Sleep disturbances and reduced work functioning in depressive or anxiety disorders

Sleep Med. 2013 Nov;14(11):1170-7. doi: 10.1016/j.sleep.2013.04.016. Epub 2013 Aug 29.

Abstract

Objectives: We aimed to examine the associations between sleep disturbances and work functioning in an epidemiologic cohort study in subjects with or without depressive or anxiety disorders.

Methods: There were 707 subjects included in our analyses with depressive or anxiety disorders and 728 subjects without current depressive or anxiety disorders. Insomnia was defined as a score ≥9 using the Insomnia Rating Scale. Self-reported sleep duration was categorized in short, normal, and long (≤6, 7-9, and ≥10 h, respectively). Work absenteeism was defined as none, short (≤2 weeks), or long (>2 weeks). Work performance was defined as not impaired, reduced, or impaired. Logistic regression analyses were performed to examine the associations of sleep disturbances with work functioning.

Results: In subjects with psychopathology, insomnia and short sleep duration were significantly associated with impaired work performance (odds ratio [OR] for insomnia, 2.20; [95% confidence interval {CI}, 1.50-3.22]; OR for short sleep, 2.54 [95% CI, 1.66-3.88] compared to normal sleep duration). Insomnia (OR, 2.48 [95% CI, 1.67-3.69]) and short sleep duration (OR, 1.85 [95% CI, 1.23-2.78]) also were associated with long-term absenteeism. These findings remained the same after considering clinical characteristics including medication use and symptom severity. In subjects without psychopathology, no significant associations were found between insomnia and short sleep duration on work functioning after considering subthreshold depression symptoms.

Conclusions: In subjects with psychopathology, sleep disturbances were negatively associated with work functioning, independent of disorder severity and use of psychotropic medication. Further research is needed to determine if treatment of sleep disturbances in subjects with psychopathology improves work functioning.

Keywords: Absenteeism; Anxiety; Depression; Insomnia; Sleep; Work.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Adult
  • Antidepressive Agents / therapeutic use
  • Anxiety Disorders / drug therapy
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Cohort Studies
  • Depressive Disorder / drug therapy
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Employment / psychology
  • Employment / statistics & numerical data
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sick Leave / statistics & numerical data*
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / psychology

Substances

  • Antidepressive Agents