1.

Sleep, Work, and Occupational Stress

Article · January 2012 with 33 Reads
DOI: 10.1093/oxfordhb/9780195376203.013.0013
Cite this publication

Torbjörn Åkerstedt

o 47.38
o Karolinska Institutet

Göran Kecklund

o 42.3
o Stockholm University

Abstract
Work is a necessity of life and has many positive effects on human well-being, but some aspects may also be a
threat to well-being. The present chapter has focused on some of the factors that may constitute an impediment to
sleep-stress, work hours, and socioeconomic group. With regard to stress there is a large number of studies that link
self-reported stress to self-reports of impaired sleep. Prospective studies are surprisingly rare but essentially support
this link, as do the even rarer polysomnographical studies of real-life stress. Some loss of sleep efficiency and
increase of sleep latency and time awake are seen in groups on sick leave for stress-related fatigue (burnout) where
the impairment is pronounced. A key link between stress and impaired sleep seems to be the effort expended at work
and the inability to turn off thoughts of work ("rumination") around bedtime. It is also suggested that the physiological
effects of sleep loss are very similar to those characteristic of stress, and the metabolic diseases linked to stress
seem to have a similarly strong link to disturbed sleep. A second major work-related cause of impaired sleep is
irregular work hours. In particular, night and early morning work truncate sleep and result in high levels of
fatigue/sleepiness during work and leisure. The mechanism mainly involves work during the circadian low and sleep
during the circadian high. The first causes high sleepiness/fatigue, and the second terminates sleep prematurely,
adding to sleepiness/fatigue. Night work and early morning work is also a major cause of road accidents in particular,
but also other types of accidents. The long-term effects of night work also include cardiovascular and gastrointestinal
disease. A third work-related factor behind poor sleep seems to be socioeconomic group. On the whole, blue-collar
workers report more disturbed sleep than do white-collar workers. The active component in the causation has not
been clearly identified, but physical work load, financial strain, and a less positive situation in life may contribute.
Being employed or not has not been extensively researched, but results indicate more sleep problems than in those
unemployed.
 2. PUTTING WORK TO BED: STRESSFUL
EXPERIENCES ON THE JOB AND SLEEP
QUALITY*
Sarah A. Burgard and Jennifer A. Ailshire
Author information Copyright and License information Disclaimer
The publisher's final edited version of this article is available at J Health Soc Behav
See other articles in PMC that cite the published article.

Abstract
Most adults spend one third of every day sleeping and another third of most days at work.
However, there was little analysis of the possible connections between common workplace
experiences and sleep quality. This study uses the longitudinal and nationally-representative
Americans’ Changing Lives study to examine whether and how common conditions and
experiences at work may “follow workers home” and impinge on their quality of sleep. They
also explore how competing stressful experiences at home may influence sleep quality, and
whether these are more salient than work experiences. Results show that frequently being
bothered or upset at work was associated with changes toward poorer sleep quality, and the
association was not explained by stressful experiences at home. These findings were discussed in
relation to the sociological literatures on work, stress and emotion.

3. Sleep, Emotional
Intelligence, and
Interpersonal Effectiveness:
Natural Bedfellows
 Kenneth M. Nowack
 Published 2017
 DOI:10.1037/cpb0000077
According to the National Sleep Foundation’s Sleep in America Poll, U.S. adults sleep
between 6.7 to 7.3 hr every night, which has decreased by approximately 2 hr per night
since the 19th century (National Sleep Foundation, 2016). Inconsistent or insufficient sleep
can be costly for business, impacting leadership decision making/judgment, interpersonal
relations, absenteeism, presenteeism, safety, productivity, and health (Gaultney & Collins-
McNeil, 2009; Mills et al., 2007; Rosekind et al., 2010). Daytime sleepiness can be
dangerous, and inadequate sleep is a known health hazard resulting in fatigue that can
impair both performance and social functioning. In light of existing research on the effects of
insufficient sleep on work performance, this study investigated the relationship between
self-reported sleep quality and quantity (Stress Profile) of leaders with a concurrent
evaluation of relationship skills by their manager and others (direct reports and peers) on a
measure of emotional and social competence. Regression analyses indicated that leaders
who reported poor quality and quantity of sleep were rated significantly lower on
interpersonal effectiveness after controlling for gender and perceived work/life stress by
their direct reports and peers but not by their manager.

Int J Prev Med. 2013 Sep;4(9):1095-100.

4. Sleep quality of professional firefighters.

Mehrdad R1, Haghighi KS, Esfahani AH.
Author information
1

Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran,
Iran.

Abstract
BACKGROUND:
Firefighting is a unique job with contradictious demands that expose firefighters to many well
documented causal factors of sleep debt, but no studies in Iran and only a few worldwide studies
have investigated their sleep quality while sleep problems may lead to catastrophes especially in
critical service workers. The aim of this study is to evaluate sleep quality and its related factors
among a sample of professional Iranian firefighters.

METHODS:
Using simple random sampling method in a cross-sectional study, 427 personnel of fire and rescue
service were invited. They completed the Persian version of Pittsburgh Sleep Quality Index (PSQI)
and a data collection sheet about their demographic and occupational features during an individual
face to face interview in central office and firehouses throughout Tehran. Response rate was 88.7%.

RESULTS:
The mean ± SD global PSQI score was 7.97 ± 3.77. Sleep latency was the component of PSQI with
the greatest degree of abnormality. 69.9% of participants were poor sleepers. Interestingly, we found
no significant differences between sleep quality of shift workers and non shift workers. Using multiple
logistic regression analysis, only having another job, smoking and years of job experience were
predictors of poor sleep.
 CONCLUSIONS:
In comparison with adult population of Tehran, sleep quality deterioration is notably more common in
Tehran firefighters which require health promotion interventions to prevent its serious adverse
outcomes.
KEYWORDS:
Firefighters; pittsburgh sleep quality index; shift working; sleep quality

5. Exploring the Relationship Between

Work-Related Rumination, Sleep
Quality, and Work-Related Fatigue
Article (PDF Available) in Journal of Occupational Health Psychology 17(3):341-53 · July 2012 with 845 Reads

DOI: 10.1037/a0028552 · Source: PubMed

Cite this publication

Dawn Querstret

o 17.85
o University of Surrey

Mark Cropley

o 37.04
o University of Surrey

Abstract

This study examined the association among three conceptualizations of work-related rumination (affective rumination,
problem-solving pondering, and detachment) with sleep quality and work-related fatigue. It was hypothesized that
affective rumination and poor sleep quality would be associated with increased fatigue and that problem-solving
pondering and detachment would be associated with decreased fatigue. The mediating effect of sleep quality on the
relationship between work-related rumination and fatigue was also tested. An online questionnaire was completed by
a heterogeneous sample of 719 adult workers in diverse occupations. The following variables were entered as
predictors in a regression model: affective rumination, problem-solving pondering, detachment, and sleep quality. The
dependent variables were chronic work-related fatigue (CF) and acute work-related fatigue (AF). Affective rumination
was the strongest predictor of increased CF and AF. Problem-solving pondering was a significant predictor of
decreased CF and AF. Poor sleep quality was predictive of increased CF and AF. Detachment was significantly
negatively predictive for AF. Sleep quality partially mediated the relationship between affective rumination and fatigue
and between problem-solving pondering and fatigue. Work-related affective rumination appears more detrimental to
an individual's ability to recover from work than problem-solving pondering. In the context of identifying mechanisms
by which demands at work are translated into ill-health, this appears to be a key finding and suggests that it is the
type of work-related rumination, not rumination per se, that is important

J Psychosom Res. 2002 Jul;53(1):585-8.

6. Work load and work hours in relation to disturbed

sleep and fatigue in a large representative sample.
Akerstedt T1, Fredlund P, Gillberg M, Jansson B.
Author information
Abstract
OBJECTIVE:
To study the relation between work and background factors on the one hand and disturbed sleep
and fatigue on the other.

METHOD:
A representative national sample of 58,115 individuals was selected at regular intervals over a
period of 20 years and interviewed on issues related to work and health. The data were subjected to
a multiple logistic regression analysis.

RESULTS:
The number of cases was 18,828 (32.8%) for fatigue and 7347 (12.8%) for disturbed sleep. For
disturbed sleep, the significant predictors became: female gender, age above 49 years, present
illness, hectic work, physically strenuous work, and shift work. For fatigue, the significant predictors
became female gender, age below 49 years, high socioeconomic status, present illness, hectic work,
overtime work, and physically strenuous work.

CONCLUSION:
Work stress, shift work, and physical workload interfere with sleep and are related to fatigue.

7. Tossing and turning – insomnia in relation

to occupational stress, rumination, fatigue,
 and well-being by Michiel AJ Kompier, PhD, 1 Toon W Taris, PhD,1, 2 Marc
van Veldhoven, PhD 3 Kompier MAJ, Taris TW, van Veldhoven M. Tossing and turning –
insomnia in relation to occupational stress, rumination, fatigue, and well-being. Scand J Work
Environ Health. 2012;38(3):238–246. doi:10.5271/sjweh.3263 Objectives This study of a large
and heterogeneous sample of 5210 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.

8. Emotion Regulation in Rescue Workers:

Differential Relationship With Perceived
Work-Related Stress and Stress-Related
Symptoms
Article (PDF Available) in Frontiers in Psychology 9:2744 · January 2019 with 89 Reads

DOI: 10.3389/fpsyg.2018.02744

Cite this publication

Anne Gärtner

o 13.28
o Technische Universität Dresden


Alexander Behnke

o 9.19
o Ulm University
 +1

Daniela Conrad

o 11.52
o Universität Konstanz

Iris-Tatjana Kolassa

o 40.52
o Ulm University

Show more authors

Abstract

Rescue workers are exposed to enduring emotional distress, as they are confronted with (potentially) traumatic
mission events and chronic work-related stress. Thus, regulating negative emotions seems to be crucial to withstand
the work-related strain. This cross-sectional study investigated the influence of six emotion regulation strategies (i.e.,
rumination, suppression, avoidance, reappraisal, acceptance, and problem solving) on perceived work-related stress
and stress-related depressive, post-traumatic, and somatic symptoms in a representative sample of 102 German
rescue workers. Multiple regression analyses identified rumination and suppression to be associated with more work-
related stress and stress-related symptoms. Acceptance was linked to fewer symptoms and, rather unexpectedly,
avoidance was linked to less work-related stress. No effects were observed for reappraisal and problem solving. Our
findings confirm the dysfunctional role of rumination and suppression for the mental and physical health of high-risk
populations and advance the debate on the context-specific efficacy of emotion regulation strategies.

29
CrossRef citations to date
 Research Article

9. Work-Related Stress and Posttraumatic

Stress in Emergency Medical Services
Elizabeth Donnelly , PhD, MPH, NREMT-B

Pages 76-85 | Received 29 Apr 2011, Accepted 22 Aug 2011, Published online: 05 Jan 2012

 Download citation

 https://doi.org/10.3109/10903127.2011.621044

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Abstract
Introduction. Recent research efforts in emergency medical services (EMS) has
identified variability in the ability of EMS personnel to recognize their level of
stress-related impairment. Developing a better understanding of how workplace
stress may affect EMS personnel is a key step in the process of increasing
awareness of the impact of work-related stress and stress-related
impairment. Objective. This paper demonstrates that for those in EMS, exposure
to several types of workplace stressors is linked to stress reactions. Stress
reactions such as posttraumatic stress symptomatology (PTSS) have the
potential to negatively influence the health of EMS providers. This research
demonstrates that two different types of work-related stress and alcohol use
influence the development of PTSS. Methods. A probability sample of nationally
registered emergency medical technician (EMT)-Basics and EMT-Paramedics
(n = 1,633) completed an Internet-based survey. Respondents reported their
levels of operational and organizational types of chronic stress, critical incident
stress, alcohol use, and PTSS. Results. Ordinary least squares regression
illustrated that when demographic factors were controlled, organizational and
operational forms of chronic stress, critical incident stress, and alcohol use were
all significant predictors of PTSS (p < 0.01). Inclusion of an interaction effect
between operational stress and critical incident stress (p < 0.01) as well as
between operational stress and alcohol use (p < 0.01) created a robust final
model with an R2 of 0.343. Conclusion. These findings indicate that exposure to
 both chronic and critical incident stressors increases the risk of EMS providers’
developing a posttraumatic stress reaction. Higher levels of chronic stress,
critical incident stress, and alcohol use significantly related to an increased level
of PTSS. Further, for those reporting high levels of alcohol use or critical incident
stress, interactions with high levels of chronic operational stress were associated
with higher rates of PTSS. For those interested in the impact of work-related
stress in EMS, these findings indicate that attention must be paid to levels of
stress associated with both critical incident exposure as well as the chronic
stress providers experience on a day-to-day basis. Key words:emergency
medical services; mental health; stress disorders, posttraumatic; workplace;
stress, psychological

Social Psychiatry and Psychiatric Epidemiology

June 2012, Volume 47, Issue 6, pp 1001–1011| Cite as

10.Rescuers at risk: a systematic review and

meta-regression analysis of the worldwide
current prevalence and correlates of PTSD
in rescue workers
 Authors
 Authors and affiliations
 William Berger
 Evandro Silva Freire Coutinho
 Ivan Figueira
 Carla Marques-Portella
 Mariana Pires Luz
 Thomas C. Neylan
 Charles R. Marmar
 Mauro Vitor Mendlowicz

1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
Original Paper
First Online: 18 June 2011
  9Shares

 4.6kDownloads

 146Citations
Abstract
Purpose

We sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD)
among rescue workers and to determine the variables implicated in the heterogeneity observed
among the prevalences of individual studies.

Methods

A systematic review covering studies reporting on the PTSD prevalence in rescue teams was
conducted following four sequential steps: (1) research in specialized online databases, (2)
review of abstracts and selection of studies, (3) review of reference list, and (4) contact with
authors and experts. Prevalence data from all studies were pooled using random effects model.
Multivariate meta-regression models were fitted to identify variables related to the prevalences
heterogeneity.

Results

A total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The
worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out
in the Asian continent had, on average, higher estimated prevalences than those from Europe, but
not higher than the North American estimates. Studies of ambulance personnel also showed
higher estimated PTSD prevalence than studies with firefighters and police officers.

Conclusions

Rescue workers in general have a pooled current prevalence of PTSD that is much higher than
that of the general population. Ambulance personnel and rescuers from Asia may be more
susceptible to PTSD. These results indicate the need for improving pre-employment strategies to
select the most resilient individuals for rescue work, to implement continuous preventive
measures for personnel, and to promote educational campaigns about PTSD and its therapeutic
possibilities.

Format: Abstract
 Send to

Br J Psychiatry. 2001 Jan;178(1):76-81.

11. Ambulance personnel and critical incidents: impact of accident

and emergency work on mental health and emotional well-being.
Alexander DA1, Klein S.

Author information
Abstract
BACKGROUND:
The association between mental health and occupational factors among ambulance personnel has
not bseen thoroughly investigated in the UK.

AIMS:
To identify the prevalence of psychopathology among ambulance personnel and its relationship to
personality and exposure to critical incidents.

METHOD:
Data were gathered from ambulance personnel by means of an anonymous questionnaire and
standardised measures.

RESULTS:
Approximately a third of the sample reported high levels of general psychopathology, burnout and
posttraumatic symptoms. Burnout was associated with less job satisfaction, longer time in service,
less recovery time between incidents, and more frequent exposure to incidents. Burnout and GHQ-
28 caseness were more likely in those who had experienced a particularly disturbing incident in the
previous 6 months. Concerns about confidentiality and career prospects deter staff from seeking
personal help.

CONCLUSIONS:
The mental health and emotional well-being of ambulance personnel appear to be compromised by
accident and emergency work.

PMID:11136215

DOI:10.1192/bjp.178.1.76

 Format: Abstract
 Send to
 J Trauma Stress. 2005 Oct;18(5):497-505.

12. Risk and resilience in canine search and rescue handlers after
9/11.
Alvarez J1, Hunt M.

Author information
Abstract
Research has suggested that rescue workers are at increased risk for psychological distress. To
determine whether 9/11 deployment was a significant risk factor for canine search and rescue
handlers, 82 deployed handlers were compared to 32 nondeployed handlers on measures of
posttraumatic stress disorder (PTSD), depression, anxiety, acute stress, and clinical diagnoses.
Deployed handlers reported more PTSD and general psychological distress 6 months after 9/11.
Among deployed handlers, prior diagnoses and peritraumatic reactions were associated with
psychological distress whereas social support and training were protective. Results suggest that
more extensive screening and prophylactic interventions for individuals with a history of mental
illness could be beneficial. Future research should examine identified risk/resilience factors
prospectively, and training and intervention should be designed accordingly.

PMID:16281248

DOI:10.1002/jts.20058

13. The Relationship Between Sleep and

Work: A Meta-Analysis
Article (PDF Available) in Journal of Applied Psychology 102(4) · November 2016 with 1,140 Reads

DOI: 10.1037/apl0000169

Cite this publication

Brett Litwiller


 Lori Anderson Snyder

o 16.66
o University of Oklahoma

William D. Taylor

Logan Steele

o 24.11
o University of South Florida

Abstract

Sleep has tremendous importance to organizations because of its relationship with employee performance, safety,
health, and attitudes. Moreover, sleep is a malleable behavior that may be improved by individual and organizational
changes. Despite the consequential and modifiable nature of sleep, little consensus exists regarding its
conceptualization, and how the choice of conceptualization may impact relationships with organizational antecedents
and outcomes. To offer a stronger foundation for future theory and research about employee sleep, this study
calculated meta-analytic correlations of sleep quality and sleep quantity from 152 primary studies of sleep among
workers in organizations. Analyses revealed that both sleep quality and sleep quantity associated negatively with
workload and a number of health, attitudinal, and affective outcomes. Despite their conceptual similarity, notable
differences existed in sleep quality and sleep quantity in terms of their relationships to many different correlates.
Generally, the relationships between sleep quality and the examined correlates were stronger for variables that
reflected perceptions. Moderator analyses showed that relationships between sleep quality and quantity may be
affected by measurement method and the number of self-report items used, while there is little evidence of the effect
of measurement time frame. Findings from this first meta-analytic investigation of the occupational sleep literature
have implications for the development of theory about relationships between sleep and work, the measurement of
sleep, the identification of organizational correlates of sleep, and the design of interventions intended to improve
employee sleep.

Stress Health. 2011 Apr;27(2):e71-82.

14. Work stressors and impaired sleep: rumination as a

mediator.
Berset M1, Elfering A, Lüthy S, Lüthi S, Semmer NK.
Author information
Abstract
An association between stress at work and impaired sleep is theoretically plausible and supported
by empirical evidence. The current study's main aim was to investigate how the influence of
stressors is carried over into the evening and the night. We assume that this relationship is mediated
by perseverative cognitions. We tested this assumption in two cross-sectional samples with
structural equation modeling, using bootstrapped standard errors to test for significance. Effort–
reward imbalance and time pressure were used as stressors, and rumination as a measure for
perseverative cognitions. Results show that the stressors are related to perseverative cognitions,
and these are related to impaired sleep in both samples. Indirect effects are significant in both
samples. With rumination controlled, direct effects of stressors on sleep are only significant in one
out of four cases. Thus, there is full mediation in three out of four cases, and partial mediation in the
fourth one. Our results underscore the notion that perseverative cognitions are crucial for
transferring negative effects of work stressors into private life, including sleep, thus hindering
individuals to successfully recover.

PMID:27486625

J Psychosom Res. 2015 Nov;79(5):391-8. doi: 10.1016/j.jpsychores.2015.08.011. Epub 2015 Sep 2.

15. Bidirectional relations between work-related stress,

sleep quality and perseverative cognition.
Van Laethem M1, Beckers DG2, Kompier MA3, Kecklund G4, van den Bossche SN5, Geurts SA6.
Author information
Abstract
OBJECTIVE:
In this longitudinal two-wave study, bidirectional relations between work-related stress and sleep
quality were examined. Moreover, it was investigated whether perseverative cognition is a potential
underlying mechanism in this association, related to both work-related stress and sleep quality.

METHODS:
A randomly selected sample of Dutch employees received an online survey in 2012 and 2013. Of all
invited employees, 877 participated in both waves. Structural equation modeling was performed to
analyze the data.
 RESULTS:
We found evidence for reversed relations between work-related stress and sleep quality.
Specifically, when controlling for perseverative cognition, work-related stress was not directly related
to subsequent sleep quality, but low sleep quality was associated with an increase in work-related
stress over time. Moreover, negative bidirectional associations over time were found between
perseverative cognition and sleep quality, and positive bidirectional associations were found
between work-related stress and perseverative cognition. Lastly, a mediation analysis showed that
perseverative cognition fully mediated the relationship between work-related stress and sleep
quality.

CONCLUSION:
The study findings suggest that perseverative cognition could be an important underlying
mechanism in the association between work-related stress and sleep quality. The bidirectionality of
the studied relationships could be an indication of a vicious cycle, in which work-related stress,
perseverative cognition, and sleep quality mutually influence each other over time.

 Format: Abstract

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Scand J Work Environ Health. 2013 Nov;39(6):535-49. doi: 10.5271/sjweh.3376. Epub 2013 Aug 12.

16. Psychosocial work characteristics and sleep quality: a systematic

review of longitudinal and intervention research.
Van Laethem M1, Beckers DG, Kompier MA, Dijksterhuis A, Geurts SA.

Author information
Abstract
OBJECTIVES:
The objective of this study was to review longitudinal and intervention studies examining the
association between psychosocial work characteristics (eg, job demands, job control, and social
support) and sleep quality. Our main research aims were to examine whether (i) psychosocial work
characteristics are a predictor of sleep quality, and (ii) sleep quality, in turn, is a predictor of
psychosocial work characteristics.
METHODS:
A systematic literature search resulted in 20 relevant papers, of which 16 were longitudinal studies
and 3 were intervention studies (1 study was discussed in separate papers). To quantify results, we
assessed the strength of evidence of all examined associations and subsequently evaluated the
studies' research quality based on predefined quality criteria.

RESULTS:
One intervention and three longitudinal studies studies were categorized as being of high-quality. In
longitudinal studies, we found consistent and strong evidence for a negative relation between job
demands and sleep quality as well as evidence for a positive relation between job control and sleep
quality. Other psychosocial work characteristics were examined in an insufficient number of (high-
quality) studies. Moreover, both intervention studies as well as studies investigating reversed and
reciprocal relations are rare, which further limits the possibility of drawing conclusions on causality.

CONCLUSIONS:
Based on the current literature, it can be concluded that high job demands and low job control are
predictors of poor sleep quality. More high-quality research is needed to examine the possible
causal relationship between these and other psychosocial work characteristics with sleep quality, in
addition to research focusing on reversed and reciprocal relations.