Yang Bing, Wang Yongwei, Cui Fangfang, Huang Ting, Sheng Peijia, Shi Ting, Huang Chan, Lan Yajia, Huang Yi-Na
Department of Environmental Health and Occupational Medicine, West China School of Public Health, Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Occupational Health, No.4 West China Teaching Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Sleep Breath. 2018 Dec;22(4):1221-1231. doi: 10.1007/s11325-018-1682-y. Epub 2018 Jun 29.
Insomnia has become one of the foremost health concerns among workers. Despite a significant number of epidemiological studies have reported on the correlation between insomnia and job stress, comprehensive evidence remains insufficient. Therefore, this research seeks to provide evidence with greater reliability, through summarizing relevant contemporary literature via a meta-analysis.
Literature from across Europe and Asia that was of both a prospective and cross-sectional design was included, if well-controlled odds ratios were available. The meta-analysis was undertaken in accordance with the guidelines devised by PRISMA, including tests for publication bias and heterogeneity.
High job stress was associated with a greater risk of suffering from insomnia (random OR = 1.73, 95% CI 1.46-2.05), and the correlation between effort-reward imbalance and insomnia was statistically significant (random OR = 2.63, 95% CI 1.22-5.69). Higher demand was correlated to a relatively greater risk of insomnia (random OR = 1.35, 95% CI 1.20-1.51), while the pooled effect of low control was not found to be statistically significant. The summary random odds ratio of heavy workload was 2.76, and a pooled odds ratio of 1.67 (fixed, 95% CI 1.11-2.52) was calculated in low social support. With regard to the overall population, work-family conflict was correlated with insomnia (random OR = 2.32, 95% CI 1.53-3.51). The subgroup analysis provided comparable outcomes, for both males (fixed OR = 1.97, 95% CI 1.50-2.57) and females (random OR = 2.80, 95% CI 1.30-6.05). Egger's regression indicated that publication bias may be apparent in the syntheses of effort-reward imbalance, low social support, and work-family conflict (p < 0.05). Heterogeneity was caused by design, measuring the exposure or outcome, in addition to the region where the research was conducted.
The correlation between insomnia and higher levels of job stress, effort-reward imbalance, high demand, heavy workload, and low social support was determined. Publication bias and heterogeneity were partially observed. Furthermore, future studies with improved methodologies and a focus on mechanisms are anticipated.
失眠已成为劳动者最主要的健康问题之一。尽管大量流行病学研究报告了失眠与工作压力之间的相关性，但全面的证据仍然不足。因此，本研究旨在通过荟萃分析总结相关当代文献，以提供更可靠的证据。
纳入来自欧洲和亚洲的前瞻性和横断面设计的文献，前提是有良好控制的比值比。荟萃分析按照PRISMA制定的指南进行，包括发表偏倚和异质性检验。
高工作压力与患失眠症的风险增加相关（随机效应比值比=1.73，95%置信区间1.46-2.05），努力-回报失衡与失眠之间的相关性具有统计学意义（随机效应比值比=2.63，95%置信区间1.22-5.69）。更高的工作要求与相对较高的失眠风险相关（随机效应比值比=1.35，95%置信区间1.20-1.51），而低工作控制的合并效应未发现具有统计学意义。高工作量的汇总随机效应比值比为2.76，低社会支持的合并比值比为1.67（固定效应，95%置信区间1.11-2.52）。对于总体人群，工作-家庭冲突与失眠相关（随机效应比值比=2.32，95%置信区间1.53-3.51）。亚组分析为男性（固定效应比值比=1.97，95%置信区间1.50-2.57）和女性（随机效应比值比=2.80，95%置信区间1.30-6.05）提供了可比的结果。Egger回归表明，在努力-回报失衡、低社会支持和工作-家庭冲突的综合分析中可能存在发表偏倚（p<0.05）。除了研究开展的地区外，异质性还由设计、暴露或结果的测量引起。
确定了失眠与较高水平的工作压力、努力-回报失衡、高工作要求、高工作量和低社会支持之间的相关性。部分观察到了发表偏倚和异质性。此外，预计未来将开展方法改进且关注机制的研究。
