Hjelt Institute, Department of Public Health, University of Helsinki, Finland.
Soc Sci Med. 2013 Feb;79:66-75. doi: 10.1016/j.socscimed.2012.05.011. Epub 2012 Jun 5.
Work and family are two key domains of life among working populations. Conflicts between paid work and family life can be detrimental to sleep and other health-related outcomes. This study examined longitudinally the influence of work-family conflicts on subsequent sleep medication. Questionnaire data were derived from the Helsinki Health Study mail surveys in 2001-2002 (2929 women, 793 men) of employees aged 40-60 years. Data concerning sleep medication were derived from the Finnish Social Insurance Institution's registers covering all prescribed medication from 1995 to 2007. Four items measured whether job responsibilities interfered with family life (work to family conflicts), and four items measured whether family responsibilities interfered with work (family to work conflicts). Cox proportional hazard models were fitted, adjusting for age, sleep medication five years before baseline, as well as various family- and work-related covariates. During a five-year follow-up, 17% of women and 10% of men had at least one purchase of prescribed sleep medication. Among women, family to work conflicts were associated with sleep medication over the following 5 years after adjustment for age and prior medication. The association remained largely unaffected after adjusting for family-related and work-related covariates. Work to family conflicts were also associated with subsequent sleep medication after adjustment for age and prior medication. The association attenuated after adjustment for work-related factors. No associations could be confirmed among men. Thus reasons for men's sleep medication likely emerge outside their work and family lives. Concerning individual items, strain-based ones showed stronger associations with sleep medication than more concrete time-based items. In conclusion, in particular family to work conflicts, but also work to family conflicts, are clear determinants of women's sleep medication.
工作和家庭是在职人群生活的两个关键领域。有偿工作和家庭生活之间的冲突可能对睡眠和其他健康相关结果产生不利影响。本研究纵向研究了工作家庭冲突对随后睡眠药物使用的影响。问卷调查数据来自 2001-2002 年赫尔辛基健康研究的邮件调查（2929 名女性，793 名男性），对象为年龄在 40-60 岁的员工。睡眠药物使用的数据来自芬兰社会保险机构的登记，涵盖了 1995 年至 2007 年所有处方药物。四项指标衡量了工作职责是否会干扰家庭生活（工作对家庭的冲突），四项指标衡量了家庭责任是否会干扰工作（家庭对工作的冲突）。使用 Cox 比例风险模型进行拟合，调整了年龄、基线前五年的睡眠药物使用情况以及各种家庭和工作相关的协变量。在五年的随访期间，17%的女性和 10%的男性至少购买过一次处方睡眠药物。在女性中，调整年龄和先前药物使用情况后，家庭对工作的冲突与五年后的睡眠药物使用相关。调整家庭相关和工作相关协变量后，这种关联基本保持不变。调整年龄和先前药物使用情况后，工作对家庭的冲突也与随后的睡眠药物使用相关。调整工作相关因素后，这种关联减弱。在男性中无法确认这些关联。因此，男性使用睡眠药物的原因可能出现在他们的工作和家庭生活之外。就个别项目而言，基于压力的项目与睡眠药物的相关性强于基于具体时间的项目。总之，特别是家庭对工作的冲突，以及工作对家庭的冲突，是女性睡眠药物使用的明确决定因素。
