Sleep disturbances as a predictor of cause-specific work disability and delayed return to work.

STUDY OBJECTIVE

To examine sleep disturbances as a predictor of cause-specific work disability and delayed return to work.

DESIGN

Prospective observational cohort study linking survey data on sleep disturbances with records of work disability (> or = 90 days sickness absence, disability pension, or death) obtained from national registers.

SETTING

Public sector employees in finland.

PARTICIPANTS

56,732 participants (mean age 44.4 years, 80% female), who were at work and free of work disability at the study inception.

MEASUREMENTS AND RESULTS

During a mean follow-up of 3.3 years, incident diagnosis-specific work disability was observed in 4,028 (7%) employees. Of those, 2,347 (60%) returned to work. Sleep disturbances 5-7 nights per week predicted work disability due to mental disorders (hazard ratio [HR] 1.6, 95% confidence interval [CI] 1.3-1.9) and diseases of the circulatory system (HR = 1.6, 95% CI 1.2-2.1), musculoskeletal system (HR = 1.6, 95% CI 1.4-1.8) and nervous system (HR = 1.5, 95% CI 1.0-2.2), and injuries and poisonings (HR = 1.6, 95% CI 1.2-2.1) after controlling for baseline age, sex, socioeconomic status, night/shift work, health behaviors (e.g., smoking, exercise), diagnosed somatic diseases, use of pain killers, depression, and anxiety. In addition, sleep disturbances prior to disability were associated with higher likelihood of not returning to work after work disability from musculoskeletal diseases (HR = 1.2, 95% CI 1.1-1.7) and, in men, after work disability due to mental disorders (HR = 4.4, 95% CI 1.7-11.1).

CONCLUSIONS

Sleep disturbances are associated with increased risk for subsequent disabling mental disorders and various physical illnesses. They also predict the outcome of work disability due to musculoskeletal disorders.