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Effort–reward imbalance, sleep disturbances and fatigue

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Abstract

Objectives: The objective of this study was to investigate the validity of the effort–reward imbalance (ERI) model in relation to disturbed sleep and fatigue. Methods: The study population derived from a subset of the WOLF (WOrk, Lipids, Fibrinogen) cohort study of cardiovascular risk in a working population who replied to the ERI-questionnaire comprising 789 men and 214 women. Cox regression analysis was used to calculate the prevalence ratio (PR) for sleep disorders and fatigue in relation to the components of ERI. Results: As sleep disturbances and fatigue, based on literature, were defined to be represented by the uppermost quintile, 14% of the men and 23% of the women were affected by sleep disturbances while 14 and 26%, respectively, were affected by fatigue. Higher levels of exposure for the ERI components were associated with increased prevalence of sleep disturbances and fatigue. For men, the strongest association was seen between high overcommitment and fatigue (PR 5.77, 95% confidence interval 2.89–11.5). For women, high effort and sleep disturbances (PR 4.04, CI 1.53–10.7), high effort/reward ratio and sleep disturbances (PR 4.13, CI 1.62–10.5), and between low reward and fatigue (PR 4.36, CI 1.79–10.6) yielded the most obvious associations. Conclusions: The present study adds sleep disturbances and fatigue to the list of adverse consequences of effort–reward imbalance.

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Acknowledgements

The authors are grateful for the contribution made by the staffs at the occupational health units that participated in the WOLF-studies. The study was supported by a grant from the Swedish Council for Working Life and Social Science.

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Authors and Affiliations

  1. Department of Health Science, Mid Sweden University, 851 70, Sundsvall, Sweden

    Göran Fahlén & Anders Knutsson

  2. Department of Medical Sociology, University of Ulm, 890 81, Ulm, Germany

    Richard Peter

  3. National Institute for Psychosocial Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden

    Torbjörn Åkerstedt

  4. Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umeå, 901 85, Umeå, Sweden

    Göran Fahlén & Maria Nordin

  5. Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden

    Lars Alfredsson

  6. Stockholm Center for Public Health, Stockholm County Council, Stockholm, Sweden

    Lars Alfredsson

  7. National Institute for Working Life, 113 91, Stockholm, Sweden

    Peter Westerholm

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  1. Göran Fahlén
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  2. Anders Knutsson
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  3. Richard Peter
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  4. Torbjörn Åkerstedt
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  5. Maria Nordin
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  6. Lars Alfredsson
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  7. Peter Westerholm
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Correspondence to Göran Fahlén.

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Fahlén, G., Knutsson, A., Peter, R. et al. Effort–reward imbalance, sleep disturbances and fatigue. Int Arch Occup Environ Health 79, 371–378 (2006). https://doi.org/10.1007/s00420-005-0063-6

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  • DOI: https://doi.org/10.1007/s00420-005-0063-6

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