Sivertsen Børge, Overland Simon, Bjorvatn Bjørn, Maeland John Gunnar, Mykletun Arnstein
Department of Clinical Psychology, University of Bergen, Bergen, Norway.
J Psychosom Res. 2009 Jan;66(1):67-74. doi: 10.1016/j.jpsychores.2008.06.011. Epub 2008 Nov 22.
The purpose of this study is to prospectively examine the independent contribution of symptoms of insomnia on sick leave.
We used a historical cohort design with 4 years of follow-up. Information on sick leave was obtained from Norwegian official registry data and merged with health information from the Hordaland Health Study in Western Norway, 1997 to 1999. Six thousand eight hundred ninety-two participants aged 40 to 45 years were assessed for self-reported symptoms of insomnia, sociodemographic factors, lifestyle behaviors, body mass index, symptoms of sleep apnea, anxiety, depression, as well as a range of somatic diagnoses, somatic symptoms, and pain. The outcome was the total number of sick days during a 4-year follow-up period, as registered in the official registries by the National Insurance Administration.
Overall, insomnia was found to be a significant predictor of sick leave [odds ratio (OR)=2.20; 95% confidence interval (CI), 1.77-2.74], and the effect remained significant when adjusting for possible confounders (OR=1.51; 95% CI, 1.19-1.94). The effect increased with longer durations of sickness leave.
This is the first study to demonstrate that insomnia is an independent risk factor for long-term sick leave.
本研究旨在前瞻性地探讨失眠症状对病假的独立影响。
我们采用了具有4年随访期的历史性队列设计。病假信息来自挪威官方登记数据，并与1997年至1999年挪威西部霍达兰健康研究的健康信息相结合。对6892名年龄在40至45岁之间的参与者进行了自我报告的失眠症状、社会人口学因素、生活方式行为、体重指数、睡眠呼吸暂停症状、焦虑、抑郁以及一系列躯体诊断、躯体症状和疼痛的评估。结局指标是国家保险管理机构在官方登记处记录的4年随访期内的病假总天数。
总体而言，失眠被发现是病假的一个重要预测因素[比值比（OR）=2.20；95%置信区间（CI），1.77 - 2.74]，在对可能的混杂因素进行调整后，该效应仍然显著（OR = 1.51；95% CI，1.19 - 1.94）。随着病假时间延长，该效应增强。
这是第一项证明失眠是长期病假独立危险因素的研究。
