title: Sleep and sickness absence: a nationally representative register-based follow-up study.
abstract: OBJECTIVE
  We aimed to examine various sleep measures as determinants of sickness absence while considering confounders.
  
  
  METHODS
  Nationally representative Health 2000 Survey linked with sickness absence data from the Finnish Social Insurance Institution.
  
  
  METHODS
  Finland.
  
  
  METHODS
  Working-aged women (n = 1,875) and men (n = 1,885).
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Insomnia-related symptoms, early morning awakenings, being more tired during daytime than other people of same age, use of sleeping pills, excessive daytime sleepiness, probable sleep apnea (4 items about snoring/apnea), and reporting that sleep duration varies between different seasons were examined as determinants of sickness absence over a 7.2 year follow-up. Poisson and gamma regression models were fitted. After adjusting age, all examined sleep disturbances except excessive daytime sleepiness were associated with sickness absence among men (RRs 1.3-2.5). Among women, after adjusting for age, insomnia-related symptoms, early morning awakenings, being more tired than others, and use of sleeping pills were associated with sickness absence (RRs 1.4-1.8). After further adjustments for education, working conditions, health behaviors, and objectively measured mental and somatic health, the associations somewhat attenuated but mainly remained. The optimal sleep duration with the lowest risk of sickness absence was 7.6 hours for women and 7.8 hours for men. Although persistence of other health problems could affect the estimates, direct costs due to sickness absence could decrease by up to 28% if sleep disturbances could be fully addressed.
  
  
  CONCLUSIONS
  This study highlights the need for prevention of sleep disturbances and promotion of optimal sleep length to prevent sickness absence.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.forename: Risto
authors.initials: R
authors.lastname: Kaikkonen
authors.forename: Tommi
authors.initials: T
authors.lastname: Härkänen
authors.forename: Erkki
authors.initials: E
authors.lastname: Kronholm
authors.forename: Timo
authors.initials: T
authors.lastname: Partonen
authors.forename: Ossi
authors.initials: O
authors.lastname: Rahkonen
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
mesh_terms: D000328:Adult; D000367:Age Factors; D003365:Costs and Cost Analysis; D004526:Efficiency; D005221:Fatigue / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012042:Registries; D012621:Seasons; D012737:Sex Factors; D018582:Sick Leave / Q000191:economics* / Q000706:statistics & numerical data*; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D012913:Snoring / Q000453:epidemiology; D013997:Time Factors; D014937:Work / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D006993:Hypnotics and Sedatives
keywords: cohort study; cost; hypnotics; insomnia; register based; sleep duration; work disability