Academic journal article Scandinavian Journal of Work, Environment & Health

Tossing and Turning - Insomnia in Relation to Occupational Stress, Rumination, Fatigue, and Well-Being

Academic journal article Scandinavian Journal of Work, Environment & Health

Tossing and Turning - Insomnia in Relation to Occupational Stress, Rumination, Fatigue, and Well-Being

Article excerpt

Objectives This study of a large and heterogeneous sample of 52 1 0 daytime employees was designed to shed more light on the work effort-recovery mechanism by examining the cross-sectional relations between subjective sleep quality and (i) psychosocial work characteristics, (ii) work-related rumination, (iii) fatigue after work, and (iv) affective well-being at work and work pleasure.

Methods We used the Dutch Questionnaire on the Experience and Evaluation of Work and created three sleep quality groups (low, low-to-intermediate, and high quality). Group differences were studied through analysis of variance (ANOVA). To examine the relations among the study variables in more detail, we also conducted four sets of stepwise regression analyses. In all the analyses, we corrected for age, level of education, and gender.

Results A series of (M)ANOVA provided strong evidence for a relation between sleep quality and adverse work characteristics and work-related rumination. Furthermore, poor sleepers reported higher levels of fatigue after work, and poor sleep quality was related to both lower affective well-being during work and work pleasure. Regression analyses revealed that sleep quality was the strongest statistical predictor of after-work fatigue and affective well-being at work, and high levels of work rumination constituted the strongest statistical predictor of sleep complaints.

Conclusions As this study showed strong relations between sleep quality, occupational stress, fatigue, perseverative cognitions, and work motivation, it supports effort-recovery theory. Interventions should aim to prevent a disbalance between effort and recovery.

Key terms psychosocial work environment; sleep quality; work pleasure.

One of the challenges of occupational health psychology is to clarify the mechanisms that may explain how combinations of stressful psychosocial work characteristics in the long-term may cause ill-health (1). One such mechanism is the psycho-physiological effort-recovery mechanism (2, 3). It holds that, in the case of prolonged or repeated (daily) exposure to stressful work characteristics combined with insufficient recovery and coping possibilities, a cumulative process may start in which psychophysiological reactions that initially were adaptive and reversible are sustained and in the long run may result in subsequent adverse health. Within effort-recovery theory and comparable theoretical approaches, such as allostatic load theory (4-6) and the cognitive activation theory of stress (7), recovery is a process of psycho-physiological unwinding that is the opposite of the activation of the sympathetic-adrenal-medullary system and the hypothalamic-pituitary-adrenal system during effort expenditure, particularly under stressful conditions (3). According to effort-recovery theory, recovery is an important intervening variable in the hypothesized causal chain between the exposure to a stressful psychosocial work environment and the development of acute load reactions and also in the gradual transformation from acute load reactions ("sustained activation") into more chronic and serious load reactions and, eventually, ill-health.

Sleep is the prototypical recovery activity. It is essential for physiological balance, long-term health and mental functioning (8, 9). Sleep is important for the restoration of alertness, mood, and performance capacity. It also regenerates the central nervous system, the metabolic system, the endocrine system, and the immune system. In the long run, reduced or impaired sleep leads to metabolic diseases, depression, burnout, and mortality (9). Insufficient sleep is also a cause of poor work performance and work accidents (8). Poor sleep is mainly a matter of sleep (dis)continuity. Over the years, research concerning sleep quality and insomnia has been hampered by a lack of widely accepted operational research diagnostic criteria for their definition. However, according to a report of an American Academy of Sleep Medicine Work Group (10, p 1580), research diagnostic criteria for insomnia disorder include one or more of the following sleep-related complaints: (i) difficulty initiating sleep; (ii) difficulty maintaining sleep; (iii) waking up too early; and (iv) sleep that is chronically non-restorative or poor in quality. …

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