Sleep disturbances and risk of sick leave: systematic review and meta-analysis
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REVIEW ARTICLE
Sleep disturbances and risk of sick leave: systematic review and meta‑analysis Sohrab Amiri1 · Sepideh Behnezhad2 Received: 1 February 2020 / Accepted: 9 April 2020 © Japanese Society of Sleep Research 2020
Abstract Sleep disturbances have multiple negative effects on psychological, social, and occupational aspects. The effects of sleep disturbances on the risk of taking sick leave was investigated in a meta-analysis. According to the PRISMA protocol, PubMed, Google Scholar, Scopus, and ResearchGate sites were searched by the researchers until October 2018. Studies with prospective design and also the articles in which sleep disturbances are considered as exposure and sick leave is regarded as an outcome, were eligible. After screening the studies, eligible articles were finally selected and analyzed; besides, several subgroup analyses were done. Random effects method were used to analyze the results. The bias of publication and heterogeneity were reported. Eleven prospective cohort studies were systematically reviewed and meta-analyzed. Sleep disturbances increase the risk of sick leave up to 23% with confidence interval (CI) 1.17–1.30. There was a significant difference in a stratified analysis between men and women. In men, RR was 1.23; CI 1.05–1.46 and in women RR was 1.22; CI 1.09–1.37. Begg test for eleven studies in the meta-analysis showed no release bias in this test (P = 0.102) and Egger test yielded a similar result (P = 0.114). Sleep disturbances are risk factors for sick leave. Sleep problems can lead to various health problems that affect the amount of sick leave. Improving sleep quality can have a decisive impact on job performance. Sleep disturbances are risk factors for increased sick leave. Limitations should be taken into account in interpreting these findings, including the distinction between types of sick leave and possible comorbidities. Keywords Sleep disturbances · Meta-analysis · Sick leave · Systematic review
Introduction Sleep disturbances include problems with sleep onset and maintenance [1], somnolence, sleep–wake schedule, dysfunctions in sleep, sleep stages, or partial arousals [2] are of the most common health problems [3]. To clarify the sleep problem, there is a range of sleep disorders that specialist should know about and this is described in details by the Association of Sleep Disorders Centers [4]. The International Classification of Sleep Disorders version 2 classified sleep disorders into 8 categories [5]. Insomnia means having trouble starting or continuing to sleep, waking up too early, or unrestrictive sleep [6]. This sleep disorder is very
* Sohrab Amiri [email protected]; [email protected] 1
Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
Kharazmi University, Tehran, Iran
2
common and the most debilitating one which also imposes a high burden of diseases caused by many factors including behavioral, medical, emotional, environmental and other factors [6]. The preval
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