Dataset Information

Change in Job Strain as a Predictor of Change in Insomnia Symptoms: Analyzing Observational Data as a Non-randomized Pseudo-Trial.

ABSTRACT:

Study objectives

To examine whether change in job strain leads to change in insomnia symptoms.

Methods

Among 24873 adults (82% women, mean age 44 years) who participated in a minimum of three consecutive study waves (2000-2012), job strain was assessed at the first and second wave and insomnia symptoms at all three waves. We analyzed observational data as a "pseudo-trial" including participants with no job strain in the first wave and no insomnia symptoms in the first and second wave (n = 7354) to examine whether the onset of job strain between the first and second waves predicted the onset of insomnia symptoms in the third wave. We used a corresponding approach, including those with job strain in the first wave and insomnia symptoms in the first and second wave (n = 2332), to examine whether the disappearance of job strain between the first two waves predicted remission of insomnia symptoms in the third wave.

Results

The onset of job strain predicted the onset of subsequent insomnia symptoms after adjustment for sex, age, marital status, education, smoking, physical activity, alcohol consumption, body mass index, and comorbidities (odds ratio compared to no onset of job strain 1.32, 95% CI 1.16-1.51). The disappearance of job strain was associated with lower odds of repeated insomnia symptoms (odds ratio compared to no disappearance of job strain 0.78, 95% CI 0.65-0.94). Further adjustment for shift work or sleep apnea did not change these associations.

Conclusions

These results suggest that job strain is a modifiable risk factor for insomnia symptoms.

SUBMITTER: Halonen JI

PROVIDER: S-EPMC5806551 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Publications

Change in Job Strain as a Predictor of Change in Insomnia Symptoms: Analyzing Observational Data as a Non-randomized Pseudo-Trial.

Halonen Jaana I JI Lallukka Tea T Pentti Jaana J Stenholm Sari S Rod Naja H NH Virtanen Marianna M Salo Paula P Kivimäki Mika M Vahtera Jussi J

Sleep 20170101 1

<h4>Study objectives</h4>To examine whether change in job strain leads to change in insomnia symptoms.<h4>Methods</h4>Among 24873 adults (82% women, mean age 44 years) who participated in a minimum of three consecutive study waves (2000-2012), job strain was assessed at the first and second wave and insomnia symptoms at all three waves. We analyzed observational data as a "pseudo-trial" including participants with no job strain in the first wave and no insomnia symptoms in the first and second w ...[more]

PMID: 28364463

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Project description:BackgroundThe Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ) is a new validated 14-item patient-reported outcome (PRO) instrument for evaluating daytime functioning in people with insomnia. It comprises three domains: Alert/Cognition, Mood, and Sleepiness.ObjectiveThe aim of this analysis was to estimate the minimum within-patient change for IDSIQ scores that an adult patient with insomnia would consider meaningful.MethodsData were from a randomized, double-blind, placebo-controlled, phase III clinical trial of daridorexant in adults with insomnia. Subjects completed the IDSIQ daily in the evening, with a recall period of 'today', throughout the 3-month double-blind treatment period. Scores were calculated as a weekly average. Each IDSIQ item was scored on an 11-point numeric rating scale ranging from 0 (not at all/none at all) to 10 (very/a lot), with a higher score indicating a greater severity or impact. PRO measures with correlation coefficients ≥0.30 were included in a subsequent anchor-based analysis. For the IDSIQ total score and each IDSIQ domain, meaningful within-patient change was estimated as the minimum score change patients would consider meaningful in an anchor-based analysis using data from PRO instruments capturing daytime and night-time insomnia symptoms (the Insomnia Severity Index [four items, each scored 0-4, with a higher score indicating greater symptom severity; assessed at screening, baseline, month 1 and month 3], Patient Global Assessment of Disease Severity [6-point scale from 'none' to 'very severe'; assessed weekly], Patient Global Impression of Severity [4-point scale from 'none' to 'severe'; assessed weekly], and Patient Global Impression of Change [7-point scale from 'very much better' to 'very much worse'; assessed weekly for night-time and daytime symptoms separately]). A supplemental distribution-based analysis was also conducted to support the anchor-based analysis.ResultsThe analysis included 930 subjects aged 18-88 years. Spearman correlation coefficients for the relationships between score changes/ratings for anchors and the IDSIQ (0.36-0.44 at month 1, 0.45-0.57 at month 3) were all above the prespecified threshold of 0.30. Mean IDSIQ score changes at months 1 and 3 based on the different anchors supported meaningful within-patient change estimates starting at 17 points for the IDSIQ total score, 9 points for the Alert/Cognition domain, and 4 points for the Mood and Sleepiness domains.ConclusionThis analysis demonstrates the meaningful within-patient change for the IDSIQ total score and domain scores, that the instrument is sensitive to changes in the patient experience of insomnia, and that it can be used in clinical trials to evaluate changes in daytime functioning.Clinical trials registrationNCT03545191 (4 June 2018).

Dataset Information

Change in Job Strain as a Predictor of Change in Insomnia Symptoms: Analyzing Observational Data as a Non-randomized Pseudo-Trial.

Study objectives

Methods

Results

Conclusions

Publications

Change in Job Strain as a Predictor of Change in Insomnia Symptoms: Analyzing Observational Data as a Non-randomized Pseudo-Trial.

Similar Datasets

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