title: Early morning awakening and nonrestorative sleep are associated with increased minor non-fatal accidents during work and leisure time.
abstract: BACKGROUND
  The relationship between a composite measure of insomnia and occupational or fatal accidents has been investigated previously; however, little is known regarding the effect of various insomnia symptoms on minor non-fatal accidents during work and leisure time.
  
  
  OBJECTIVE
  We investigated the predicting role of insomnia symptoms on minor non-fatal accidents during work and leisure time.
  
  
  METHODS
  Data from the 2005 Taiwan Social Development Trend Survey of 36,473 Taiwanese aged ≥18 years were analyzed in 2013. Insomnia symptoms, including difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA), and nonrestorative sleep (NRS) were investigated. A minor non-fatal accident was defined as any mishap such as forgetting to turn off the gas or faucets, accidental falls, and abrasions or cuts occurring during work and leisure time in the past month that do not require immediate medical attention. Multivariable logistic regression was performed to assess the odds ratios (ORs) and associated 95% confidence interval (CI) of minor non-fatal accidents (as a binary variable) for each insomnia symptom compared with those of people presenting no symptoms, while controlling for possible confounders.
  
  
  RESULTS
  EMA and NRS increased the odds of minor non-fatal accidents occurring during work and leisure time (adjusted OR=1.19, 95% CI=1.08-1.32 and adjusted OR=1.27, 95% CI=1.17-1.37, respectively).
  
  
  CONCLUSIONS
  EMA and NRS are two symptoms that are significantly associated with an increased likelihood of minor non-fatal accidents during work and leisure time after adjusting for of a range of covariates.
authors.affiliation: Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsiao-Yean
authors.initials: HY
authors.lastname: Chiu
authors.affiliation: Department of Nursing, Cardinal Tien College of Healthcare and Management, New Taipei City, Taiwan.
authors.forename: Mei-Yeh
authors.initials: MY
authors.lastname: Wang
authors.affiliation: Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
authors.forename: Cheng-Kuei
authors.initials: CK
authors.lastname: Chang
authors.affiliation: Department of Nursing/Institute of Gerontology, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ching-Min
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kuei-Ru
authors.initials: KR
authors.lastname: Chou
authors.affiliation: Department and Institute of Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jen-Chen
authors.initials: JC
authors.lastname: Tsai
authors.affiliation: Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Sleep Science Center, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: ptsai@tmu.edu.tw.
authors.forename: Pei-Shan
authors.initials: PS
authors.lastname: Tsai
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data*; D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D007899:Leisure Activities; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology; D015599:Trauma Severity Indices
keywords: Early morning awakening; Insomnia symptoms; Non-fatal accident; Nonrestorative sleep; Sleep disturbance