title: Sleep disturbances and reduced work functioning in depressive or anxiety disorders.
abstract: OBJECTIVE
  We aimed to examine the associations between sleep disturbances and work functioning in an epidemiologic cohort study in subjects with or without depressive or anxiety disorders.
  
  
  METHODS
  There were 707 subjects included in our analyses with depressive or anxiety disorders and 728 subjects without current depressive or anxiety disorders. Insomnia was defined as a score ≥9 using the Insomnia Rating Scale. Self-reported sleep duration was categorized in short, normal, and long (≤6, 7-9, and ≥10 h, respectively). Work absenteeism was defined as none, short (≤2 weeks), or long (>2 weeks). Work performance was defined as not impaired, reduced, or impaired. Logistic regression analyses were performed to examine the associations of sleep disturbances with work functioning.
  
  
  RESULTS
  In subjects with psychopathology, insomnia and short sleep duration were significantly associated with impaired work performance (odds ratio [OR] for insomnia, 2.20; [95% confidence interval {CI}, 1.50-3.22]; OR for short sleep, 2.54 [95% CI, 1.66-3.88] compared to normal sleep duration). Insomnia (OR, 2.48 [95% CI, 1.67-3.69]) and short sleep duration (OR, 1.85 [95% CI, 1.23-2.78]) also were associated with long-term absenteeism. These findings remained the same after considering clinical characteristics including medication use and symptom severity. In subjects without psychopathology, no significant associations were found between insomnia and short sleep duration on work functioning after considering subthreshold depression symptoms.
  
  
  CONCLUSIONS
  In subjects with psychopathology, sleep disturbances were negatively associated with work functioning, independent of disorder severity and use of psychotropic medication. Further research is needed to determine if treatment of sleep disturbances in subjects with psychopathology improves work functioning.
authors.affiliation: Department of Psychiatry and the EMGO Institute for Health and Care Research, The Netherlands; NeuroCampus Amsterdam, VU University Medical Center Amsterdam, The Netherlands. Electronic address: j.mill@ggzingeest.nl.
authors.forename: Josine G
authors.initials: JG
authors.lastname: van Mill
authors.forename: Nicole
authors.initials: N
authors.lastname: Vogelzangs
authors.forename: Witte J G
authors.initials: WJ
authors.lastname: Hoogendijk
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000041:Absenteeism; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology
chemical_list: D000928:Antidepressive Agents
keywords: Absenteeism; Anxiety; Depression; Insomnia; Sleep; Work