1
|
Robbins R. Employee Sleep Promotion Programs in Workplace Settings: An Exciting, Viable Area for Lifestyle Medicine. Am J Lifestyle Med 2024; 18:335-339. [PMID: 38737884 PMCID: PMC11082868 DOI: 10.1177/15598276231197179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
In the past several decades, our population sleep health has fallen short of recommendations. Moreover, there has been an increase in sleep difficulties amidst COVID-19. Work consumes a huge proportion of our waking lives, and the nature of our work can impact the quantity and quality of employee sleep. Conversely, employee sleep also matters for work-related outcomes as evidence demonstrates poor employee sleep health is associated with increased presenteeism, absenteeism, and health care costs. Given the prevalence of poor sleep health in our population, the changing nature of work and increasing demands on capped time, the worksite represents a promising and potentially underexplored venue for lifestyle medicine practitioners to consider employee sleep health and, where possible, novel employee sleep health promotion programs. This article outlines the impact of work on sleep and reviews the potential for incorporating sleep into lifestyle interventions in workplace settings.
Collapse
Affiliation(s)
- Rebecca Robbins
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA (RR)
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital (RR)
| |
Collapse
|
2
|
Pienaar PR, Bosma AR, Rae DE, Roden LC, van Mechelen W, Lambert EV, Boot CRL. Barriers and Facilitators to Participation and Key Components of Sleep Health Programs: Perspectives for the Corporate Work Environment. J Occup Environ Med 2024; 66:35-42. [PMID: 37853643 DOI: 10.1097/jom.0000000000002991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVE The aim of the study is to explore the barriers and facilitators of participation and key components for sleep health programs designed for corporate work environments. METHODS Semistructured interviews with corporate executives and occupational medicine specialists in the decision making and management of workplace health promotion programs (WHPP) within their companies were held before and during COVID-19. Interviews were transcribed verbatim and analyzed using thematic content analysis to identify themes. RESULTS Barrier and facilitator themes emerging from the data include sleep health awareness, work culture, work-family balance, and confidentiality. Key components for sleep health programs included the following: identifying the need for a program, incorporating sleep health risk screening to WHPP, and promoting sleep health by raising awareness thereof. CONCLUSIONS The identified barriers and facilitators to employee participation and key components of an ideal sleep health program provide guidance for further WHPP.
Collapse
Affiliation(s)
- Paula R Pienaar
- From the Health through Physical Activity Lifestyle and Sport Research Centre and Division of Physiological Sciences Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa (P.R.P., D.E.R., L.C.R., W.v.M., E.V.L.); Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (P.R.P., A.R.B., W.v.M., C.R.L.B.); School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom (L.C.R.); Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia (W.v.M.); and School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland (W.v.M.)
| | | | | | | | | | | | | |
Collapse
|
3
|
Glick DR, Abariga SA, Thomas I, Shipper AG, Gunia BC, Grandner MA, Rosenberg E, Hines SE, Capaldi V, Collen J, Wickwire EM. Economic Impact of Insufficient and Disturbed Sleep in the Workplace. PHARMACOECONOMICS 2023; 41:771-785. [PMID: 36933184 DOI: 10.1007/s40273-023-01249-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Insufficient and disturbed sleep are associated with significant morbidity among working-age adults. Poor sleep results in negative health outcomes and increases economic costs to employers. The current systematic review surveyed the peer-reviewed scientific literature and aggregated scientific evidence of sleep-related economic burdens borne by employers. METHODS A systematic review was performed to identify peer-reviewed, English language studies evaluating the economic impact of insufficient and disturbed sleep among adult employee populations. An exhaustive literature search was performed using keywords related to sleep, economics, and the workplace. Included were scientific studies (randomized controlled trials, cohort and case control studies, cross-sectional and longitudinal studies) examining specific employee populations with relevant sleep and economic outcomes. Each included study was evaluated for risk of bias and relevant data was extracted and summarized. RESULTS Sleep problems among employee populations are associated with worsened workplace outcomes, such as presenteeism, absenteeism, and accidents. Sleep problems also increased costs to employers, ranging from US$322 to US$1967 per employee. Interventions to improve sleep, such as the use of blue-light filtering glasses, strategic shift scheduling, and targeted interventions to treat insomnia, may improve workplace outcomes and reduce costs. CONCLUSIONS This review synthesizes the existing data regarding the negative impacts of insufficient and disturbed sleep on the workplace, suggesting that employers have an economic stake in their employees' sleep. TRIAL REGISTRATION PROSPERO: CRD42021224212.
Collapse
Affiliation(s)
- Danielle R Glick
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sleep Disorders Center, University of Maryland School of Medicine, 100 N Greene St, 2nd Floor, Baltimore, MD, 21201, USA.
| | - Samuel A Abariga
- Department of Epidemiology & Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Irine Thomas
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrea G Shipper
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA
- Charles Library, Temple University, Philadelphia, PA, USA
| | - Brian C Gunia
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | | | - Stella E Hines
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Vincent Capaldi
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jacob Collen
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Emerson M Wickwire
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sleep Disorders Center, University of Maryland School of Medicine, 100 N Greene St, 2nd Floor, Baltimore, MD, 21201, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
4
|
Robbins R, Weaver MD, Quan SF, Sullivan JP, Qadri S, Glasner L, Cohen-Zion M, Czeisler CA, Barger LK. Evaluating the impact of a sleep health education and a personalised smartphone application on sleep, productivity and healthcare utilisation among employees: results of a randomised clinical trial. BMJ Open 2022; 12:e062121. [PMID: 36104122 PMCID: PMC9476153 DOI: 10.1136/bmjopen-2022-062121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We evaluated an online Sleep Health and Wellness (SHAW) programme paired with dayzz, a personalised sleep training programme deployed via smartphone application (dayzz app) that promotes healthy sleep and treatment for sleep disorders, among employees at a large healthcare organisation. DESIGN Open-label, randomised, parallel-group controlled trial. SETTING A healthcare employer in the USA. PARTICIPANTS 1355 daytime workers. INTERVENTION Participants were randomised to intervention (n=794) or control (n=561) on consent. Intervention participants received the SHAW educational programme at baseline plus access to the personalised dayzz app for up to 9 months. The control condition received the intervention at month 10. PRIMARY AND SECONDARY OUTCOME MEASURES Our primary outcome measures were sleep-related behavioural changes (eg, consistent sleep schedule); sleep behaviour tracked on an electronic sleep diary and sleep quality. Our secondary outcome measures included employee absenteeism, performance and productivity; stress, mood, alertness and energy; and adverse health and safety outcomes (eg, accidents). RESULTS At follow-up, employees in the intervention condition were more likely to report increased sleep duration on work (7.20 vs 6.99, p=0.01) and on free (8.26 vs 8.04, p=0.03) nights. At follow-up, the prevalence of poor sleep quality was lower in the intervention (n=160 of 321, 50%) compared with control (n=184 of 327, 56%) (p=0.04). The mean total dollars lost per person per month due to reduced workplace performance (presenteeism) was less in the intervention condition (US$1090 vs US$1321, p=0.001). Employees in the intervention reported fewer mental health visits (RR 0.72, 95% CI 0.56 to 0.94, p=0.01) and lower healthcare utilisation over the study interval (RR 0.81, 95% CI 0.67 to 0.98, p=0.03). We did not observe differences in stress (4.7 (95% CI 4.6 to 4.8) vs 4.7 (95% CI 4.6 to 4.8)), mood (4.5 (95% CI 4.4 to 4.6) vs 4.6 (95% CI 4.5 to 4.7)), alertness (4.9 (95% CI 4.8 to 5.0) vs 5.0 (95% CI 4.9 to 5.1)) or adverse health and safety outcomes (motor vehicle crashes: OR 0.82 (95% CI 0.34 to 1.9); near-miss crashes: OR=0.89 (95% CI 0.5 to 1.5) and injuries: 0.9 (95% CI 0.6 to 1.3)); energy was higher at follow-up in the intervention group (4.3 vs 4.5; p=0.03). CONCLUSIONS Results from this trial demonstrate that a SHAW programme followed by access to the digital dayzz app can be beneficial to both the employee and employer. TRIAL REGISTRATION NUMBER NCT04224285.
Collapse
Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Stuart F Quan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jason P Sullivan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Salim Qadri
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Laura Glasner
- Psychiatric Division, Sheba Medical Center, Tel Hashomer, Israel
- dayzz Live Well Ltd, Herzliya, Israel
| | | | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Strategic Choice and Implementation of Workplace Wellness Programs in the United States. Healthcare (Basel) 2022; 10:healthcare10071216. [PMID: 35885743 PMCID: PMC9319888 DOI: 10.3390/healthcare10071216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/21/2022] [Accepted: 06/26/2022] [Indexed: 11/16/2022] Open
Abstract
Despite widespread discussion and public policy support for workplace wellness programs in the United States, their diffusion has been slow. Using data from the 2017 Workplace Health Administration Survey, this paper explored the importance of establishment characteristics, unionization, and strategic choice in the adoption of workplace health initiatives and employee participation in these programs. An ordinary least squares analysis revealed that unionization (β = 1.59, 95% CI = 1.20−1.97, p < 0.001) and management support (β = 1.67, 95% CI = 1.25−2.10, p < 0.001) were the strongest predictors of the number of programs adopted by an establishment. In logistic regression analyses of nine workplace wellness programs, it was also found that unionization and management were the strongest predictors of the adoption of these programs. Management support was also correlated with employee participation of in nutrition (OR = 2.66, 95% CI = 1.23−5.71, p < 0.05) and obesity programs (OR = 3.66, 95% CI = 1.03−12.97, p < 0.05).
Collapse
|
6
|
Duggan NM, Hasdianda MA, Baker O, Jambaulikar G, Goldsmith AJ, Condella A, Azizoddin D, Landry AI, Boyer EW, Eyre AJ. The Effect of Noise-Masking Earbuds (SleepBuds) on Reported Sleep Quality and Tension in Health Care Shift Workers: Prospective Single-Subject Design Study. JMIR Form Res 2022; 6:e28353. [PMID: 35315781 PMCID: PMC8984824 DOI: 10.2196/28353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/06/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background Shift work is associated with sleep disorders, which impair alertness and increase risk of chronic physical and mental health disease. In health care workers, shift work and its associated sleep loss decrease provider wellness and can compromise patient care. Pharmacological sleep aids or substances such as alcohol are often used to improve sleep with variable effects on health and well-being. Objective We tested whether use of noise-masking earbuds can improve reported sleep quality, sleepiness, and stress level in health care shift workers, and increase alertness and reaction time post night shift. Methods Emergency medicine resident physicians were recruited for a prospective, single-subject design study. Entrance surveys on current sleep habits were completed. For 14 days, participants completed daily surveys reporting sleep aid use and self-rated perceived sleepiness, tension level, and last nights’ sleep quality using an 8-point Likert scale. After overnight shifts, 3-minute psychomotor vigilance tests (PVT) measuring reaction time were completed. At the end of 14 days, participants were provided noise-masking earbuds, which they used in addition to their baseline sleep regimens as they were needed for sleep for the remainder of the study period. Daily sleep surveys, post–overnight shift PVT, and earbud use data were collected for an additional 14 days. A linear mixed effects regression model was used to assess changes in the pre- and postintervention outcomes with participants serving as their own controls. Results In total, 36 residents were recruited, of whom 26 participants who completed daily sleep surveys and used earbuds at least once during the study period were included in the final analysis. The median number of days of earbud use was 5 (IQR 2-9) days of the available 14 days. On days when residents reported earbud use, previous nights’ sleep quality increased by 0.5 points (P<.001, 95% CI 0.23-0.80), daily sleepiness decreased by 0.6 points (P<.001, 95% CI –0.90 to –0.34), and total daily tension decreased by 0.6 points (P<.001, 95% CI –0.81 to –0.32). These effects were more pronounced in participants who reported worse-than-average preintervention sleep scores. Conclusions Nonpharmacological noise-masking interventions such as earbuds may improve daily sleepiness, tension, and perceived sleep quality in health care shift workers. Larger-scale studies are needed to determine this interventions’ effect on other populations of shift workers’ post–night shift alertness, users’ long-term physical and mental health, and patient outcomes.
Collapse
Affiliation(s)
- Nicole M Duggan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - M Adrian Hasdianda
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Olesya Baker
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, United States
| | - Guruprasad Jambaulikar
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Andrew J Goldsmith
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Anna Condella
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Desiree Azizoddin
- Health Promotion Research Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Adaira I Landry
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Edward W Boyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Andrew J Eyre
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| |
Collapse
|
7
|
Robbins R, Yi F, Chobotar T, Hawkins S, Putt D, Pepe J, Manoucheri M. Evaluating "The REST of your Life," a workplace health program to improve employee sleep, health, energy, and productivity. Am J Health Promot 2022; 36:781-788. [PMID: 35081755 DOI: 10.1177/08901171211069357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose Sleep is critical for employee health, well-being, and productivity. Our purpose is to evaluate a sleep-focused interactive workplace health promotion program. Design We evaluate sleep and mental health before and after exposure to the program using a pre/post quasi-experimental pilot study design with surveys administered at baseline and 1-, 6-, and 12-months post-exposure (Phase 1). We design program evaluation surveys for dissemination when the program is offered broadly to hospital employees (Phase 2). Setting The study was conducted at a large teaching hospital in the Southeast U.S. in 2016. Subjects Subjects were full-time hospital employees. Intervention The program was presented to subjects in one four-hour interactive session. Measures In Phase 1 (n=55), surveys included the validated Apnea Risk Evaluation System (ARES), Dysfunctional Beliefs About Sleep (DBAS), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire (PHQ-9). Phase 2 (n=3,935) utilized program evaluation surveys. Analysis We compare survey responses between pre- and post-program using ANOVA with post-hoc tests. Results Statistically significant improvement in all sleep and mental health domains was demonstrated. In Phase 2, 81.9% reported "strongly agree" to willingness to recommend the program to co-workers. Conclusion We demonstrate improvement in employee sleep and mental health after exposure to a novel workplace health promotion program to improve sleep.
Collapse
Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders1861Brigham and Women's Hospital
| | | | | | | | | | - Julie Pepe
- Center for Academic Excellence558924AdventHealth Central Florida
| | | |
Collapse
|
8
|
Robbins R, Weaver MD, Quan SF, Sullivan JP, Cohen-Zion M, Glasner L, Qadri S, Czeisler CA, Barger LK. A clinical trial to evaluate the dayzz smartphone app on employee sleep, health, and productivity at a large US employer. PLoS One 2022; 17:e0260828. [PMID: 34986183 PMCID: PMC8730427 DOI: 10.1371/journal.pone.0260828] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/04/2021] [Indexed: 11/19/2022] Open
Abstract
Sleep deficiency is a hidden cost of our 24-7 society, with 70% of adults in the US admitting that they routinely obtain insufficient sleep. Further, it is estimated that 50-70 million adults in the US have a sleep disorder. Undiagnosed and untreated sleep disorders are associated with diminished health for the individual and increased costs for the employer. Research has shown that adverse impacts on employees and employers can be mitigated through sleep health education and sleep disorder screening and treatment programs. Smartphone applications (app) are increasingly commonplace and represent promising, scalable modalities for such programs. The dayzz app is a personalized sleep training program that incorporates assessment of sleep disorders and offers a personalized comprehensive sleep improvement solution. Using a sample of day workers affiliated with a large institution of higher education, we will conduct a single-site, parallel-group, randomized, waitlist control trial. Participants will be randomly assigned to either use the dayzz app throughout the study or receive the dayzz app at the end of the study. We will collect data on feasibility and acceptability of the dayzz app; employee sleep, including sleep behavioral changes, sleep duration, regularity, and quality; employee presenteeism, absenteeism, and performance; employee mood; adverse and safety outcomes; and healthcare utilization on a monthly basis throughout the study, as well as collect more granular daily data from the employee during pre-specified intervals. Our results will illuminate whether a personalized smartphone app is a viable approach for improving employee sleep, health, and productivity. Trial registration: ClinicalTrials.gov Identifier: NCT04224285.
Collapse
Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Stuart F. Quan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jason P. Sullivan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
| | - Mairav Cohen-Zion
- dayzz Live Well Ltd, Herzliya, Israel
- The Academic College of Tel Aviv-Jaffa, Tel Aviv, Israel
| | - Laura Glasner
- dayzz Live Well Ltd, Herzliya, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Salim Qadri
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
| | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| |
Collapse
|
9
|
Robbins R, Weaver MD, Quan SF, Barger LK, Zhivotovsky S, Czeisler CA. The Hidden Cost of Caregiving: The Association Between Self-Assessed Caregiving-Related Awakenings and Nighttime Awakenings and Workplace Productivity Impairment Among Unpaid Caregivers to Older Adults in the US. J Occup Environ Med 2022; 64:79-85. [PMID: 34412088 PMCID: PMC8727389 DOI: 10.1097/jom.0000000000002355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate whether caregiving for older adults is associated with insomnia symptoms and diminished workplace productivity. METHODS We analyzed data collected from caregivers to older adults in the US. Participants self-reported awakenings from sleep (caregiving-related or spontaneous) and workplace measures (presenteeism, absenteeism, and productivity impairment). We conduct generalized linear modeling to examine the relationship between awakenings and workplace outcomes, controlling for confounders. RESULTS Two hundred fifty-eight caregivers to older adults reported current employment and met our inclusion criteria. Adjusted analyses found that reporting caregiving-related awakenings was associated with presenteeism (OR = 1.27, 95%CI: 1.16 to 1.40), absenteeism (OR = 1.10, 95%CI: 1.06 to 1.15), and productivity impairment (OR = 1.41, 95%CI: 1.25 to 1.58). Adjusted analyses found that spontaneous nighttime awakenings were associated with absenteeism (OR = 1.05, 95%CI: 1.01 to 1.08) and productivity impairment (OR = 1.12, 95%CI: 1.02 to 1.124) but not presenteeism. CONCLUSIONS Caregiving-related awakenings are a risk factor for workplace productivity impairment. Future studies should examine means for improving caregiver sleep.
Collapse
Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA*
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA*
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Stuart F. Quan
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA*
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA*
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | | | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA*
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| |
Collapse
|
10
|
Mental health, substance use, and suicidal ideation among unpaid caregivers of adults in the United States during the COVID-19 pandemic: Relationships to age, race/ethnicity, employment, and caregiver intensity. J Affect Disord 2021; 295:1259-1268. [PMID: 34706440 PMCID: PMC8413485 DOI: 10.1016/j.jad.2021.08.130] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/30/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unpaid caregivers of adults play critical roles in health care systems by providing care to older adults and those with chronic conditions. The COVID-19 pandemic has heightened caregiving needs, forcing some into caregiving roles and disrupting others. We sought to estimate the prevalence of and identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation amongst unpaid caregivers of adults versus non-caregivers. METHODS During June 24-30, 2020, surveys were administered to U.S. adults. Quota sampling and survey weighting were implemented to improve sample representativeness of age, gender, and race/ethnicity. RESULTS Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys and 5,011 (92.6%) met screening criteria and were analyzed, including 1,362 (27.2%) caregivers. Caregivers had higher adverse mental health symptom prevalences than non-caregivers, including suicidal ideation (33.4% vs 3.7%, p < 0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18-24 vs ≥65 years, aPR 2.75, 95% CI 1.95-3.88, p < 0.0001) and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65-3.23; 2.81, 2.00-3.94; both p < 0.0001). LIMITATIONS Self-report data may be subject to recall, response, and social desirability biases; unpaid caregivers were self-identified; child caregiving roles were not assessed; and internet-based survey samples might not fully represent the U.S. CONCLUSIONS Caregivers experienced disproportionately high levels of adverse mental health symptoms. Younger caregivers and those with higher caregiving intensity were disproportionately affected. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.
Collapse
|
11
|
Abstract
Sufficient sleep is vital to the health and safety of healthcare workers and patients alike. Despite this, formal sleep promotion programs rarely exist within healthcare. Guidance does exist for how to incorporate strategies within healthcare organizations. Nurse leaders can spearhead efforts by promoting healthy sleep and instituting change through scheduling practices, unit policies, and supporting staff when barriers to healthy sleep develop.
Collapse
Affiliation(s)
- Beverly M Hittle
- Author Affiliations: Assistant Professor (Dr Hittle), College of Nursing, University of Cincinnati; Associate Professor (Dr Daraiseh), University of Cincinnati, Department of Pediatrics, Cincinnati Children's Hospital, Ohio
| | | |
Collapse
|
12
|
Czeisler MÉ, Howard ME, Rajaratnam SMW. Mental Health During the COVID-19 Pandemic: Challenges, Populations at Risk, Implications, and Opportunities. Am J Health Promot 2021; 35:301-311. [DOI: 10.1177/0890117120983982b] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mark É. Czeisler
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
| | - Mark E. Howard
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Shantha M. W. Rajaratnam
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
13
|
Johnson SS, Czeisler MÉ, Howard ME, Rajaratnam SMW, Sumner JA, Koenen KC, Kubzansky LD, Mochari-Greenberger H, Pande RL, Mendell G. Knowing Well, Being Well: well-being born of understanding: Addressing Mental Health and Substance Use Disorders Amid and Beyond the COVID-19 Pandemic. Am J Health Promot 2021; 35:299-319. [DOI: 10.1177/0890117120983982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|