title: U-shaped associations between time in bed and the physical and mental functioning of Japanese civil servants: the roles of work, family, behavioral and sleep quality characteristics.
abstract: OBJECTIVE
  This study aimed to evaluate (i) whether work, family, behavioral and sleep quality characteristics differ among individuals with different time in bed (TIB), and (ii) whether and how much the U-shaped associations between TIB and health can be explained by these characteristics.
  
  
  METHODS
  Participants were 3510 employees (2371 males and 1139 females) aged 20-65 years working in local government in Japan. They completed a questionnaire regarding work, family, and behavioral characteristics. Sleep quality and physical and mental functioning were evaluated using the Pittsburgh Sleep Quality Index and the Short Form 36.
  
  
  RESULTS
  High job demands, long work hours, and high work-family conflict were more prevalent among those with short TIB. Those with long TIB had daily drinking habits. Whereas those with short TIB had poor sleep, mainly due to poor subjective sleep quality and daytime dysfunction, those with long TIB had poor sleep, mainly due to long sleep latency, poor sleep efficiency and sleep disturbances. The U-shaped associations between TIB and poor physical and mental health, with the best health observed in those spending ~8 h in bed, weakened considerably after adjustment for sleep quality, followed by work and family characteristics. After adjusting for behavioral characteristics and long-standing illnesses, the associations hardly changed.
  
  
  CONCLUSIONS
  The U-shaped associations between TIB and health may be explained by U-shaped associations between TIB and poor sleep and psychosocial stress in work and family life.
authors.affiliation: Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan. Electronic address: sekine@med.u-toyama.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Sekine
authors.affiliation: Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tatsuse
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Cable
authors.affiliation: The Cathie Marsh Centre for Census and Survey Research (CCSR), University of Manchester, Manchester, UK.
authors.forename: T
authors.initials: T
authors.lastname: Chandola
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Marmot
mesh_terms: D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000208:ethnology; D004651:Employment; D005190:Family; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007564:Japan; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000208:ethnology; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Psychosocial stress; Shift work; Sleep; Socio-economic status; Work hours; Work–family conflict