title: Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program.
abstract: OBJECTIVE
  To examine the relationships between employees' trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period.
  
  
  METHODS
  Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and health care costs as the outcomes.
  
  
  RESULTS
  EWP participants (N = 11,698 in 2008; 5636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all P < 0.0005), have lower work performance ratings (all P < 0.0005), and have higher health care costs (P < 0.0005). Longitudinally, more trouble sleeping was significantly related to negative changes in all outcomes.
  
  
  CONCLUSIONS
  Employees' trouble sleeping, even at a subclinical level, negatively impacts on work attendance, work performance, and health care costs.
authors.affiliation: Cancer Prevention and Control Program (Dr Hui), Fox Chase Cancer Center and Department of Psychiatry (Dr Grandner), Perelman School of Medicine, University of Pennsylvania.
authors.forename: Siu-kuen Azor
authors.initials: SK
authors.lastname: Hui
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics; D006801:Humans; D007615:Kansas; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000191:economics; D012189:Retrospective Studies; D057566:Self Report; D012893:Sleep Wake Disorders / Q000191:economics* / Q000523:psychology; D000066477:Work Performance / Q000706:statistics & numerical data*