The association between sleep disorders on employment and income among adults in the United States

Associations of non-employment with common mental disorder subcomponents among working age population: analysis of national data from 1993, 2000, 2007 and 2014

BACKGROUND

Associations between employment status and mental health are well-recognised and such associations may have multiple modifying factors which may also contribute to variations in results.

AIMS

We aimed to investigate associations between non-employment and CMD subcomponents and the extent of their variation across age groups using nationally representative data in Britain.

METHOD

We used a series of national mental health surveys of adults living in private households: the British National Surveys of Psychiatric Morbidity of 1993, 2000, 2007 and 2014. Employment status was the primary exposure of interest. Presence or absence of each fourteen symptoms of common mental disorder (CMD), as the primary outcome, was ascertained identically in all surveys from the revised Clinical Interview Schedule (CIS-R). Odds ratio for the association between exposure and outcome and population attributional fractions (PAFs) for each association was calculated.

RESULTS

Within the highest-risk 45 to 54 years age group, all odds ratios were statistically significant and strongest associations were observed with panic symptoms (OR = 2.33), followed by depressive symptoms (1.90), worry about physical health (1.84), depression (1.82), forgetfulness (1.82) and somatic symptoms (1.70). In the 55 to 64 years age group, highest population attributable fractions were observed for non-employment as a hypothetical risk factor for panic symptoms (51.7%), phobias (44.2%), forgetfulness (39.5%), depressive symptoms (38.5%), worries about physical health (37.9%) and somatic symptoms (36.0%).

CONCLUSIONS

The particularly high impact in middle-aged, pre-retirement groups of non-employment on CMD suggests a policy focus on alleviating stressors and providing support for those made redundant and/or compelled to take unwanted early retirement.

Disadvantaged social status contributed to sleep disorders: An observational and genome-wide gene-environment interaction analysis

BACKGROUND

Sleep is a natural and essential physiological need for individuals. Our study aimed to research the associations between accumulated social risks and sleep disorders.

METHODS

In this study, we came up with a polysocial risk score (PsRS), which is a cumulative social risk index composed of 13 social determinants of health. This research includes 239,165 individuals with sleep disorders and social determinants of health data from the UK Biobank cohort. First, logistic regression models were performed to examine the associations of social determinants of health and sleep disorders, including chronotype, narcolepsy, insomnia, snoring, short and long sleep duration. Then, PsRS was calculated based on statistically significant social determinants of health for each sleep disorder. Third, a genome-wide gene-environment interaction study was conducted to explore the interactions between single-nucleotide polymorphisms and PsRS in relation to sleep disorders.

RESULTS

Higher PsRS scores were associated with worse sleep status, with the adjusted odds ratio (OR) ranging from 1.10 (95% Confidence interval [CI]: 1.09-1.11) to 1.29 (95% CI: 1.27-1.30) for sleep disorders. Emotional stress (OR = 1.36, 95% CI: 1.28-1.43) and not in paid employment (OR = 2.62, 95% CI: 2.51-2.74) were found to have significant contributions for sleep disorders. Moreover, multiple single-nucleotide polymorphisms were discovered to have interactions with PsRS, such as FRAS1 (P = 2.57 × 10-14) and CACNA1A (P = 8.62 × 10-14) for narcolepsy, and ACKR3 (P = 1.24 × 10-8) for long sleep.

CONCLUSIONS

Our findings suggested that cumulative social risks was associated with sleep disorders, while the interactions between genetic susceptibility and disadvantaged social status are risk factors for the development of sleep disorders.

Adverse childhood experience and persistent insomnia during emerging adulthood: do positive childhood experiences matter?

BACKGROUND

Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood.

METHODS

A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted.

RESULTS

Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE.

CONCLUSIONS

PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.