The role of poor sleep in the relation between workplace bullying/unwanted sexual attention and long-term sickness absence

  • Kirsten Nabe-NielsenEmail author
  • Matias Brødsgaard Grynderup
  • Theis Lange
  • Johan Hviid Andersen
  • Jens Peter Bonde
  • Paul Maurice Conway
  • Anne Helene Garde
  • Annie Høgh
  • Linda Kaerlev
  • Reiner Rugulies
  • Åse Marie Hansen
Original Article



While exposure to bullying and unwanted sexual attention was previously found to increase the risk of sickness absence, the underlying mechanisms are largely unknown. Poor sleep can be a consequence of stressful exposures and a cause of poor health, and poor sleep is also a determinant of insufficient recovery. Therefore, the present study investigated whether poor sleep mediates and/or moderates the association between bullying and unwanted sexual attention, on the one hand, and long-term sickness absence (LTSA), on the other hand.


We used questionnaire data from 7650 individuals contributing with 15,040 2-year observation periods. Workplace bullying, unwanted sexual attention, disturbed sleep, and difficulties awakening were measured at three time points, and participants were followed in registers to measure the occurrence of LTSA, defined as ≥30 consecutive days of sickness absence during the subsequent 2 years.


The odds of LTSA were significantly increased by workplace bullying (OR 1.77; 95 % CI 1.50–2.12) and unwanted sexual attention (OR 1.55; 95 % CI 1.06–2.29). Together, disturbed sleep and difficulties awakening mediated 12.8 % (95 % CI 8.1–19.8) of the association between bullying and long-term sickness absence, and 8.5 % (95 % CI −0.45 to 37.1) of the association between unwanted sexual attention and long-term sickness absence in the fully adjusted model. Neither disturbed sleep nor difficulties awakening moderated these associations.


As expected, bullying and unwanted sexual attention were prospectively associated with long-term sickness absence. Only a small part of this association was mediated by poor sleep.


Negative acts Mediation Moderation Offensive behavior Sexual harassment Sick leave 



The study was funded by The Danish Working Environment Research Fund (Grant Number 20130023294) and The Danish Council for Independent Research (Grant Number 1319-00092). The funding organs played no role in the collection of data, formulation of study hypothesis, analyses, or interpretation of findings.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Kirsten Nabe-Nielsen
    • 1
    Email author
  • Matias Brødsgaard Grynderup
    • 1
  • Theis Lange
    • 1
    • 2
  • Johan Hviid Andersen
    • 3
  • Jens Peter Bonde
    • 4
  • Paul Maurice Conway
    • 5
  • Anne Helene Garde
    • 1
    • 6
  • Annie Høgh
    • 5
  • Linda Kaerlev
    • 7
    • 8
  • Reiner Rugulies
    • 1
    • 5
    • 6
  • Åse Marie Hansen
    • 1
    • 6
  1. 1.Centre for Health and Society, Department of Public HealthUniversity of CopenhagenCopenhagen KDenmark
  2. 2.Center for Statistical SciencePeking UniversityBeijingPeople’s Republic of China
  3. 3.Danish Ramazzini Centre, Department of Occupational Medicine, University Research ClinicRegional Hospital West JutlandHerningDenmark
  4. 4.Department of Occupational and Environmental MedicineBispebjerg-Frederiksberg University HospitalCopenhagen NVDenmark
  5. 5.Department of PsychologyUniversity of CopenhagenCopenhagen KDenmark
  6. 6.The National Research Centre for the Working EnvironmentCopenhagen ØDenmark
  7. 7.Research Unit of Clinical Epidemiology, Institute of Clinical ResearchUniversity of Southern DenmarkOdense MDenmark
  8. 8.Center for Clinical EpidemiologyOdense University HospitalOdense CDenmark

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