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10-11-2013 | Mental health | Article

Insomnia hurts job performance of depressed patients


Free abstract

medwireNews: Sleep disturbances in patients with current depressive or anxiety disorders are associated with poor work performance and absenteeism, a subanalysis of the Netherlands Study of Depression and Anxiety suggests.

The study authors Josine van Mill (VU University, Amsterdam, the Netherlands) and colleagues note that this association could not be explained by symptom severity or the use of psychotropic medications and highlights a possible need for treatment to improve work functioning in these individuals.

They also found that the association between sleep disturbances and work functioning occurred almost exclusively in patients with psychopathology.

“It may be that subjects with psychopathology call in sick earlier, as they find it harder to cope with their sleep disturbances,” the team writes in Sleep Medicine. “The reason might be a decreased (psychologic) flexibility due to their underlying depressive or anxiety disorder.”

A total of 1435 individuals with depressive or anxiety disorders were included in the analysis, 707 of whom had current psychopathology.

Of the patients with psychopathology, 385 had insomnia, scoring at least 9 on the Insomnia Rating Scale (IRS). These individuals were 1.63-fold more likely than those without insomnia to have impaired work performance, defined as at least 2 inefficient weeks of work in the past 6 months, and 2.08-fold more likely to have been absent from work due to health problems for more than 2 weeks in the past 6 months. This was after depressive symptom severity and use of psychotropic medications had been accounted for.

A short sleep duration, of 6 hours or less per night compared with a normal 7–9 hours, was also significantly associated with impaired work performance and long-term absenteeism, increasing the odds 2.19-fold and 1.61-fold, respectively.

But the presence of insomnia in 182 of the 728 patients without current psychopathology was not associated with impaired work performance or long-term absenteeism once subthreshold depressive symptoms were considered.

A long sleep duration was the only sleep disturbance that remained significantly associated with work outcomes in patients without psychopathology independently of symptom severity. While in these patients it significantly increased the risk for long-term absenteeism by 37%, it significantly reduced the risk by 17% in those with psychopathology.

“Our study stresses the importance of addressing sleep disturbances in individuals with a current depressive or anxiety disorder,” say the researchers.

“Further research will need to determine if treating these symptoms with cognitive behavioral therapy or other therapeutic approaches will have a favorable influence on work performance and absenteeism.”

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lucy Piper, Senior medwireNews Reporter

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