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940, 95% confidence interval [CI] 3.124-11.292), anxiety (aOR 4.233, 95% CI 2.138-8.381), stress (aOR 2.880, 95% CI 1.915-4.33 and social support (aOR 0.959, 95% CI 0.939-0.98 have a significant effect on sleep quality after adjusted by ****, age, smoking status, drinking status, caffeine intake, past shift working and circadian rhythm type. Conclusions Depression, anxiety, stress and social support were associated with sleep quality among pre-employed firefighters. Repeated follow-up studies of pre-employed firefighters are needed