Department of Public Health, University of Copenhagen, 1014, Copenhagen, Denmark.
National Research Centre for the Working Environment, Copenhagen, Denmark.
Int Arch Occup Environ Health. 2018 May;91(4):445-456. doi: 10.1007/s00420-018-1294-7. Epub 2018 Jan 30.
AIM: The aim of the present study was to examine the bidirectional associations between subjective role ambiguity and role conflicts at work, respectively, and self-reported sleep 2 years later. In addition, we also examine whether sense of coherence (SOC) moderate or mediate the association between role stressors and poor sleep and between poor sleep and role stressors. METHODS: We used questionnaire data collected in 2006 and 2008 from the Workplace Bullying and Harassment cohort. In 2006, 3363 responded to the questionnaire and in 2008 1671 responded. In total, 1569 participants responded in both 2006 and 2008 to the questions on role stressors (in terms of role ambiguity and role conflicts at work) and sleep problems in both 2006 and 2008. Sleep problems were assessed with the awakening index (AWI) and the disturbed sleep index (DSI). Moderation and mediation analyses of the association were estimated using structural equation modelling. RESULTS: We found a prospective association between role stressors and sleep problems [beta values were 0.07 (95% CI 0.03-0.11) and 0.05 (CI 0.01-0.10) for DSI and AWI, respectively] when adjusting for sleep problems at baseline, age, sex, and life style factors (i.e. alcohol, smoking, and leisure time physical activity). SOC moderated the association showing that participants with lower SOC scores who reported higher role ambiguity reported sleep problems to a higher extent than participants with high SOC scores. SOC also mediated the association between role stressors and sleep problems. We also found support for sleep problems at baseline and role stressors 2 years later [DSI 0.04 (CI 0.00-0.08) and 0.15 (CI 0.09-0.21)] for role ambiguity and role conflicts, respectively. Similar results were observed for AWI. CONCLUSION: Subjective role stressors were prospectively associated with sleep problems. Yet, sleep problems could also prospectively predict subjective role stressors (i.e. reverse causation). The analyses also showed that SOC may be regarded as both a mediating and a moderating factor of the association between subjective role conflicts and poor sleep. We found that SOC moderated the prospective association so participants with low SOC report more sleep problems with subjective role conflicts compared to participants with high SOC. Finally, we also found SOC mediated the prospective association between subjective role stressors and sleep problems and the reverse association.
目的：本研究旨在分别考察工作中主观角色模糊和角色冲突与 2 年后自我报告的睡眠之间的双向关联。此外，我们还检验了心理一致感（SOC）是否调节或介导了角色压力源与睡眠质量差之间以及睡眠质量差与角色压力源之间的关联。
方法：我们使用了 2006 年和 2008 年工作场所欺凌和骚扰队列中收集的问卷调查数据。2006 年有 3363 人回复了问卷，2008 年有 1671 人回复。共有 1569 名参与者在 2006 年和 2008 年两次回复了关于角色压力源（工作中的角色模糊和角色冲突）和 2006 年和 2008 年睡眠问题的问题。使用觉醒指数（AWI）和睡眠障碍指数（DSI）评估睡眠问题。使用结构方程模型估计关联的调节和中介分析。
结果：在调整基线时的睡眠问题、年龄、性别和生活方式因素（即酒精、吸烟和休闲时间体育活动）后，我们发现角色压力源与睡眠问题之间存在前瞻性关联[DSI 的β值分别为 0.07（95%CI 0.03-0.11）和 0.05（CI 0.01-0.10），AWI 的β值分别为 0.07（95%CI 0.03-0.11）和 0.05（CI 0.01-0.10）]。SOC 调节了这种关联，表明报告角色模糊度较高的 SOC 得分较低的参与者报告的睡眠问题比 SOC 得分较高的参与者更为严重。SOC 还介导了角色压力源与睡眠问题之间的关联。我们还发现，基线睡眠问题与 2 年后的角色压力源存在关联[DSI 分别为 0.04（CI 0.00-0.08）和 0.15（CI 0.09-0.21）]，对于角色模糊和角色冲突。AWI 也观察到了类似的结果。
结论：主观角色压力源与睡眠问题存在前瞻性关联。然而，睡眠问题也可能前瞻性地预测主观角色压力源（即反向因果关系）。分析还表明，SOC 可能被视为主观角色冲突与睡眠问题之间关联的调节和中介因素。我们发现，SOC 调节了前瞻性关联，因此 SOC 得分较低的参与者报告的主观角色冲突引起的睡眠问题比 SOC 得分较高的参与者更多。最后，我们还发现 SOC 介导了角色压力源与睡眠问题以及反向关联的前瞻性关联。
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