Abstract
Background
Insomnia symptoms are prevalent and associated with impaired health and well-being.
However, scant research has investigated whether midlife insomnia symptoms are also
associated with earlier retirement, thereby contributing to additional economic consequences.
Participants and Methods
We analyzed data from a community-based sample of 1635 Wisconsin State employees (51.6%
women) that were collected from 1988 until 2014. Study participants were asked about
insomnia symptoms (difficulty getting to sleep, difficulty getting back to sleep,
repeated nocturnal awakenings, and early morning awakenings) in midlife, with prospective
follow-up questions about the specific reasons for retirement between 2010 and 2014.
Using Cox proportional hazards models, we investigated longitudinal associations between
insomnia symptom measures (ie, each individual insomnia symptom, any insomnia symptom,
and number of insomnia symptoms) and rates of retirement. We also investigated reasons
for retirement and the potentially mediating role of depression.
Results
For most of our insomnia measures, after adjusting for confounding variables, we did
not find that insomnia symptoms at age 50 years were predictive of earlier overall
retirement. One exception is that early morning awakening at age 50 years is associated
with an increased rate of overall retirement (hazard ratio, 1.22; 95% confidence interval,
1.04-1.43). With regard to reason for retirement, we found that all measures of insomnia
were associated with increased rates of retirement due to poor health/disability.
For example, the presence of at least one insomnia symptom was associated with a hazard
ratio of 1.38 (95% confidence interval, 1.13-1.68). We also found evidence that depressive
symptoms mediate the association between insomnia symptoms and retirement due to poor
health/disability.
Discussion
Our study finds an association between insomnia symptoms in midlife and retirement
due to poor health/disability, whereas there is less compelling evidence between insomnia
symptoms and retirement due to other reasons. Future research on insomnia should consider
how earlier retirement affects the social and economic consequences of insomnia.
Keywords
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References
- Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors.Sleep Med. 2006; 7: 123-130https://doi.org/10.1016/j.sleep.2005.08.008
- Epidemiology of insomnia: what we know and what we still need to learn.Sleep Med Rev. 2002; 6: 97-111
- Management of primary sleep disorders among elderly persons.Psychiatr Serv. 1995; 46: 49-55
- Somatic diseases and complaints: epidemiological study of 3201 Swedish men.Acta Med Scand. 1987; 221: 475-481
- Epidemiological study on insomnia in the general population.Sleep. 1996; 19: S7-15
- How a general population perceives its sleep and how this relates to the complaint of insomnia.Sleep. 1997; 20: 715-723
- DSM-IV and ICSD-90 insomnia symptoms and sleep dissatisfaction.Br J Psychiatry. 1997; 171: 382-388
- Impact of chronic pain on health care seeking, self care, and medication. Results from a population-based Swedish study.J Epidemiol Community Health. 1999; 53: 503-509
- Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years.Sleep. 1999; 22: S366-S372
- Sleep habits and sleep disturbances among the elderly—an epidemiological survey.J Intern Med. 1993; 234: 31-39
- Sleep loss affects vigilance: effects of chronic insomnia and sleep therapy.J Sleep Res. 2008; 17: 335-343
- Chronic insomnia and immune functioning.Psychosom Med. 2003; 65: 211-221
- Self-reported sleep quality is associated with the metabolic syndrome.Sleep. 2007; 30: 219-223
- Effect of retirement on sleep disturbances: the GAZEL prospective cohort study.Sleep. 2009; 32: 1459-1466
- Effects of age, gender, and retirement on perceived sleep problems: results from the VISAT combined longitudinal and cross-sectional study.Sleep. 2012; 35: 1115-1121https://doi.org/10.5665/sleep.2000
- Changes in sleep duration and sleep timing associated with retirement transitions.Sleep. 2016; 39: 665-673https://doi.org/10.5665/sleep.5548
- Insomnia symptoms, sleep duration, and disability pensions: a prospective study of Swedish workers.Int J Behav Med. 2014; 21: 319-328https://doi.org/10.1007/s12529 013-9315-0
- Sleep problems and disability retirement: a register-based follow-up study.Am J Epidemiol. 2011; 173: 871-881https://doi.org/10.1093/aje/kwq462
- The joint association of sleep duration and insomnia symptoms with disability retirement—a longitudinal, register-linked study.Scand J Work Environ Health. 2012; 38: 427-435https://doi.org/10.5271/sjweh.3269
- Insomnia and long sleep duration are risk factors for later work disability. The Hordaland Health Study.J Sleep Res. 2009; 18: 122-128https://doi.org/10.1111/j.1365-2869.2008.00697.x
- Risk factors for depression among elderly community subjects: a systematic review and meta-analysis.Am J Psychiatry. 2003; 160: 1147-1156https://doi.org/10.1176/appi.ajp.160.6.1147
- Insomnia as a risk factor for onset of depression in the elderly.Behav Sleep Med. 2006; 4: 104-113https://doi.org/10.1207/s15402010bsm0402_3
- Emerging research on the treatment and etiology of secondary or comorbid insomnia.Sleep Med Rev. 2006; 10: 7-18
- A comparison of insomnia and depression as predictors of disability pension: the HUNT study.Sleep. 2008; 31: 875-880
- The long-term effect of insomnia on work disability: the HUNT-2 historical cohort study.Am J Epidemiol. 2006; 163: 1018-1024https://doi.org/10.1093/aje/kwj145
- Poor sleep predicts symptoms of depression and disability retirement due to depression.J Affect Disord. 2014; 172C: 381-389https://doi.org/10.1016/j.jad.2014.10.002
- Insomnia and the performance of US workers: results from the America Insomnia Survey.Sleep. 2011; 34: 1161-1171https://doi.org/10.5665/SLEEP.1230
- Gender differences in early retirement behaviour.Eur Sociol Rev. 2003; 19: 179-198https://doi.org/10.1093/esr/19.2.179
- Educational attainment, occupational history, and stratification: determinants of later-life economic outcomes.J Geront. 1992; 47: S213-S221
- Overweight and obesity in young and middle age and early retirement: the ARIC study.Obesity. 2009; 17: 143-149https://doi.org/10.1038/oby.2008.464
- Marital characteristics and retirement decisions.Res Aging. 2000; 22: 470-498
- Smoking and subsequent risk of early retirement due to permanent disability.Eur J Public Health. 2004; 14: 86-92
- A self-rating depression scale.Arch Gen Psychiatry. 1965; 12: 63-70
- Channing laboratory.Harvard University, 2012
- Estimating the proportion of treatment effect explained by a surrogate marker.Stat Med. 1997; 16: 1515-1527
Article info
Publication history
Published online: April 01, 2017
Accepted:
March 7,
2017
Received in revised form:
February 17,
2017
Received:
October 11,
2016
Footnotes
☆This work was supported by US National Institutes of Health (NIH) grants 1R01AG036838, R01HL62252, and 1UL1RR02501.
Identification
Copyright
© 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
