title: Sleep disturbances as a predictor of long-term increase in sickness absence among employees after family death or illness.
abstract: OBJECTIVE
  This study examined whether sleep disturbances after family death or illness are associated with an increase in health problems and delayed recovery.
  
  
  METHODS
  Longitudinal observational cohort study.
  
  
  METHODS
  Ten cities in Finland.
  
  
  METHODS
  A population of 6032 male and 20,933 female city employees.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Self-reports of a family death or illness, the timing of the event, and postevent sleep duration and quality, measured by the Jenkins Scale, were linked with monthly sickness absence records from 36 months prior to the event to 30 months after the event. A repeated-measures Poisson regression analysis with the generalized estimating equation method showed no differences in the preevent absence rates between the employees with and without disturbed sleep. For employees with disturbed sleep, the rate of absence in the month the event occurred was 2.08-fold higher (95% confidence interval: 1.71, 2.53) compared with the employee's baseline level of sickness absence, and it was still 1.67-fold higher (95% confidence interval: 1.42, 1.98) 19 to 30 months after the event. The corresponding rate ratios were lower for the employees with undisturbed sleep after the event (1.49 and 1.16, respectively). Delayed recovery with disturbed sleep was observed after family illness but not after family death.
  
  
  CONCLUSIONS
  These findings suggest that a long-term increase in sickness absence is particularly likely if a family illness is associated with sleep disturbances. Identifying people with sleep disturbances may be important in preventing health problems in the aftermath of a family death or illness.
authors.affiliation: Finnish Institute of Occupational Health, Hämeenkatu 10, FIN-20500 Turku, Finland. jussi.vahtera@ttl.fi
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: Hans
authors.initials: H
authors.lastname: Helenius
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000041:Absenteeism; D001601:Bereavement; D002391:Catchment Area, Health; D015331:Cohort Studies; D003710:Demography; D004651:Employment / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D019370:Observation; D011237:Predictive Value of Tests; D018582:Sick Leave / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000453:epidemiology*