Sleep Issues May Mess With Work Performance

Poor sleep patterns among depression and anxiety patients linked to decreased work performance

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) It's possible that sleep issues can affect a person's ability to perform everyday activities. For people with depression or anxiety, too little sleep could seriously affect their ability to do their job.

A recent study found that insomnia or too little sleep negatively affected work performance and attendance among people with anxiety and depressive disorders.

The researchers suggested that sleep should be considered in treating these disorders.

"Talk to a psychiatrist if you are having trouble sleeping."

The lead author of this study was Josine G. van Mill from the Department of Psychiatry and the EMGO Institute for Health and Care Research and Neurocampus Amsterdam at VU University Medical Center Amsterdam in the Netherlands.

The study used data on 1,435 participants — 511 men and 924 women — from a previous study called the Netherlands Study of Depression and Anxiety (NESDA).

The average age of the participants at time of the current study was 41.5 years old.

There were 707 participants diagnosed with depressive or anxiety disorders, and 728 who were not diagnosed with any disorder.

The researchers interviewed and assessed the participants between September 2004 and February 2007 about their psychiatric and mental histories (including medication use), sociodemographic characteristics (age, gender, education level) and number of hours worked per week (all participants worked at least eight hours per week).

The participants were then asked how much work they had missed in the previous six months. Possible answers included none (zero weeks missed), short (two or fewer weeks missed) or long-term (more than two weeks missed).

Next, the researchers asked about the participants' sleeping patterns. Average time spent sleeping in the previous month was split up into three categories: short sleep duration (six hours or fewer per night), normal sleep duration (seven to nine hours) or long sleep duration (10 or more hours).

The participants then answered five questions by giving each one a score of 0 to 4:

  • Do you have trouble falling asleep?
  • Do you wake up during the night?
  • Do you wake up in the early morning?
  • Do you have trouble falling back asleep after waking up?
  • What is the quality of your sleep?

For the first four questions, a score of 0 meant "no" and a score of 4 meant "five or more times per week". For the last question, a score of 0 meant "very sound or restful" and a score of 4 meant "very restless."

The researchers added the scores together, with a 9 or higher indicating insomnia.

Lastly, work performance was determined by how many days a participant had problems at work due to their mental health, and how well they worked on those days. The researchers set up a scoring range from 0 to 26, where a score of 0 meant "no impairment", a score between 0 and 2 meant "reduced performance" and a score of 2 or higher meant "impaired performance".

The researchers found that insomnia increased the odds of impaired work performance by 2.20 times in participants with disorders.

The participants with disorders who reported having short sleeping durations had 2.54 times increased odds of impaired work performance.

The findings also showed that there were 56 percent increased odds of reduced work performance if participants had insomnia.

Long sleep duration was associated with 20 percent decreased odds of impaired work performance among those with disorders.

The researchers discovered that long sleep duration among the participants without disorders was associated with 4.28 times increased odds of impaired work performance.

Both insomnia and short sleep duration in the participants with disorders were significantly associated with missing work long-term — with 2.48 times increased odds for insomnia and 85 percent increased odds for short sleep duration.

The researchers discovered that longer sleep duration among participants with disorders led to 17 percent decreased odds of missing work long-term.

Shorter duration of sleep was associated with 48 percent increased odds of only missing work for a short amount of time in these participants.

For the participants without disorders, longer sleep duration was associated with 37 percent increased odds of missing work long-term.

When the researchers adjusted for the severity of the disorder and use of medication, the findings did not differ much and were still statistically significant.

Therefore, the researchers concluded that sleep disturbances were associated with decreased ability to function normally at work for people with depressive and anxiety disorders, independent of symptom severity and use of medication.

The researchers suggested that health professionals should take a patient's sleeping patterns into consideration during treatment. They also believe that more research is needed to see if treatment for sleep issues in patients with depressive or anxiety disorders could help improve functioning at work.

"Forty percent of all patients with chronic insomnia have anxiety and depression," Robert S. Rosenberg, DO, leading national expert in sleep medicine practicing at Sleep Disorders Centers of Prescott Valley and Flagstaff, told dailyRx News.

"This is an interesting study in that it focuses on work performance and exhibits how negatively insomnia affects it. We now have yet one more investigation that demonstrates the importance of addressing insomnia in mood and anxiety disorders. Previous studies have shown that if untreated, insomnia will result in a very high relapse rate of depression and anxiety," said Dr. Rosenberg.

The authors mentioned a few limitations of their study.

First, sleep and work data were self-reported. Second, the researchers did not have data on whether or not the participants had sleeping conditions.

This study was published in the November edition of Sleep Medicine.

Servier provided funding.

Review Date: 
November 14, 2013
Last Updated:
December 30, 2013