Abstract
OBJECTIVE: To measure the prevalence of sleep problems in a working population and examine their association with health problems, health-related quality-of-life measures, work-related problems, and medical expenditures. Also, to explore the usefulness of a sleep-problems screen for mental health conditions and underlying sleep disorders.
DESIGN: Cross-sectional survey administered via voice mail and telephone interview.
SETTING: A San Francisco Bay Area telecommunications firm.
PARTICIPANTS: Volunteer sample of 588 employees who worked for a minimum of six months at the company and were enrolled in its fee-for-service health plan.
MEASUREMENTS AND MAIN RESULTS: Thirty percent of respondents reported currently experiencing sleep problems and were found to have worse functioning and well-being (general health, cognitive functioning, energy), more work-related problems (decreased job performance and lower satisfaction, increased absenteeism), and a greater likelihood of comorbid physical and mental health conditions than were the respondents who did not have sleep problems. They also demonstrated a trend toward higher medical expenditures.
CONCLUSIONS: Self-perceived sleep problems were common among the respondents and were associated with poorer health and health-related quality of life. A single question about sleep problems may serve as an effective screen for identifying primary care patients with mental health problems, as well as underlying sleep disorders.
Similar content being viewed by others
References
Manfredi RL, Vgontzas A, Kales A. An update on sleep disorders. Bull Menninger Clin. 1989;53:250–73.
Welstein L, Dement WC, Redington D, Guilleminault C, Mitler MM. Insomnia in the San Francisco Bay Area: a telephone survey. In: Guilleminault C, Lugaresi E (eds). Sleep/Wake Disorders: Natural History, Epidemiology, and Long-Term Evolution. New York: Raven Press, 1983:73–85.
Bixler EO, Kales A, Soldatos CR, Kales JD, Healey S. Prevalence of sleep disorders in the Los Angeles Metropolitan Area. Am J Psychiatry. 1979;136:1257–62.
Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment. Arch Gen Psychiatry. 1985;42:225–32.
National Commission on Sleep Disorders Research. Wake Up America: A National Sleep Alert, Volume One. Submitted to the U.S. Congress, January 1993.
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.
Jacquinet-Salord MC, Lang T, Fouriaud C, Nicoulet I, Bingham A. Sleeping tablet consumption, self reported quality of sleep, and working conditions. J Epidemiol Community Health. 1993;47:64–8.
Johns MW, Dudley HAF, Masterton JP. The sleep habits, personality and academic performance of medical students. Med Educ. 1976;10:158–62.
Johnson LC, Spinweber CL. Good and poor sleepers differ in Navy performance. Mil Med. 1983;148:727–31.
Urponen H, Vuori I, Hasan J, Partinen M. Self-evaluations of factors promoting and disturbing sleep: an epidemiological survey in Finland. Soc Sci Med. 1988;26:443–50.
Hoch CC, Buysse DJ, Reynolds CF III. Sleep and depression in late life. Clin Geriatr Med. 1989;5:259–74.
Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. JAMA. 1989;262:1479–84.
Kales JD, Kales A, Bixler EO, et al. Biopsychobehavioral correlates of insomnia. V: Clinical characteristics and behavioral correlates. Am J Psychiatry. 1984;141:1371–6.
Vollrath M, Wicki W, Angst J. The Zurich study. VIII: Insomnia: association with depression, anxiety, somatic syndromes, and course of insomnia. Eur Arch Psychiatry Neurol Sci. 1989;239:113–24.
Hyyppa MT, Kronholm E. Quality of sleep and chronic illnesses. J Clin Epidemiol. 1989;42:633–8.
Moffitt PF, Kalucy EC, Kalucy RS, Baum FE, Cooke RD. Sleep difficulties, pain and other correlates. J Intern Med. 1991;230:245–9.
Wingard DL, Berkman LF. Mortality risk associated with sleeping patterns among adults. Sleep. 1983;6:102–7.
Home JA. Sleep loss and “divergent” thinking ability. Sleep. 1988;11:528–36.
An Analysis of the Prevalence and Effects of Sleep Problems in a Healthy Working Population. Paper #100-2: 1991. Internal publication: Technology Assessment Group. San Francisco, CA.
Stewart AL, Sherbourne CD, Hays RD, et al. Summary and discussion of MOS measures. In: Stewart AL, Ware JE Jr (eds). Measuring Functioning and Weil-Being: The Medical Outcomes Study Approach. Durham, NC, and London: Duke University Press, 1992:345–71.
Stewart AL, Hays RD, Ware JE Jr. The MOS Short-form General Health Survey: reliability and validity in a patient population. Med Care. 1988;26:724–32.
Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Med Care. 1991;29:169–76.
Goldberg DP, Blackwell B. Psychiatric illness in general practice: a detailed study using a new method of case identification. Br Med J. 1970;2:439–43.
Barsky AJ, Wyshak G, Klerman GL. Medical and psychiatric determinants of outpatient medical utilization. Med Care. 1986;24:548–60.
U.S. Department of Labor. Current labor statistics: employment data. Monthly Labor Rev. 1992:March:62, 67.
Fifer SK, Mathias SD, Patrick DL, Mazonson PD, Lubeck DL, Buesching DP. Untreated anxiety among adult primary care patients in a health maintenance organization. Arch Gen Psychiatry. 1994;51:740–50.
Wetzler HP, Cruess DF. Self-reported physical health practices and health care utilization: findings from the National Health Interview Survey. Am J Public Health. 1985;75:1329–30.
Kales A, Caldwell AB, Soldatos CR, Bixler EO, Kales JD. Biopsychobehavioral correlates of insomnia. II. Pattern specificity and consistency with the Minnesota Multiphasic Personality Inventory. Psychosom Med. 1983;45:341–56.
Bixler EO, Kales A, Leo LA, Slye T. A comparison of subjective estimates and objective sleep laboratory findings in insomnia patients [abstract]. Sleep Res. 1973;2:143.
Carskadon MA. Dement WC, Mitler MM. et al. Self-reports versus sleep laboratory findings in 122 drug-free subjects with the complaints of chronic insomnia. Am J Psychiatry. 1976;133:1382–8.
Frankel BL, Coursey RD, Buchbinder R, Snyder F. Recorded and reported sleep in chronic primary insomnia. Arch Gen Psychiatry. 1976;33:615–23.
Coates TJ, Killen JD, George J, Marchini E, Silverman S, Thoresen C. Estimating sleep parameters: a multitrait—multimethod analysis. J Consult Clin Psychol. 1982;50:345–52.
Author information
Authors and Affiliations
Additional information
Supported by The Upjohn Company. Dr. Buesching is a former employee of The Upjohn Company but owns no stock or options to purchase stock in that company. Drs. Kuppermann. Lubeck, Mazonson, Patrick, Stewart, and Fifer own no stock or options in The Upjohn Company.
Rights and permissions
About this article
Cite this article
Kuppermann, M., Lubeck, D.P., Mazonson, P.D. et al. Sleep problems and their correlates in a working population. J Gen Intern Med 10, 25–32 (1995). https://doi.org/10.1007/BF02599573
Issue Date:
DOI: https://doi.org/10.1007/BF02599573