Sleep problems and their correlates in a working population

Stanford University Department of Medicine Palo Alto California
Journal of General Internal Medicine (Impact Factor: 3.45). 01/1995; 10(1):25-32. DOI: 10.1007/BF02599573


OBJECTIVE: To measure the prevalence of sleep problems in a working population and examine their association with health problems, health-related
quality-of-life measures, work-related problems, and medical expenditures. Also, to explore the usefulness of a sleep-problems
screen for mental health conditions and underlying sleep disorders.

DESIGN: Cross-sectional survey administered via voice mail and telephone interview.

SETTING: A San Francisco Bay Area telecommunications firm.

PARTICIPANTS: Volunteer sample of 588 employees who worked for a minimum of six months at the company and were enrolled in its fee-for-service
health plan.

MEASUREMENTS AND MAIN RESULTS: Thirty percent of respondents reported currently experiencing sleep problems and were found to have worse functioning and
well-being (general health, cognitive functioning, energy), more work-related problems (decreased job performance and lower
satisfaction, increased absenteeism), and a greater likelihood of comorbid physical and mental health conditions than were
the respondents who did not have sleep problems. They also demonstrated a trend toward higher medical expenditures.

CONCLUSIONS: Self-perceived sleep problems were common among the respondents and were associated with poorer health and health-related
quality of life. A single question about sleep problems may serve as an effective screen for identifying primary care patients
with mental health problems, as well as underlying sleep disorders.

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    • "As a central part of recovery, sleep quality is said to be important in preventing long-term negative effects of stress on health. Poor sleep quality, including fragmented sleep (increased amount of awakenings), inefficient sleep (reduced percentage of time spent sleeping) and increased sleep onset latency (increased time needed to fall asleep), has been associated with a variety of negative consequences, including health impairments such as elevated risk of myocardial infarction, coronary heart disease, muscle pain, headaches and gastrointestinal problems (Kuppermann et al., 1995; Schwartz et al., 1999). The causes of low sleep quality are various; however, evidence is increasing that work stress may play an important role in the development of disturbed sleep quality. "
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    ABSTRACT: The present study investigated short-term effects of daily social exclusion at work on various indicators of sleep quality and tested the mediating role of work-related worries using a time-based diary study with ambulatory assessments of sleep quality. Ninety full-time employees participated in a 2-week data collection. Multilevel analyses revealed that daily workplace social exclusion and work-related worries were positively related to sleep fragmentation in the following night. Daily social exclusion, however, was unrelated to sleep onset latency, sleep efficiency and self-reported sleep quality. Moreover, worries did not mediate the effect of social exclusion at work on sleep fragmentation. Theoretical and practical implications of the results are discussed.
    Full-text · Article · Aug 2013 · Stress and Health
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    • "It is estimated that 25% to 30% of adults have occasional sleep difficulties and about 10% encounter chronic insomnia that meet diagnostic criteria for insomnia with the presence of symptoms for at least 1 month [2,3]. Health troubles associated with insomnia include lower quality of life, greater use of medical services as well as decreased work efficiency [4]. Insomnia is also associated with higher risk of depression and augment rates of absenteeism [5,6]. "
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    ABSTRACT: Background Insomnia is a widespread human health problem, but there currently are the limitations of conventional therapies available. Suanzaoren decoction (SZRD) is a well known classic Chinese herbal prescription for insomnia and has been treating people’s insomnia for more than thousand years. The objective of this study was to evaluate the efficacy and safety of SZRD for insomnia. Methods A systematic literature search was performed for 6 databases up to July of 2012 to identify randomized control trials (RCTs) involving SZRD for insomniac patients. The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. Results Twelve RCTs with total of 1376 adult participants were identified. The methodological quality of all included trials are no more than 3/8 score. Majority of the RCTs concluded that SZRD was more significantly effective than benzodiazepines for treating insomnia. Despite these positive outcomes, there were many methodological shortcomings in the studies reviewed, including insufficient information about randomization generation and absence of allocation concealment, lack of blinding and no placebo control, absence of intention-to-treat analysis and lack of follow-ups, selective publishing and reporting, and small number of sample sizes. A number of clinical heterogeneity such as diagnosis, intervention, control, and outcome measures were also reviewed. Only 3 trials reported adverse events, whereas the other 9 trials did not provide the safety information. Conclusions Despite the apparent reported positive findings, there is insufficient evidence to support efficacy of SZRD for insomnia due to the poor methodological quality and the small number of trials of the included studies. SZRD seems generally safe, but is insufficient evidence to make conclusions on the safety because fewer studies reported the adverse events. Further large sample-size and well-designed RCTs are needed.
    Full-text · Article · Jan 2013 · BMC Complementary and Alternative Medicine
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    • "Cross-sectional studies demonstrate that 40–60% of individuals with insomnia exhibit depressive symptoms (Foley et al. 1995; Ohayon et al. 1998), 10–25% may have clinical depression, and 20–30% have anxiety disorder (Ohayon and Roth 2003; Taylor et al. 2005). Chronic insomnia is associated with reduced quality of life, higher absenteeism, impaired job performance, and higher healthcare utilization (Kuppermann et al. 1995; Simon and VonKorff 1997). In a large population-based study, a linear relationship was demonstrated between insomnia prevalence and number of self-reported comorbid medical disorders (Budhiraja et al. 2011). "
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    ABSTRACT: Effective noninvasive interventions for insomnia are needed. High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM™) is a noninvasive, electroencephalography (EEG)-based method to facilitate greater client-unique, autocalibrated improvements of balance and harmony in cortical neural oscillations. This study explores using HIRREM for insomnia. Twenty subjects, with an Insomnia Severity Index (ISI) score of ≥15 (14 women, mean age 45.4, mean ISI 18.6), were enrolled in this randomized, unblinded, wait-list control, crossover, superiority study. Subjects were randomized to receive 8-12 HIRREM sessions over 3 weeks, plus usual care (HUC), or usual care alone (UC). Pre- and post-HIRREM data collection included ISI (primary outcome), and many secondary, exploratory measures (CES-D, SF-36, HR, BP, neurocognitive testing, and VAS scales). The UC group later crossed over to receive HIRREM. ISI was also repeated 4-6 weeks post-HIRREM. All subjects completed the primary intervention period. Analysis for differential change of ISI in the initial intervention period for HUC versus UC showed a drop of 10.3 points (95% CI: -13.7 to -6.9, P < 0.0001, standardized effect size of 2.68). Key secondary outcomes included statistically identical differential change for the crossed-over UC group, and persistence of the effect on the ISI up to > 4 weeks post-HIRREM. Differential change in the HUC group was also statistically significant for CES-D (-8.8, 95% CI: -17.5 to -0.1, P = 0.047), but other exploratory outcomes were not statistically significant. For all receiving HIRREM (n = 19), decreased high-frequency total power was seen in the bilateral temporal lobes. No adverse events were seen. This pilot clinical trial, the first using HIRREM as an intervention, suggests that HIRREM is feasible and effective for individuals having moderate-to-severe insomnia, with clinically relevant, statistically significant benefits based on differential change in the ISI. Effects persisted for 4 weeks after completion of HIRREM. Larger controlled clinical trials are warranted.
    Full-text · Article · Nov 2012 · Brain and Behavior
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