 95% CI: 0.84–1.06). However, the association differed significantly according to supervisor support level (interaction p < 0.001). Among workers with high supervisor support, manual availability was associated with significantly reduced sleep disorder risk (OR 0.72, 95% CI: 0.61–0.85), whereas among those with low supervisor support, risk was significantly increased (OR 1.35, 95% CI: 1.14–1.59). Effect modification by rest autonomy was also statistically significant (interaction p = 0.001), and the protective effect of manual availability was significant only among workers with high rest autonomy (OR 0.76, 95% CI: 0.63–0.91). No significant gender-based effect modification was observed (interaction p = 0.718). Conclusions Although emotional labor manual availability itself showed no significant association with sleep disorder, the pattern of this association differed significantly according to the levels of supervisor support and rest autonomy. These findings suggest that emotional labor management policies should not rely on the introduction of a manual alone, but should be implemented together with organizational support systems. In particular, manual adoption significantly increased sleep disorder risk among workers with low supervisor support, who comprised approximately 40% of study participants. This indicates that supervisory training and the establishment of organizational support systems should precede manual adoption. Ensuring substantive rest conditions should also be considered a core element of emotional labor protection policies.</p>