Redeker Nancy S, Caruso Claire C, Hashmi Sarah D, Mullington Janet M, Grandner Michael, Morgenthaler Timothy I
Yale School of Nursing, Orange, Connecticut.
National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio.
J Clin Sleep Med. 2019 Apr 15;15(4):649-657. doi: 10.5664/jcsm.7734.
The purpose of this review is to synthesize the published literature that addresses employer-initiated interventions to improve the sleep of workers and in turn improve health, productivity, absenteeism, and other outcomes that have been associated with sleep disorders or sleep deficiency.
We conducted a systematic search and a selective narrative review of publications in PubMed from 1966 to December 2017. We extracted study characteristics, including the workers' professions, workplace settings and shift work, and workplace interventions focused on worker sleep. Because of the high degree of heterogeneity in design and outcomes, we conducted a narrative review.
We identified 219 publications. After restriction to publications with studies of workplace interventions that evaluated the outcomes of sleep duration or quality, we focused on 47 articles. An additional 13 articles were accepted in the pearling process. Most studies employed non-randomized or controlled pretest and posttest designs and self-reported measures of sleep. The most common workplace interventions were educational programs stressing sleep hygiene or fatigue management. Other interventions included timed napping before or after work, urging increased daytime activity levels, modifying workplace environmental characteristics such as lighting, and screening, and referral for sleep disorders treatment. Overall, most reports indicated that employer efforts to encourage improved sleep hygiene and healthier habits result in improvements in sleep duration, sleep quality, and self-reported sleepiness complaints.
These studies suggest employer-sponsored efforts can improve sleep and sleep-related outcomes. The existing evidence, although weak, suggests efforts by employers to encourage better sleep habits and general fitness result in self-reported improvements in sleep-related outcomes, and may be associated with reduced absenteeism and better overall quality of life. Candidate workplace strategies to promote sleep health are provided.
本综述的目的是综合已发表的文献，这些文献涉及雇主发起的干预措施，以改善工人的睡眠，进而改善健康、提高生产力、减少旷工以及改善与睡眠障碍或睡眠不足相关的其他结果。
我们对1966年至2017年12月期间发表在PubMed上的文献进行了系统检索和选择性叙述性综述。我们提取了研究特征，包括工人的职业、工作场所环境和轮班工作，以及专注于工人睡眠的工作场所干预措施。由于设计和结果的高度异质性，我们进行了叙述性综述。
我们识别出219篇文献。在将范围限制为评估睡眠时间或质量结果的工作场所干预研究的文献后，我们重点关注了47篇文章。在提炼过程中又纳入了13篇文章。大多数研究采用非随机或对照的前测和后测设计以及睡眠的自我报告测量方法。最常见的工作场所干预措施是强调睡眠卫生或疲劳管理的教育项目。其他干预措施包括在工作前或工作后定时小睡、敦促增加白天活动水平、改变工作场所的环境特征（如照明）以及筛查和转诊睡眠障碍治疗。总体而言，大多数报告表明，雇主鼓励改善睡眠卫生和养成更健康习惯的努力会使睡眠时间、睡眠质量以及自我报告的困倦抱怨得到改善。
这些研究表明雇主赞助的努力可以改善睡眠及与睡眠相关的结果。现有证据虽然薄弱，但表明雇主鼓励更好睡眠习惯和总体健康的努力会使自我报告中与睡眠相关的结果得到改善，并且可能与旷工减少和总体生活质量提高有关。文中提供了促进睡眠健康的候选工作场所策略。
