We know that decreased sleep duration and extended shifts in healthcare workers are linked to workplace injuries. The effects of decreased sleep on pain in the workplace are less clear. New research from the Harvard Center for Work, Health and Wellbeing –one of four NIOSH Centers of Excellence funded to explore and research the concepts of Total Worker Health™- examines the question: Does lack of sleep increase pain and limit function among hospital care workers?
The study, published in the American Journal of Occupational and Environmental Medicine, finds that sleep deficiency (including short sleep duration, insomnia symptoms, sleep insufficiency, or all three) is significantly associated with pain, functional limitations of daily living tasks due to that pain, and difficulty performing work tasks due to that pain, among hospital care workers. These effects may impact productivity or the ability to perform demanding health care work such as patient handling. This study is in agreement with a growing body of research linking poor sleep with pain. For example, laboratory studies have shown that restricting sleep duration can increase reports of new pain, consistent with the higher pain reports associated with insomnia. Other studies have shown that sleep-deprived persons respond differently to a standard pain stimulus.
These findings are particularly noteworthy given the high risk of musculoskeletal disorders, pain and injury prevalent among healthcare workers. The annual incidence of back injury and pain in the nursing workforce ranges between 30% and 75%. Nursing aides suffer more days away from work for back pain than any other occupation.
Prior work in sleep typically focused on the presence or absence of a specific sleep disorder. An innovative aspect of this analysis in this study is the use of the sleep deficiency construct. The sleep deficiency construct suggests that sleep may become “deficient” for a variety of or even a constellation of reasons. Sleep deficiency may be caused by work factors. Alternatively, bodily pain, work interference from this pain, and functional limitations of daily living tasks may increase the likelihood of sleep deficiency.
The study recommends that comprehensive workplace interventions include a sleep deficiency component in assessments of modifiable outcomes. The study also suggests that multilevel interventions may be an effective way of supporting changes among individual workers in the work environment. For example, policies that provide increased flexibility on shift length and timing may contribute to a supportive work environment that acknowledges the pivotal role of sleep in worker health outcomes. Educational programs that inform workers of the important associations between sleep, musculoskeletal disorders, and pain may help motivate workers to adopt better sleep practices and behaviors. Research shows solid support that good sleep practices and behaviors improve sleep.
Healthy sleep is known to be related to alertness and performance, to be involved in memory and learning and can influence chronic disease risk, and even mortality. These new data show that sleep affects employees at both work and home.
We would like to hear from readers.
- Does work impact your sleep? Either amount or quality of your sleep?
- Does your sleep affect how things go at work?
- Do you find you have more pain when you sleep poorly?
Orfeu M. Buxton, PhD; Glorian Sorensen, PhD, MPH
Dr. Buxton is Assistant Professor, Division of Sleep Medicine, Harvard Medical School and Associate Neuroscientist, Department of Medicine, Brigham and Women’s Hospital
Dr. Sorenson is the Director of the Harvard Center for Work, Health and Wellbeing and Professor of Society, Human Development and Health at the Harvard School of Public Health
For more information on sleep see the Harvard Medical School’s Division of Sleep Medicine webpage and the CDC’s Sleep and Sleep Disorders webpage for data on sleep insufficiency of U.S. adults.
For information on sleep and work see the NIOSH topic page: Work Schedules: Shift Work and Long Work Hours and two recent posts on the NIOSH Science Blog: Sleep and Work and NIOSH Research on Work Schedules and Work-related Sleep Loss.
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August 10, 2012 at 1:53 pm ET - Carla Bentley RN COHN-S
Evaluation of sleep habits should be part of everyone’s medical history questionnaire. My personal experience with this (not pain, thankfully; but overall quality of life and job performance affected by quality of sleep) is that many workers, and their employers, would benefit from diagnosing & treating their sleep disorders sooner rather than later.
I suspect sleeping pills are way over used. Sleeping pills are commonly reported as a prescription used by health care employees. The prescription drug history from health insurance claims for any health care employer would be revealing.
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August 13, 2012 at 5:44 am ET - Diana Sabrain
I concur with Carla, sleeping pills are way over used.
There are natural supplements for sleep like ZMA, 5-HTP, melatonin, valerian root etc.
And also a lot of us are not getting enough sunlight. Which can be supplemented with Vit D3 if you fon’d get enough
Diana Sabrain
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August 31, 2012 at 12:03 pm ET - William Buchta
Since you ask for personal experience, I am willing to share that if I have 2 or more consecutive shortened sleep cycles, I will predictably be crabby and less tolerant of stress, particularly at work. A good night of sleep will take care of it. As noted above, soporifics should not automatically take preference over tried and true steps toward good sleep hygiene, which simply takes discipline.
Professionally, having focused my occupational medicine career on treatment of healthcare workers for the past 20 years, I can definitely agree that most workers with pain issues also have sleep issues — not always sure which came first but it tends to become cyclical such that it really does not matter which is causative. My policy has been to address the sleep issues aggressively, assuming the pain will not resolve as quickly otherwise. This would be a good area for research. Rules on shift assignment, particularly overtime, is a reasonable administrative control measure to reduce work injuries and/or their impact on performance.
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September 13, 2012 at 3:35 am ET - SELLES F. MD,PICORELLI S. MD
Epidemiological studies have shown sleep disturbances in patients experiencing acute or chronic pain. But research on sleep disturbance for these specific types of pain, have been few and almost none has included the use of polysomnographic studies polisomnografia.Los have found disruptions and sleep fragmentation in a high prevalence and low in primary alterations sueño.El the problem is not just the pain itself, but the sleep disorder, affects the quality of life, both physically and psychologically and that it weakens the body. Turn makes it more vulnerable to feel and suffer pain, which becomes a vicious cycle, especially for those workers who have aches hospital routine.
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September 23, 2012 at 9:00 pm ET - Depok
Skillfully, obtaining targeted my occupational medication profession on remedy associated with health care staff to the beyond two decades, I can definitely concur that most staff having ache difficulties also have rest difficulties — not absolutely guaranteed that arrived very first but it tends to turn into cyclical such that it really does not issue which is causative. My own insurance plan continues to be to address the particular rest difficulties in a hostile manner, presuming the particular ache will not take care of because quickly in any other case. This specific will be a excellent location regarding exploration. Policies on adjust job, specifically overtime, is usually a fair management management calculate to cut back function accidental injuries and/or their influence on functionality.
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October 30, 2012 at 6:44 am ET - raja
I agree involved in memory and learning and can influence chronic disease risk, and even mortality.
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November 3, 2012 at 10:08 pm ET - BD Dale
As many times as I have been in hospitals, it never occurred to me that Health Care workers get injured. Wow..
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November 25, 2012 at 11:22 am ET - Antonio
I really aprecciate to read your blog. We here from Brazil have learned a lot from your posts. Antonio B Duarte Jr.
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