title: Different levels of work-related stress and the effects on sleep, fatigue and cortisol.
abstract: OBJECTIVE
  The aim of the study was to relate different levels of work stress to measures of sleep and the diurnal pattern of salivary cortisol and subjective sleepiness.
  
  
  METHODS
  Thirty-four white-collar workers participated under two different conditions. One workweek with a relatively high stress level (H) and one with a lower stress level (L) as measured through self-rated stress during workdays. The workers wore activity monitors, filled out a sleep diary, gave saliva samples (for cortisol), and rated their sleepiness and stress during one workday and one free day.
  
  
  RESULTS
  During the week with stress the number of workhours increased and total sleep time decreased. Sleepiness showed a significant interaction between weeks and time of day, with particularly high levels towards the evenings of the stress week. Cortisol also showed a significant interaction, with a more flattened pattern, probably due to increased evening levels during the stress week. Stress (restlessness) at bedtime was significantly increased during the stress week.
  
  
  CONCLUSIONS
  The results demonstrate that a workweek with a high workload and much stress increases sleepiness and workhours, impairs sleep, and affects the pattern of diurnal cortisol secretion.
authors.affiliation: National Institute for Psychosocial Medicine, Stockholm, Sweden. anna.dahlgren@ipm.ki.se
authors.forename: Anna
authors.initials: A
authors.lastname: Dahlgren
authors.forename: Göran
authors.initials: G
authors.lastname: Kecklund
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Akerstedt
mesh_terms: D004651:Employment; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry; D012890:Sleep / Q000502:physiology*; D013315:Stress, Psychological / Q000503:physiopathology*
chemical_list: D006854:Hydrocortisone