Sleep problems and sickness absence among middle-aged employees

Abstract

Objective The aim of this study was to examine whether sleep problems predict subsequent sickness absence among middle-aged public sector employees. MethodsThe data included 5391 female and 1454 male employees of the City of Helsinki from questionnaire surveys at baseline in [2000][2001][2002]. These data were prospectively linked to the employer's sickness absence register data, with a mean follow-up time of 4.1 years. Using Poisson regression analysis, we examined associations between sleep problems (none, rare, occasional, and frequent), as indicated by the Jenkins Sleep Questionnaire, and self-certified short (1-3 days) and medically confirmed intermediate (4-14 days) and long (≥15 days) sickness absence spells. Sociodemographic factors, working conditions, work-family interface, health behaviors, and health status were obtained from the baseline surveys.Result At baseline, 21% of women and 17% of men reported frequent sleep problems. Frequent sleep problems were associated with subsequent sickness absence spells irrespective of length of absence among both women and men after adjusting for age. After full adjustment for all covariates, the associations attenuated but remained for self-certified sickness absence [risk ratio (RR) for women 1.40, 95% confidence interval (95% CI) 1.25-1.56 and RR 1.59, 95% CI 1.24-2.03 for men], and medically confirmed intermediate (RR 1.34, 95% CI 1.17-1.52 and RR 1.35, 95% CI 1.02-1.77, for women and men, respectively) and long (RR 1.58, 95% CI 1.29-1.94 and RR 1.44, 95% CI 0.93-2.21, for women and men, respectively) sickness absence spells. Occasional sleep problems were also associated with sickness absence, but the associations were somewhat weaker. ConclusionIn occupational healthcare, sleep problems should be addressed to prevent their occurrence and subsequent ill-health and sickness absence.Key terms health; health behavior; obesity; prospective study; sleep problem; sickness absence; working conditions. Sleep problems consist of difficulties initiating and maintaining sleep or non-restorative sleep. The prevalence of sleep problems, referred to as insomnia symptoms, in the general population has been around 35%, with a range of 10-15% being assessed as chronic (1-4). During the past three decades, occasional sleep problems have been increasing among the working population in Finland, while prevalence of chronic sleep problems has remained relatively stable (1). It is therefore important to know whether sleep problems have consequences for health.Sickness absence is a generic indicator of overall health, functioning, and work-related disability, and it predicts future health outcomes, such as self-rated health and mortality (5, 6). However, there is only limited evidence on the association between sleep problems and sickness absence. A study from Norway reported that sleep problems predicted sickness absence and that the association of sleep problems was stronger for sickness absence spells >90 days than for spells of 15-89 days (7). In Sweden, sleep problems have also...

Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults

“…Furthermore, health risks indicated by work disability, for example, are higher for frequent as compared to occasional insomnia symptoms [18,19,62]. In order to promote better health and well-being, our results also highlight the importance to focus on the milder insomnia-related symptoms as well as the more serious ones.…”

“…The response alternatives were reclassified into three groups: no (answering modes ‘not at all’ and ‘a little’), occasional (answering mode ‘to some extent’), and frequent (answering modes ‘quite often’ and ‘very often’). Three categories were formed to be able to better show a gradient in the associations between sociodemographic and socioeconomic factors and insomnia symptoms, and because even milder and occasional symptoms are related to poorer health and work ability [18,19]. In addition to insomnia-related symptoms, frequency of hypnotic use was requested.…”

“…Moreover, nationally representative studies focusing on a broad variety of sociodemographic and socioeconomic factors as determinants of both sleep duration and insomnia-related symptoms over life course are sparse. Further evidence is needed because insomnia is the most prevalent sleep problem, and it is associated with key public health problems [16,17], work disability [18,19], health care use [20,21], and mortality [22]. In Finland, insomnia is even more prevalent than in many other European countries [23] highlighting the importance to shed light on social patterning of sleep in the Finnish general population.…”

Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs

“…These findings were echoed in the study by Bultmann and colleagues (2013) 3 , who found that in the Danish Work Environment Cohort Study, sleep disturbances and fatigue significantly predicted sickness absence. Rahkonen and colleagues (2012) 4 examined data from employees of the City of Helsinki and found that frequent sleep problems were associated with increased sickness absences, both short and long in duration. Rajaratnam and colleagues (2011) 5 found that police officers with probable sleep disorders were more likely to miss work as well.…”

Insomnia Symptoms, Sleep Duration, and Disability Pensions: a Prospective Study of Swedish Workers

“…Prospective studies have shown clear associations between sleep problems and long-term sick leave or disability retirement [4][5][6][7][8][9][10][11]. Musculoskeletal disorders and mental illness were often implicated [9,10].…”