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Economic difficulties and subsequent sleep problems: evidence from British and Finnish occupational cohorts.

ABSTRACT: BACKGROUND:Social determinants of sleep may prove to be as important as health status. In this study we examined the extent to which persistent and changing economic difficulties are associated with sleep problems in two prospective occupational cohorts. METHODS:We used data from Finnish (baseline 2000-2002; follow-up 2007; n=6328) and British (baseline 1997-1999; follow-up 2003-2004; n=5002) public sector employees. Economic difficulties, sleep problems, and a variety of covariates were assessed at baseline and follow-up. RESULTS:Prevalence of frequent sleep problems at follow-up was 27% and 20% among women and men in the Finnish cohort, and 34% and 27% in the British cohort, respectively. Odds for sleep problems were higher among those with persistent economic difficulties (frequent economic difficulties at baseline and follow-up) compared to those with no difficulties. This association remained after multiple adjustments, including parental and current socioeconomic position, in the Finnish (OR 1.72, 95% CI 1.35-2.18) cohort. Increases in economic difficulties were similarly associated with sleep problems in the Finnish and the British cohort. CONCLUSION:Evidence from two occupational cohorts suggests strong associations between economic difficulty and poor sleep. Awareness of this association will help health care professionals identify and prevent sleep problems.

SUBMITTER: Lallukka T

PROVIDER: S-EPMC3382711 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Economic difficulties and subsequent sleep problems: evidence from British and Finnish occupational cohorts.

Lallukka Tea T Ferrie Jane E JE Kivimäki Mika M Shipley Martin J MJ Rahkonen Ossi O Lahelma Eero E

Sleep medicine 20120323 6

<h4>Background</h4>Social determinants of sleep may prove to be as important as health status. In this study we examined the extent to which persistent and changing economic difficulties are associated with sleep problems in two prospective occupational cohorts.<h4>Methods</h4>We used data from Finnish (baseline 2000-2002; follow-up 2007; n=6328) and British (baseline 1997-1999; follow-up 2003-2004; n=5002) public sector employees. Economic difficulties, sleep problems, and a variety of covariat ...[more]

PMID: 22445231

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Project description:Importance:Although multiple cross-sectional and longitudinal studies have established that sleep problems and behavioral difficulties are associated in children, the directionality of this association and whether sleep problems are differentially associated with different types of childhood behavioral difficulties are unclear. Understanding these associations will inform the focus and timing of interventions. Objective:To determine whether longitudinal and reciprocal associations exist between child sleep problems and externalizing, internalizing, or both behavioral difficulties. Design, Setting, and Participants:Prospective cohort study using nationally representative data from the first 5 waves (2004, 2006, 2008, 2010, and 2012) of the kindergarten cohort (4983 children aged 4-5 years in 2004) collected for the Longitudinal Study of Australian Children. Associations were evaluated using cross-lagged structural equation model analyses performed from May 25, 2016, to September 20, 2017. Main Outcomes and Measures:Child sleep problems and internalizing and externalizing behavioral difficulties. Sleep problems were defined using parent-reported child sleep problem severity and specific difficulties (ie, difficulty getting to sleep at night, not happy sleeping alone, waking during the night, and restless sleep) on 4 or more nights of the week. Child behavioral difficulties were defined using the parent-reported Strengths and Difficulties Questionnaire for externalizing difficulties (conduct problems and hyperactivity/inattention subscales) and internalizing difficulties (emotional problems subscale). Results:The 4983 children enrolled in 2004 had a mean (SD) age of 4.7 (0.2) years and comprised a similar percentage of boys (2536 [50.9%]) and girls. In 2012, 3956 children (79.4%) aged 12 to 13 years were retained. Significant bidirectional associations were detected between sleep problems and externalizing difficulties during the elementary school transition period, with greater sleep problems associated with later externalizing behavior and vice versa (cross-lagged path coefficient, 0.04 [95% CI, 0.01-0.08] to 0.09 [95% CI, 0.06-0.13]). Although sleep was a significant driver of later internalizing difficulties (coefficient, 0.10 [95% CI, 0.07-0.14] to 0.16 [95% CI, 0.12-0.19]), the reverse association was not significant. In the final model that included all 3 constructs, the associations were attenuated but remained significant over time. Conclusions and Relevance:These results suggest that future studies should investigate whether implementing sleep problem intervention decreases the occurrence of both externalizing and internalizing difficulties. Interventions targeting externalizing, but not internalizing, difficulties may benefit childhood sleep.

Dataset Information

Economic difficulties and subsequent sleep problems: evidence from British and Finnish occupational cohorts.

Publications

Economic difficulties and subsequent sleep problems: evidence from British and Finnish occupational cohorts.

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