A systematic review of the effect of sleep interventions on presenteeism

Impact of carbon dioxide exposures on sleep latency among healthy volunteers: A randomized order, paired crossover study, evidence from the multiple sleep latency test

BACKGROUND

Daytime sleepiness affects work efficiency, occupational safety, and public health. Although previous studies have reported an association between environmental carbon dioxide (eCO2) and daytime sleepiness, it has been challenging to draw a firm conclusion due to the lack of standardized sampling and profiling protocols.

OBJECTIVE

We examined the effect of pure CO2 exposure at 5000 (ppm, parts per million) on daytime sleepiness.

METHODS

Eleven healthy participants (males of 24 ± 3 years, mean ± SD) completed a four-nap multiple sleep latency test (MSLT) protocol in the environmentally controlled chamber under two conditions: the CO2 condition (4851 ± 229 ppm) and the Control condition (1102 ± 204 ppm). The subjective sleepiness level and cognitive performances were also evaluated using the Stanford Sleepiness Scale (SSS) questionnaire, Psychomotor Vigilance Test (PVT), and Stroop test after each nap session.

RESULTS

A significant reduction in sleep latency was observed in the CO2 exposure condition (Control vs. CO2 = 13.1 ± 3.3 min vs. 9.7 ± 3.2 min). The subjective sleepiness scores were also significantly higher in the CO2 exposure condition than in the Control condition (Control vs. CO2 = 2.7 ± 0.5 vs. 4.7 ± 0.8). Cognitive responses after naps showed no significant difference across conditions.

CONCLUSION

This study revealed that exposure to environmental CO2 at a concentration as high as the upper safety limit at work sites significantly shortened the sleep latency and enhanced subjective sleepiness during naps in the MSLT without affecting cognitive responses after each exposure. Our results demonstrated that exposure to high environmental CO2 induces daytime sleepiness that potentially compromises work efficiency and safety.

Sleep hygiene - What do we mean? A bibliographic review

There is no consensus on the definition of sleep hygiene and its components. We examined the definition of sleep hygiene based on its use in published studies. Four databases (Medline, EMBASE, PsycINFO and CINAHL) were searched from inception until December 31, 2021 for the phrase 'sleep hygiene' in the title or abstract. We identified 548 relevant studies in adults: 250 observational and 298 intervention studies. A definition of sleep hygiene was provided in only 44% of studies and converged on three themes: behavioural factors, environmental factors, and an aspect of control. Sleep hygiene components were explicitly defined in up to 70% of observational studies, but in only 35% of intervention studies. The most commonly considered components of sleep hygiene were caffeine (in 51% of studies), alcohol (46%), exercise (46%), sleep timing (45%), light (42%), napping (39%), smoking (38%), noise (37%), temperature (34%), wind-down routine (33%), stress (32%), and stimulus control (32%), although the specific details of each component varied. Lack of consistency in definitions of sleep hygiene and its components may hinder communication between researchers, clinicians, and the public, and likely limits the utility of sleep hygiene as an intervention.

Factors affecting presenteeism in workers with nocturnal hemodialysis: A two-center cross-sectional study

INTRODUCTION

Presenteeism and work dysfunction in dialysis patients should be assessed to improve disease management and work productivity. Therefore, this study aimed to investigate the prevalence and factors surrounding presenteeism and work dysfunction in workers with nocturnal hemodialysis.

METHODS

This multicenter cross-sectional study included 42 workers with nocturnal hemodialysis. Presenteeism was measured in patients using the Work Functioning Impairment Scale (WFun), employment status, exercise habit, and exercise self-efficacy (SE).

RESULTS

The WFun score was 12.5 ± 6.3 points, and patients with mild presenteeism were 12 (28.6%), moderate was 2 (4.8%), and severe was 1 (2.4%). Multiple regression analysis, which was adjusted for few confounding factors, showed that WFun had a significant relationship with lower exercise SE (r = -0.32) and normalized protein catabolism rate (r = 0.31).

CONCLUSIONS

Working patients with nocturnal hemodialysis had presenteeism and a significant correlation with exercise SE and nPCR. This study provides a framework to prevent work dysfunction in nocturnal hemodialysis patients.

Effect of cognitive behavioral therapy for insomnia in workers: A systematic review and meta-analysis of randomized controlled trials

Although cognitive behavioral therapy for insomnia (CBT-I) is recommended as a first-line treatment, its efficacy for workers with insomnia remains unclear. This systematic review and meta-analysis aimed to determine the effectiveness of CBT-I in the management of insomnia symptoms in workers. We searched the literature in three electronic databases, namely PubMed, PsycINFO, and Embase, and included 21 studies in the meta-analysis. Compared with the control group, CBT-I overall resulted in significant improvements in terms of severity of insomnia (g = -0.91), sleep onset latency (g = -0.62), wakefulness after sleep onset (g = -0.60), early morning awakening (g = -0.58), and sleep efficiency (g = 0.71). However, there was no improvement in the total sleep time relative to that in the control group. Furthermore, CBT-I significantly alleviated depressive (g = -0.37) and anxiety (g = -0.35) symptoms and fatigue (g = -0.47) compared with the control group. Our study findings suggest that both web-based and face-to-face CBT-I are effective interventions for managing insomnia symptoms in daytime workers, although it is important to note that only face-to-face CBT-I achieved clinically meaningful changes. The effectiveness of CBT-I for shift workers could not be determined.

Association of oral health with various work problems: a cross-sectional study of Japanese workers

BACKGROUND

Oral diseases affect quality of life and known to decrease productivity. We examined the impact of oral health status on various types of work problems.

METHODS

This cross-sectional study used data from an internet-based self-report questionnaire survey administered to workers in Japan. Responses to the questionnaire regarding seven types of oral health-related work problems (1. Stress; 2. Lack of focus; 3. Lack of sleep; 4. Lack of energy; 5. Lack of communication due to halitosis; 6. Lack of communication due to appearance; 7. Lack of ability due to dental-related pain) were investigated and statistically analyzed. Explanatory variables were self-reported oral health status, number of teeth, and gum bleeding. To examine the association of oral health with the presence of work problems, logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Age, sex, educational attainment, income, the presence of diabetes, and industrial classifications were used as the covariates.

RESULTS

A total of 3,930 workers (mean age: 43.3 (SD = 11.7), 2,057 males and 1,873 females) were included. Overall, a total of 6.2% of workers reported having at least one oral health-related work problem in the past year, whereas 21.8% of those with poor self-reported oral health reported work problems. Workers with poor self-reported oral health were 3.58 (95% CI (1.70-7.56) times higher odds of reporting work problems than those with excellent self-reported oral health.

CONCLUSIONS

Oral health was found to be associated with various work problems. Oral health promotion policies are needed in the workplace.

Sleep Debt Mediates the Relationship between Work-Related Social Factors, Presenteeism, and Well-Being in Japanese Workers

Sleep debt is associated with presenteeism and mental health; however, the association of sleep debt with presenteeism and well-being in the context of work-related social factors (commuting time, workdays, and working hours) has not been fully elucidated. This study aimed to examine whether work-related social factors are associated with presenteeism and well-being via sleep debt. The participant group comprised 872 full-time and 526 part-time workers (mean age: 44.65 ± 12.37 and 48.47 ± 12.93 years, respectively). For both the full-time and part-time workers, increased sleep debt was significantly associated with presenteeism (β = -0.171; β = -0.160) and low well-being (β = -0.135; β = -0.153). Notably, commuting time was significantly associated with increased sleep debt in full-time workers (β = 0.09). In contrast, the number of workdays was significantly associated with increased sleep debt in part-time workers (β = -0.102). Working hours were not significantly associated with sleep debt for both full- and part-time workers. These results reveal that sleep debt might lead to various risks among workers, elucidating the work-related social factors related to sleep debt. They also highlight the importance of considering work-related social factors when addressing sleep debt.

Association between insomnia severity and presenteeism among Japanese daytime workers

Presenteeism is the loss of productivity due to a worker's health problems, despite the worker being present at the workplace. Although the association between presenteeism and insomnia complaints is well known, few studies have examined the association between insomnia severity and presenteeism. This study aimed to explore the association between insomnia severity and presenteeism. This study included 1925 participants (1543 males, 379 females, and three of other genders) in total. The mean age of the participants was 49.94 ± 9.82 years. The inclusion criteria were full-time employment, working 8 hr per day and 5 days per week, and having no night shifts. The insomnia severity was classified based on the Insomnia Severity Index and Athens Insomnia Scale criteria. Logistic regression analysis showed that moderate and severe insomnia severity were associated to a greater magnitude with presenteeism than mild insomnia severity. Severe insomnia severity was associated to a greater magnitude with presenteeism than moderate insomnia severity. In summary, logistic regression analysis showed that increased insomnia severity based on Insomnia Severity Index classification was associated with increased odds of presenteeism, but increased insomnia severity based on Athens Insomnia Scale classification was not fully consistent with increased odds of presenteeism. Because increased insomnia severity is associated with worsening of presenteeism, early detection of and early intervention against insomnia complaints are important for reducing presenteeism. This study was the first to examine the associations between presenteeism and insomnia severity classification of no insomnia, mild, moderate, and severe insomnia severity.

Impact of sleep debt, social jetlag, and insomnia symptoms on presenteeism and psychological distress of workers in Japan: a cross-sectional study

BACKGROUND

Presenteeism is an indicator of productivity loss and the risk of absence from work due to mental health problems. The purpose of this study was to determine the impact of sleep debt, social jetlag, and insomnia symptoms on presenteeism and psychological distress.

METHODS

The participants were 351 Japanese workers (271 males, 79 females, and one of other gender, with a mean age of 49 ± 9.49 years). The eligibility criteria for this study were full-time employment, working eight hours per day, five days per week, and no night shifts. The participants answered questionnaires measuring sleep debt, social jetlag, insomnia symptoms, presenteeism, and psychological distress.

RESULTS

Insomnia symptoms had the greatest impact on presenteeism and psychological distress when compared with sleep debt and social jetlag (adjusted odds ratio (OR) = 5.61, 95% confidence interval (CI) = 2.88-10.91; adjusted OR = 7.29, 95%CI = 3.06-17.35). Sleep debt had a greater impact on presenteeism and psychological distress than did social jetlag (adjusted OR = 1.61, 95%CI = 1.14-2.27; adjusted OR = 1.68, 95%CI = 1.11-2.54), which had no impact on these variables (adjusted OR = 1.04, 95%CI = 0.91-1.20; adjusted OR = 0.96, 95%CI = 0.76-1.22).

CONCLUSIONS

The findings of this study indicated that insomnia symptoms had a more significant impact on presenteeism and psychological distress than social jetlag and sleep debt. Although sleep debt might have an independent impact on presenteeism and psychological distress, social jetlag did not.

Global prevalence of presenteeism in the nursing workforce: A meta-analysis of 28 studies from 14 countries

AIMS

This study aimed to estimate the overall presenteeism prevalence in the nursing workforce.

BACKGROUND

Nurses are more prone to presenteeism, which is associated with adverse outcomes for both nurses and patients. However, comprehensive information on the global prevalence of presenteeism in nursing workforce is lacking. Evaluation Seven databases were systematically searched without year or language restrictions in July 2021. Studies that reported the prevalence rate of presenteeism among nurses were included. A meta-analysis was performed using a random-effects model. Key issues A total of 28 studies from 14 countries were included. The overall pooled estimate of presenteeism prevalence among nursing workforce was 49.2% (95% CI: 0.411, 0.574). Subgroup analyses showed that the prevalence of presenteeism was higher when the reporting time frame was > 1 month and < 1 year compared with ≤ 1 month or ≥ 1 year.

CONCLUSION

The results of this meta-analysis showed the substantial prevalence of presenteeism in the nursing workforce with variations across different reporting time frames.

IMPLICATION FOR NURSING MANAGEMENT

The findings can be used to support nurse managers, administrators, and policymakers in recognizing the prevalence of presenteeism and developing relevant prevention strategies against presenteeism among global nursing workforce.