Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study.

Sergio Garbarino,Nicola Magnavita,Juan Manuel Marquez-Romero

doi:10.1371/journal.pone.0224259

Sergio Garbarino, Nicola Magnavita + Show 1 more

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https://doi.org/10.1371/journal.pone.0224259

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Abstract

ObjectivePrevious studies have shown that workers chronically exposed to occupational stress have an increased risk of metabolic syndrome (MetS) and sleep problems (SPs). The purpose of this study was to verify whether SPs mediate the relationship between stress and MetS.MethodA 5-year prospective cohort study included 242 police officers from a rapid response unit engaged exclusively in maintaining law and order. Perceived stress levels were measured repeatedly with the demand-control-support and the effort-reward-imbalance questionnaires; insomnia symptoms were assessed with the Pittsburgh Sleep Quality Index; excessive daytime sleepiness was measured using the Epworth Sleepiness Scale. MetS and its components were evaluated at baseline and at follow-up.ResultsDuring 5-year follow-up period, 26 new cases of MetS were identified. Both occupational stress and SPs were significantly related to incident cases of MetS. Insomnia symptoms showed a highly significant association with MetS (aOR 11.038; CI95% 2.867–42.493). Mediation analysis confirmed that SPs mediate the relationship between stress and MetS.A reciprocal relationship was found between job stress and SPs. Work-related stress was a significant predictor of insomnia symptoms, short sleep duration, sleep dissatisfaction, and sleepiness. Compared to the reference group, police officers with SPs at baseline had significantly higher odds of reporting high stress at follow-up.ConclusionSPs play a mediating role in the relationship between occupational stress and MetS. Prevention of MetS must include the control of stress factors and an increase in the resilience of workers, but correct sleep hygiene is also an essential factor.

Highlights

Metabolic syndrome (MetS) is a cluster of metabolically related cardiovascular risk factors [1] that predict a high risk of developing diabetes [2], cancer [3], and cognitive impairment [4]
Work-related stress was a significant predictor of insomnia symptoms, short sleep duration, sleep dissatisfaction, and sleepiness
In a previous longitudinal study on a rapid response police unit we observed that police officers with high job strain had a higher adjusted risk of developing MetS and hypertriglyceridemia than their colleagues classified in the lowest quartile of work-related distress [18]

Summary

Introduction

Metabolic syndrome (MetS) is a cluster of metabolically related cardiovascular risk factors (obesity, insulin resistance, dyslipidaemia and hypertension) [1] that predict a high risk of developing diabetes [2], cancer [3], and cognitive impairment [4]. A recent meta-analysis of longitudinal studies showed that work-related stress is associated with a significant increase in the pooled risk of metabolic syndrome (RR = 1.47; CI95% = 1.22–1.78) [17]. In a previous longitudinal study on a rapid response police unit we observed that police officers with high job strain had a higher adjusted risk of developing MetS (aOR = 2.68; CI95% = 1.08–6.70) and hypertriglyceridemia (aOR = 7.86; CI95% = 1.29–48.04) than their colleagues classified in the lowest quartile of work-related distress [18]. In a Swedish cohort, both short and long sleep durations, and problems with falling and staying asleep were linked to a higher prevalence of MetS [26].

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