Sleep disorders, depression and anxiety are associated with adverse safety outcomes in healthcare workers: A prospective cohort study

• Type of Material: Article
• Authors: Matthew D. Weaver, Brigham & Women's Hospital; Celine Vetter, Brigham & Women's Hospital; Shantha M. W. Rajaratnam, Brigham & Women's Hospital; Conor S. O'Brien, Brigham & Women's Hospital; Salim Qadri, Brigham & Women's Hospital; Ruth M. Benca, University of California, Irvine; Ann E Rogers, Emory University; Eileen B. Leary, Stanford University; James K. Walsh, St Luke's Hospital; Charles A. Czeisler, Brigham & Women's Hospital; Laura K. Barger, Brigham & Women's Hospital
• Language: English
• Date: 2018-12-01
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 European Sleep Research Society
• Final Published Version (URL): http://dx.doi.org/10.1111/jsr.12722
• Title of Journal or Parent Work: Journal of Sleep Research
• ISSN: 0962-1105
• Volume: 27
• Issue: 6
• Start Page: e12722
• End Page: e12722
• Grant/Funding Information: Complete funding list available in full text.; The study was supported by the The Academic Alliance for Sleep Research with funding from ResMed.; Authors were partially supported by the National Heart, Lung, and Blood Institute, Grant/Award Numbers: F32HL134249 and T32HL007901; and the National Institute for Occupational Safety and Health, Grant/Award Number R01OH010300.
• Keywords: sleep-wake disorders; Science & Technology; EVENTS; INSOMNIA; Neurosciences & Neurology; MEDICAL ERRORS; RISK; MOTOR-VEHICLE CRASHES; occupational safety; POPULATION; APNEA; QUESTIONNAIRE; mental health; Neurosciences; Clinical Neurology; SYMPTOMS; Life Sciences & Biomedicine; RESTLESS LEGS SYNDROME
• Research Categories: Psychology, Clinical; Health Sciences, Nursing

Abstract

The objective of the study was to determine if sleep disorder, depression or anxiety screening status was associated with safety outcomes in a diverse population of hospital workers. A sample of shift workers at four hospitals participated in a prospective cohort study. Participants were screened for five sleep disorders, depression and anxiety at baseline, then completed prospective monthly surveys for the next 6 months to capture motor vehicle crashes, near-miss crashes, occupational exposures and medical errors. We tested the associations between sleep disorders, depression and anxiety and adverse safety outcomes using incidence rate ratios adjusted for potentially confounding factors in a multivariable negative binomial regression model. Of the 416 hospital workers who participated, two in five (40.9%) screened positive for a sleep disorder and 21.6% screened positive for depression or anxiety. After multivariable adjustment, screening positive for a sleep disorder was associated with 83% increased incidence of adverse safety outcomes. Screening positive for depression or anxiety increased the risk by 63%. Sleep disorders and mood disorders were independently associated with adverse outcomes and contributed additively to risk. Our findings suggest that screening for sleep disorders and mental health screening can help identify individuals who are vulnerable to adverse safety outcomes. Future research should evaluate sleep and mental health screening, evaluation and treatment programmes that may improve safety.