Abstract
Sleep and functioning are associated with a risk of early workforce exit. However, patterns of change in sleep and functioning through time have not been investigated using person-oriented approaches to show what features of sleep and functioning are associated with an early exit. We examined the pattern of interactions between sleep and health functioning characterizing homogenous subgroups of employees and their associations with premature work exit. An additional aim was to provide a tutorial providing detailed description on how to apply these models, compared to traditional variable based risk factors. We analyzed data from 5148 midlife employees of the City of Helsinki, Finland, surveyed over three phases (2000–02, 2007, and 2012). Using repeated measures latent class analyses (RMLCA) we classified people into groups based on their trajectories in sleep and functioning. We identified four longitudinal groups: (1) Stable good sleep and functioning (reference), (2) Persistent sleep problems and good or moderate functioning, (3) Poor functioning with good sleep, and (4) Problematic sleep and health functioning. Compared to group 1, elevated risk was found in all classes with group 4 being the worst. In conclusion, focusing on person-orientated patterns of interactions between sleep and functioning helped produce qualitatively different and quantitatively stronger predictions than using conventional risk factor methodology. Thus, longitudinal person-oriented approaches may be a more powerful method for quantifying the role of sleep and health functioning as risks for premature exit from work.
Highlights
Premature exit from work creates serious health and societal burdens in modern societies, including Finland [1]
The lowest risk was found among a subgroup characterized by good sleep and health functioning over the whole follow-up period
Irrespective of repeated measures latent class analyses (RMLCA) model the highest risk of premature exit from work was always found among the members of a subgroup characterized by stable or increasingly high probability for both poor sleep and health functioning (Problematic sleep and health functioning, Latent class 4 (LC4))
Summary
Premature exit from work creates serious health and societal burdens in modern societies, including Finland [1]. A number of factors, including health functioning as well as poor sleep, are associated with early exit from work and work disability. Several studies suggest that sleep problems have adverse impacts on work productivity and disability by increasing the risk of future sickness absence and permanent disability retirement due to declines in health and functioning [3,4,5,6,7]. Similar covariates have been used in numerous studies focusing on sleep, functioning, and work disability/premature exit from work due to disability Managers have subordinates and do managerial/administrative work Professionals, including other upper white-collar employees, such as teachers and doctors, have a university degree, but do professional work and they typically do not have subordinates
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