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Aims: Sleep disturbances and work-related mental strain are linked to increased sickness absence and disability pension (DP), but we have no information on synergy effects. The aim of this study was to examine the combined (and separate) association of the two predictors with subsequent long-term work disability and mortality. Methods: A total of 45,498 participants aged 16–64 years were interviewed in the Swedish Surveys of Living Conditions between 1997 and 2013, and were followed up on long-term sickness absence (LTSA; >90 days/year), DP and mortality via national registers until 2016. Crude and multivariable Cox analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: For LTSA, the HRs for sleep disturbances and work-related mental strain were 1.6 (95% CI 1.5–1.7) and 1.3 (95% CI 1.2–1.4), respectively. For DP, the HRs were 2.0 (95% CI 1.8–2.2) and 1.4 (95% CI 1.2–1.5). Mortality was only predicted by sleep disturbances (HR=1.2, 95% CI 1.1–1.4). No synergy effect was seen. Conclusions: Work-related mental strain and, in particular, sleep disturbances were associated with a higher risk of subsequent LTSA and DP, but without synergy effects. Sleep disturbances were also associated with mortality. Exposure to interventions tackling sleep disturbance and prevention of workplace stress may reduce work disability. [ABSTRACT FROM AUTHOR]

We investigated whether self-ratings of health are affected by a symptom rating. A diary including a one-item self-rating of health ("pre–self-rated health"; 1 = excellent, 7 = very poor), a subsequent 26-item rating of symptoms, and thereafter a second (identical) health rating ("post–self-rated health") was completed by 820 persons 21 times. Self-rated health worsened significantly (p <.0001) after the symptom rating, from 2.72 pre–self-rated health (95% confidence interval: 2.70–2.74) to 2.77 post–self-rated health (95% confidence interval: 2.75–2.79) and more so in persons who reported more symptoms (b =.058, p <.05). The results support the notion that subjective health perception is influenced by attending to symptoms, especially so in persons with a high symptom burden. [ABSTRACT FROM AUTHOR]

Aims: Insomnia is a large health problem. In some prior studies, positive associations between insomnia symptoms and sickness absence have been observed. There is, however, no previous nationwide cohort study of clinically diagnosed insomnia and risk of incident sickness absence. Methods: Prospective nationwide cohort study based on Swedish population-based registers including all 4,956,358 individuals registered as living in Sweden on 31 December 2004/2005, aged 17–64 years, not on disability pension, old-age pension or on-going sickness absence. Those having insomnia inpatient or outpatient care, defined as having at least one admission/specialist visit with a main or secondary diagnosis of disorders of initiating and maintaining sleep [insomnias] (ICD-10: G47.0) during 2000/2001–2005, were compared to those with no such care. All-cause and diagnosis-specific incident sickness absence were followed during 2006–2010. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. Results: In models adjusted for prior sickness absence, socio-demographic factors and inpatient and specialized outpatient care, associations between insomnia and increased risks of all-cause sickness absence (IRR 1.18, 95% CI 1.04–1.35) and sickness absence due to mental diagnoses (IRR 1.75, 95% CI 1.36–2.25) were observed. After further adjustment for insomnia medications these associations disappeared. No associations between insomnia and risk of sickness absence due to cancer, circulatory or musculoskeletal diagnoses, or injuries, were observed. Conclusions: In this nationwide cohort study, we observed increased risks of all-cause sickness absence and sickness absence due to mental diagnoses after adjustment for several potential confounders that disappeared after further adjustment for insomnia medications. [ABSTRACT FROM PUBLISHER]

Subjective sleepiness at different times is often measured in studies on sleep loss, night work, or drug effects. However, the context at the time of rating may influence results. The present study examined sleepiness throughout the day at hourly intervals and during controlled activities [reading, writing, walking, social interaction (discussion), etc.] by 10-min. intervals for 3 hr. This was done on a normal working day preceded by a scheduled early rising (to invite sleepiness) for six subjects. Analysis showed a significant U-shaped pattern across the day with peaks in the early morning and late evening. A walk and social interaction were associated with low sleepiness, compared to sedentary and quiet office work. None of this was visible in the hourly ratings. There was also a pronounced afternoon increase in sleepiness, that was not observable with hourly ratings. It was concluded that there are large variations in sleepiness related to time of day and also to context and that sparse sampling of subjective sleepiness may miss much of this variation. [ABSTRACT FROM AUTHOR]

Sleepiness is a major problem when driving a vehicle and contributes to 15 to 30% of all road accidents. One possible countermeasure may be exposure to light. This study was designed to test whether 30 mm. of exposure to a bright light would reduce subjective sleepiness and BEG indicators of sleepiness, such as alpha and theta power density. 10 female and 10 male university students (recruited through advertisements) participated in a laboratory study, consisting of 30 mm. of dim light followed by 30 mm. of bright light (or red light in the control condition) exposures and then by 30 mm. of dim light exposure. In the dim light exposure, the luminance was 20 cd/m[sup2], and the illuminance was about 5 Lux. In the bright exposure, the luminance was 500 cd/m[sup2] and the illuminance about 2000 Lux. In the red light exposure, the luminance was 10 cd/m[sup2] and the illuminance about 30 Lux. The subject sat in a chair with a seating comfort corresponding to that of a driver's seat. Analysis showed that the subjects became subjectively sleepier during the pre-exposure condition, and alpha and theta power density increased in their EEGs. The intervention significantly reduced subjective sleepiness but did not have significant effects on alpha or theta power density. The results suggest that a short (30 mm.) exposure to bright light may not be a useful prophylactic against sleepiness for the period following the exposure. [ABSTRACT FROM AUTHOR]

On risk factors for premature myocardial infarction in middle-aged building construction workers. A comparison with other selected illnesses. Theorell, T., Askergren, A., Olsson, A., and Åkerstedt, T. (Dept. of Medicine, Serafimerlasarettet, Foundation for Industrial Safety and Health in the Construction Industry, and the Laboratory for Clinical Stress Research, Stockholm, Sweden).This study was carried out in order to define readily available indicators of elevated risk of imminent myocardial infarction in middle-aged building construction workers in Stockholm and also provided an opportunity for comparing the risk of myocardial infarction with that of gastric or duodenal ulcer and “social illness”.Univariate and multivariate analysis showed that the risk of myocardial infarction was associated with relative overweight, short stature, elevated blood pressure and elevated psychosocial discord index, whereas excessive cigarette smoking was associated with a risk of myocardial infarction in the univariate analysis only. Excessive cigarette smoking was associated with ulcer and “social illness”. Elevated blood pressure was associated with risk of ulcer and elevated heart rate with risk of “social illness”.The target population consisted of all male 41–61-year-old members of the union of building-construction workers in Greater Stockholm (n=8973). They were all asked to fill out a psychosocial questionnaire from which a “discord index” was calculated. Non-responders (25%) were comparable to responders with regard to a number of crude social characteristics. In order to establish somatic characteristics for the participants, the investigators utilized a standardized health check-up (Bygghälsan—building workers' health scheme) in which 55% of the participants had taken part.Official registers were utilized during the follow-up (12–27 months) in order to find instances of (1) myocardial infarction (2) gastric or duodenal ulcer, and (3) prolonged neurosis or non-illness death (“social illness”). Subjects who had been absent from work because of similar illness during the preceding year were excluded from the followup. Three roughly equal-sized diagnostic groups (n= 22–26) were formed. They were compared with a contrast group (n= 194) which was selected from the population in a representative way. [ABSTRACT FROM PUBLISHER]