Abstract
Background
Previous studies have found insomnia and long sleep duration to be independently associated with subsequent disability pension (DP). However, the issue of a possible gender-based pattern in this context has received little attention.
Purpose
This study aims to assess the impact of insomnia symptoms and sleep duration on the DP rates among Swedish women and men during a 12-year follow-up period.
Method
The participants, from the general population of Malmö, Sweden, were enrolled from 1992 to 1994 (n = 4,319; participation rate 41 %), aged 45–64, healthy, and employed ≥30 h per week. Baseline inquiry data concerning psychosocial circumstances and self-reported sleep habits were compared with official register-based DP rates.
Results
Five hundred and nine persons were granted a DP. Insomnia symptoms, affirmed by 33 % of the men and 41 % of the women, were associated with receiving a DP; the hazard ratios in the fully adjusted model were 1.4 for both men [95 % confidence interval (CI) 1.1, 1.9] and women (95 % CI 1.1, 1.7). The fully adjusted hazard ratio for women sleeping ≥9 h was 7.8 (95 % CI 3.7, 16.6) for DP due to a mental disorder. In the age-adjusted analyses, the sub-domain “difficulties falling asleep” was related to DP due to mental disorders in men and DP due to cardiovascular diseases in women.
Conclusion
The findings suggest that preventing and treating insomnia symptoms could reduce DP and that disease mechanisms linking sleep disturbances to DP may differ by gender.
Similar content being viewed by others
References
Socialstyrelsen. Folkhälsorapport 2009. The Swedish National Board of Health and Welfare. 2009. http://www.socialstyrelsen.se/publikationer2009/2009-126-71. Accessed 7 May 2012.
Kronholm E, Partonen T, Laatikainen T, Peltonen M, Harma M, Hublin C, et al. Trends in self-reported sleep duration and insomnia-related symptoms in Finland from 1972 to 2005: a comparative review and re-analysis of Finnish population samples. J Sleep Res. 2008;17:54–62.
Moloney ME, Konrad TR, Zimmer CR. The medicalization of sleeplessness: a public health concern. Am J Public Health. 2011;101:1429–33.
Åkerstedt T, Kecklund G, Alfredsson L, Selen J. Predicting long-term sickness absence from sleep and fatigue. J Sleep Res. 2007;16:341–5.
Salo P, Oksanen T, Sivertsen B, Hall M, Pentti J, Virtanen M, et al. Sleep disturbances as a predictor of cause-specific work disability and delayed return to work. Sleep. 2010;33:1323–31.
Rahkonen O, Lallukka T, Kronholm E, Vahtera J, Lahelma E, Laaksonen M. Sleep problems and sickness absence among middle-aged employees. Scand J Work Environ Health. 2011;38:47–55.
Sivertsen B, Overland S, Bjorvatn B, Maeland JG, Mykletun A. Does insomnia predict sick leave? The Hordaland Health Study. J Psychosom Res. 2009;66:67–74.
Sivertsen B, Overland S, Neckelmann D, Glozier N, Krokstad S, Pallesen S, et al. The long-term effect of insomnia on work disability: the HUNT-2 historical cohort study. Am J Epidemiol. 2006;163:1018–24.
Lallukka T, Haaramo P, Lahelma E, Rahkonen O. Sleep problems and disability retirement: a register-based follow-up study. Am J Epidemiol. 2011;173:871–81.
Haaramo P, Rahkonen O, Lahelma E, Lallukka T. The joint association of sleep duration and insomnia symptoms with disability retirement—a longitudinal, register-linked study. Scand J Work Environ Health. 2012;38:427–35.
Sivertsen B, Overland S, Pallesen S, Bjorvatn B, Nordhus IH, Maeland JG, et al. Insomnia and long sleep duration are risk factors for later work disability. The Hordaland Health Study. J Sleep Res. 2009;18:122–8.
Buxton OM, Marcelli E. Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States. Soc Sci Med. 2010;71:1027–36.
Knutson KL, Turek FW. The U-shaped association between sleep and health: the 2 peaks do not mean the same thing. Sleep. 2006;29:878–9.
Ferrie JE, Shipley MJ, Cappuccio FP, Brunner E, Miller MA, Kumari M, et al. A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort. Sleep. 2007;30:1659–66.
Arber S, Bote M, Meadows R. Gender and socio-economic patterning of self-reported sleep problems in Britain. Soc Sci Med. 2009;68:281–9.
Krueger PM, Friedman EM. Sleep duration in the United States: a cross-sectional population-based study. Am J Epidemiol. 2009;169:1052–63.
Stattin M. Retirement on grounds of ill health. Occup Environ Med. 2005;62(2):135–40.
Manjer J, Carlsson S, Elmstahl S, Gullberg B, Janzon L, Lindström M, et al. The Malmö Diet and Cancer Study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev. 2001;10:489–99.
Östergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P, et al. Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. J Epidemiol Community Health. 2005;59:721–8.
Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–7.
Overland S, Glozier N, Sivertsen B, Stewart R, Neckelmann D, Krokstad S, et al. A comparison of insomnia and depression as predictors of disability pension: the HUNT Study. Sleep. 2008;31:875–80.
Ohayon MM, Riemann D, Morin C, Reynolds 3rd CF. Hierarchy of insomnia criteria based on daytime consequences. Sleep Med. 2012;13:52–7.
Isacsson SO, Hanson BS, Janzon L, Lindell SE, Steen B. Methods to assess alcohol consumption in 68-year-old men: results from the population study ‘Men born in 1914’ Malmo. Sweden Br J Addict. 1987;82:1235–44.
Statistics Sweden S. MIS 1982:4. Socio-economic classification. Statistics Sweden. 1982. http://www.scb.se/Pages/PublishingCalendarViewInfo____259924.aspx?PublObjId=6607. Accessed 16 Nov 2012.
Karasek R, Choi B, Östergren PO, Ferrario M, De Smet P. Testing two methods to create comparable scale scores between the Job Content Questionnaire (JCQ) and JCQ-Like Questionnaires in the European JACE Study. Int J Behav Med. 2007;14:189–201.
Karasek R. Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q. 1979;24:285–307.
Theorell T, Harms-Ringdahl K, Ahlberg-Hulten G, Westin B. Psychosocial job factors and symptoms from the locomotor system—a multicausal analysis. Scand J Rehab Med. 1991;23:165–73.
Hanson B, Östergren P-O. Different social network and social support characteristics, nervous problems and insomnia: theoretical and methodological aspects on some results from the population study ‘Men born in 1914’, Malmö. Sweden Soc Sci Med. 1987;25:849–59.
Living conditions. Isolation and togetherness—an outlook on social participation 1976. The National Bureau of Statistics, Sweden 1980. Report no. 18. (In Swedish)
Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol. 1983;117:292–304.
Åkerstedt T, Nilsson PM. Sleep as restitution: an introduction. J Intern Med. 2003;254:6–12.
Redline S, Foody J. Sleep disturbances: time to join the top 10 potentially modifiable cardiovascular risk factors? Circulation. 2011;124:2049–51.
Grandner MA, Drummond SP. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Med Rev. 2007;11:341–60.
Grandner MA, Patel NP, Gehrman PR, Perlis ML, Pack AI. Problems associated with short sleep: bridging the gap between laboratory and epidemiological studies. Sleep Med Rev. 2010;14:239–47.
Stranges S, Dorn JM, Shipley MJ, Kandala NB, Trevisan M, Miller MA, et al. Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study. Am J Epidemiol. 2008;168:1353–64.
Marcus SM, Kerber KB, Rush AJ, Wisniewski SR, Nierenberg A, Balasubramani GK, et al. Sex differences in depression symptoms in treatment-seeking adults: confirmatory analyses from the Sequenced Treatment Alternatives to Relieve Depression study. Compr Psychiatry. 2008;49:238–46.
Khan AA, Gardner CO, Prescott CA, Kendler KS. Gender differences in the symptoms of major depression in opposite-sex dizygotic twin pairs. Am J Psychiatry. 2002;159:1427–9.
Suarez EC. Self-reported symptoms of sleep disturbance and inflammation, coagulation, insulin resistance and psychosocial distress: evidence for gender disparity. Brain Behav Immun. 2008;22:960–8.
Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, et al. Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study. Hypertension. 2007;50:693–700.
Miller MA, Kandala NB, Kivimaki M, Kumari M, Brunner EJ, Lowe GD, et al. Gender differences in the cross-sectional relationships between sleep duration and markers of inflammation: Whitehall II study. Sleep. 2009;32:857–64.
Canivet C, Ostergren PO, Lindeberg SI, Choi B, Karasek R, Moghaddassi M, et al. Conflict between the work and family domains and exhaustion among vocationally active men and women. Soc Sci Med. 2010;70:1237–45.
Jenkins CD, Stanton BA, Niemcryk SJ, Rose RM. A scale for the estimation of sleep problems in clinical research. J Clin Epidemiol. 1988;41:313–21.
Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.
Canivet C, Choi B, Karasek R, Moghaddassi M, Staland-Nyman C, Ostergren PO. Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers. Int Arch Occup Environ Health. 2013;86:307–19. doi:10.1007/s00420-012-0766-4.
Acknowledgments
This study was supported by grants from the Swedish Medical Research Council, the Swedish Council for Social Research, the Medical Faculty at Lund University, the National Institute of Public Health, and the Swedish Work Environment Fund.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Canivet, C., Staland-Nyman, C., Lindeberg, S.I. et al. Insomnia Symptoms, Sleep Duration, and Disability Pensions: a Prospective Study of Swedish Workers. Int.J. Behav. Med. 21, 319–328 (2014). https://doi.org/10.1007/s12529-013-9315-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12529-013-9315-0