Original articleAssociation between psychosocial job characteristics and insomnia: an investigation using two relevant job stress models—the demand-control-support (DCS) model and the effort-reward imbalance (ERI) model
Introduction
Insomnia is a common health complaint. Worldwide, 16–21% of the population experiences insomnia symptoms at least 3 nights per week, more often, or always [1]. The average prevalence of dissatisfaction with sleep quality and quantity is 8–18% [1]. Insomnia often causes daytime sleepiness and fatigue, decreased physical and mental performance, and an increased number of accidents in daily life and at the workplace.
Stress at the worksite could affect workers' sleep. The relationships between psychosocial job characteristics and insomnia have been examined. The results, however, vary [2], [3], [4], [5], [6], [7], [8], [9]. With a few exceptions [4], [8], one disadvantage of previous studies lies in the fact that each study has used its own distinct definition to assess the psychosocial job characteristics, which hinders the integration of previous findings toward establishing which job stressors should be removed in order to prevent workers from developing insomnia.
Occupational psychosocial researchers are currently using theory-based conceptual job stress models, such as the demand-control-support (DCS) model [10], [11], [12] and the effort-reward imbalance (ERI) model [13]. These models categorize job stressors that are harmful to health and offer a consistent framework for the improvement of working conditions. The DCS model focuses exclusively on the job task profile, whereas the ERI model combines situational and personal conditions at worksites. Prospective cohort studies revealed that high job strain (high psychological job demand combined with low decision latitude) and ERI (high effort at work along with low financial and positional return) were risky job stressors related to the incidence and mortality of coronary heart disease [14], [15], [16]. Moreover, the combination of these two measures of the models resulted in the creation of a more efficient predictor of other health outcomes, such as coronary heart disease [17], mental distress [18], poor well-being [19], and poor self-reported health status [20], than the use of only one of the model components. Based on these findings, it is speculated that the two models are complementary to each other in evaluating the multidimensional features of job stressors. Moreover, a combination of the two models could improve the prediction of health outcomes by providing further explanation for harmful psychosocial job characteristics than the separate use of each model. However, with regard to insomnia, only a few studies [4], [8] adopted the DCS model and no study has employed the ERI model to elucidate the worksite stressors.
The objective of this cross-sectional study was to examine whether the ERI model, the DCS model, and their combination can be used to explain the risky psychosocial job characteristics related to insomnia. Middle-aged workers were chosen as subjects in this study. As they age, these workers experience insomnia symptoms with an increasing frequency [21].
Section snippets
Subjects
All middle-aged (39 years and older) Japanese workers (n=1786) in 8 companies of a corporate group of electric products in Osaka prefecture, Japan, were considered to be eligible participants. A total of 1732 workers (97.0%) provided written informed consent to participate in this study and received the questionnaire. The self-reported questionnaires were returned by 1699 workers (95.1%). A total of 618 respondents (34.6%) were excluded because of one or more missing responses. The remaining
The summary of the subjects
The subjects were male-dominant [n of male=983 (90.9%)]. The median of age was 44 (range, 39–66). The numbers (%) of the subjects aged 39, 40–49, 50–59, and 60 and above were 68 (6.3%), 747 (69.1%), 258 (23.9%), and 8 (0.7%), respectively. Reports of previously treated diseases and current illness were obtained from 481 (44.5%) and 269 (24.9%) subjects, respectively. A total of 800 (74.0%) workers were classified as white-collar. The median of overtime work hours worked during the previous
Discussion
The findings reveal that the two theory-based conceptual job stress models, the ERI and DCS models, describe the adverse psychosocial job characteristics related to insomnia. ERI, overcommitment, and high job strain are independently associated with insomnia. The associations of ERI, overcommitment, and high job strain with insomnia remain significant even after controlling for possible confounding factors. Psychosocial job characteristics deserve considerable attention and should be studied in
Conclusions
The ERI and DCS models describe adverse psychosocial job characteristics related to insomnia. The risk of insomnia is well predicted by simultaneously employing these two job stress measurements. The conceptual framework derived from these job stress models helps to define preventive measures for insomnia in workers.
Acknowledgements
The authors wish to thank Mr Mitsuhiro Matsuda, Ms Hiromi Yamamoto, Ms Yuka Kobayashi, and Ms Kayo Yakushige for their kind support and help with the data collection.
References (39)
Epidemiology of insomnia: what we know and what we still need to learn
Sleep Med Rev
(2002)- et al.
Job strain, effort-reward imbalance and employee well-being: a large-scale cross-sectional study
Soc Sci Med
(2000) - et al.
The impact of somatic health problems on insomnia in middle age
Sleep Med
(2003) - et al.
Sleeping tablet consumption, self reported quality of sleep, and working conditions
J Epidemiol Community Health
(1993) - et al.
Sleep problems and their correlates in a working population
J Gen Intern Med
(1995) - et al.
Job strain among post office mailhandlers
Int J Health Serv
(1996) - et al.
Self-reported sleep quality, job stress, and daytime autonomic activities assessed in terms of short-term heart rate validity among male white-collar workers
Ind Health
(1998) - et al.
The prevalence and pattern of insomnia in Japanese industrial workers: relationship between psychosocial stress and type of insomnia
Psychiatry Clin Neurosci
(1998) - et al.
Effects of age, working hours, and job content on sleep: a pilot study
Exp Aging Res
(1999) - et al.
Job stress, social support at work, and insomnia in Japanese shift workers
J Human Ergol
(2001)
Impact and correlates for poor sleep quality in Japanese white-collar employees
Sleep
Job demand, job decision latitude, and mental strain: implications for job redesign
Adm Sci Q
Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population
Am J Public Health
Healthy work: stress, productivity and the reconstruction of working life
Adverse health effects of high-effort/low-reward conditions
J Occup Health Psychol
Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees
Br Med J
When reciprocity fails: effort-reward imbalance in relation to coronary heart disease and health functioning within the Whitehall II study
Occup Environ Med
Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study
J Epidemiol Community Health
Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the SHEEP Study
J Epidemiol Community Health
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