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Author Notes:

Matthew D. Weaver, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, 221 Longwood Ave, Suite 438, Boston, MA 02115., mdweaver@bwh.harvard.edu.

SMWR, RMB, AER, JKW, CAC, and LKB conceived and designed the study; MDW conducted the analysis and wrote the initial draft; All authors contributed to the interpretation of the findings, made critical revisions to the manuscript, and gave final approval for the version to be published.

The authors appreciate the participation of the healthcare workers at the four institutions; as well as data collection contributions of Paula Schweitzer, Kara Griffin, and Jeanine Hall-Porter at St. Luke’s Hospital; and Rick Lillienthal and Akindele Majekodunmi at Brigham and Women’s Hospital.

MDW, CV, CSO, SQ, RMB, AER, and EL report no conflicts of interest.

Complete list of disclosures available in full text.


Research Funding:

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.

Complete funding list available in full text.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Neurosciences
  • Neurosciences & Neurology
  • mental health
  • occupational safety
  • sleep-wake disorders
  • RISK

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

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Journal Title:

Journal of Sleep Research


Volume 27, Number 6


, Pages e12722-e12722

Type of Work:

Article | Post-print: After Peer Review


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.

Copyright information:

© 2018 European Sleep Research Society

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