August/September 2014 (vol. 11/2)

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Sleep problems may hinder return to work

This Swedish cross-sectional study of individuals on long-term sick leave highlights the importance of addressing sleep problems. The study involved 1,206 patients on sickness benefits, mostly diagnosed with depressive disorders and chronic regional or general pain. Sleep disturbance, pain and depression were assessed using various validated questionnaires. Sleep and pain scores were categorised into two levels: none or mild (level 1) and moderate to severe (level 2). The majority (83%) of participants reported some level of sleep disturbance, while 70% had depression; 57% of those with level 1 sleep problems also had depression, but this rose to 83% in level 2. Of those with level 1 pain, 64% had depression, rising to 74% in level 2. The severity of sleep disturbance, but not that of pain, influenced the prevalence of co-morbid depression (p <0.001). Those with more severe sleep disturbance at both pain levels also showed statistically significant (p <0.005 or <0.0001) reduced ability to make decisions, concentrate and undertake multiple tasks, and had higher scores for sadness and pessimistic thoughts. Those with both level 2 sleep disturbance and level 2 pain had significantly poorer energy level/fatigability scores (p< 0.0001). These factors are considered important barriers to returning to work.

Relationship between sleep disturbance, pain, depression and functioning in long-term sick-listed patients experiencing difficulty in resuming work. Journal of Rehabilitation Medicine 2014; online first: doi: 10.2340/16501977-1833. 

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Occupational Health at Work August/September 2014 (vol. 11/2) pp43