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Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs

Longitudinal Data From Kansas State Employee Wellness Program

Hui, Siu-kuen Azor PhD, MSPH; Grandner, Michael A. PhD, MTR

Journal of Occupational and Environmental Medicine: October 2015 - Volume 57 - Issue 10 - p 1031–1038
doi: 10.1097/JOM.0000000000000534

Objective: To examine the relationships between employees’ trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period.

Methods: Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and health care costs as the outcomes.

Results: EWP participants (N = 11,698 in 2008; 5636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all P < 0.0005), have lower work performance ratings (all P < 0.0005), and have higher health care costs (P < 0.0005). Longitudinally, more trouble sleeping was significantly related to negative changes in all outcomes.

Conclusions: Employees’ trouble sleeping, even at a subclinical level, negatively impacts on work attendance, work performance, and health care costs.

Cancer Prevention and Control Program (Dr Hui), Fox Chase Cancer Center and Department of Psychiatry (Dr Grandner), Perelman School of Medicine, University of Pennsylvania.

Address correspondence to: Siu-kuen Azor Hui, PhD, MSPH, Fox Chase Cancer Center, Cancer Prevention and Control, 333 Cottman Ave., Young Pavilion 4171, Philadelphia, PA 19111 (

Dr Hui is supported by the National Cancer Institute (R03CA159903). Dr Grandner is supported by the National Heart, Lung and Blood Institute (K23HL110216) and the National Institute of Environmental Health Sciences (R21ES022931).

Authors Hui and Grandner have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2015 by the American College of Occupational and Environmental Medicine