title: Insomnia as a predictor of job exit among middle-aged and older adults: results from the Health and Retirement Study.
abstract: Poor health is a recognised predictor of workforce exit, but little is known about the role of insomnia in workforce exit. We examined the association between insomnia symptoms and subsequent job exit among middle-aged and older adults from the Health and Retirement Study (HRS).
  
  
  
  The study sample consisted of 5746 respondents aged between 50 and 70 who were working for pay when interviewed in the HRS 2004 and were followed up in the HRS 2006. Multinomial logistic regression was used to determine the association between number of insomnia symptoms (0, 1-2, 3-4) and job exit (no exit, health-related exit or exit due to other reasons).
  
  
  
  In models adjusting for demographic characteristics, baseline health status and baseline job characteristics, compared with respondents with no insomnia symptoms, those with 3-4 insomnia symptoms had approximately twice the odds of leaving the workforce due to poor health (adjusted relative risk ratio=1.93, 95% CI 1.04 to 3.58, p=0.036). There was no association between insomnia and job exit due to non-health reasons.
  
  
  
  An elevated number of insomnia symptoms is independently associated with leaving paid employment. Workplace screening for and treatment of insomnia symptoms may prolong labour force participation of middle-aged and older adults.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
authors.forename: Liming
authors.initials: L
authors.lastname: Dong
authors.affiliation: Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Agnew
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.|Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.|Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.|Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Spira
mesh_terms: D000368:Aged; D004651:Employment; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012179:Retirement / Q000639:trends*; D007319:Sleep Initiation and Maintenance Disorders
keywords: OCCUPATIONAL HEALTH; SLEEP; SOCIAL EPIDEMIOLOGY