Work Stress and Sleep: Can Your Workplace Fuel Insomnia?

Quick Summary

• High work demands are associated with a greater likelihood of future sleep problems. A systematic review found that workers experiencing high demands had about 48% higher odds of later sleep disturbances

• Workplace relationships are important for sleep. Supportive colleagues and managers, fair treatment and greater control over work are associated with fewer sleep difficulties.

• Bullying, high job strain and feeling inadequately rewarded for your efforts are also linked to poorer sleep.

• Shift work is associated with disturbed sleep, while moving away from shift work may improve sleep. The evidence about long working hours alone is less conclusive

Can Your Job Affect Your Sleep?

Most people have experienced a period when work seems to follow them home. Perhaps there is an important deadline approaching, a difficult relationship with a manager, or uncertainty about the future of their job. And when sleep starts to suffer, work often seems an obvious explanation.

But how much does our work environment actually affect our sleep? Are demanding jobs inherently bad for sleep, or does the amount of control and support we experience make a difference?

It turns out that answering these questions is more complicated than it might first appear.

We know that people who report stressful working conditions also tend to report more sleep problems. However, this doesn’t necessarily tell us which comes first. Poor sleep can influence how we experience work, potentially making everyday demands feel more difficult. Equally, stressful working conditions might contribute to the development of sleep difficulties.

To better understand this relationship, Linton et al. (2015) conducted a systematic review, a study that gathers and assesses all the research on a question, examining whether workplace conditions predicted future sleep disturbances. The researchers screened almost 8,000 records and identified 24 studies that met their quality and inclusion criteria.

Importantly, Linton and colleagues focused on prospective studies, which follow employees over time, and studies that examined changes in working conditions. This allowed them to investigate whether particular work experiences were associated with sleep problems developing later, rather than simply occurring alongside them.

So does a demanding job really put your sleep at risk?

Does Having a Demanding Job Increase Your Risk of Sleep Problems?

Yes. Higher work demands are associated with a greater likelihood of future sleep problems. Across six studies involving approximately 14,700 employees, those experiencing higher demands had 48% higher odds of subsequent sleep disturbances (Linton et al., 2015).

What do we mean by “work demands?”. Work demands include:

• workload;

• the pace of work; and

• pressure to meet expectations.

The association also appears relevant to both developing and ongoing sleep difficulties. Jansson and Linton (2006) found that higher demands predicted later insomnia symptoms among employees both with and without insomnia at the beginning of their study.

However, workload is only one part of the experience of working. Two people may have equally demanding jobs but very different levels of influence over how they manage those demands.

So does having more control over your work make a difference?

Can Having More Control Over Your Work Improve Sleep?

Greater control over working conditions is associated with fewer sleep disturbances, although the relationship is generally smaller and less consistent than the association with workload (Linton et al., 2015).

Job control refers to the influence employees have over how they complete their work. This might involve deciding how to organize tasks, managing the pace of work or having flexibility over working hours.

A study by Takahashi et al. (2012) found that greater control over working time was associated with fewer insomnia symptoms and less difficulty recovering from work. Across eight studies involving about 18,200 employees, Linton et al. (2015) found evidence that greater job control was associated with fewer sleep problems later. However, individual study results varied, and the pooled association, the result of combining the studies, was relatively small.

An important concept here is job strain, which describes the combination of high work demands and limited control over how those demands are managed.

The researchers found that employees experiencing high job strain had about 35% higher odds of later sleep disturbances (Linton et al., 2015). In other words, demanding work appears particularly relevant to sleep when employees also have limited influence over how they respond to those demands.

But there is another aspect of work that may be equally important. What happens to sleep when the effort people put into their jobs doesn’t feel adequately rewarded?

Does Feeling Undervalued at Work Affect Sleep?

Feeling that the effort you put into your job is not adequately rewarded is associated with a greater likelihood of later sleep problems (Linton et al., 2015).

Researchers describe this experience as effort-reward imbalance. The concept refers to a mismatch between the demands and effort involved in a job and the rewards employees receive, whether through pay, recognition, career opportunities or job security.

In a Danish prospective study, Rugulies et al. (2009) found that men experiencing greater effort-reward imbalance were more likely to report later sleep disturbances. The association was not significant among women.

Another study found that effort-reward imbalance predicted new insomnia symptoms among employees who did not have insomnia at the beginning of the study (Ota et al., 2009).

Combining the available research, Linton et al. (2015) concluded that effort-reward imbalance was likely associated with future sleep disturbances. However, the strength of the relationship varied between studies, and the combined statistical estimates were not consistently significant. There was also insufficient evidence to determine whether the relationship was equally strong for women.

These findings suggest that the experience of work involves more than simply how much we do. The way our contribution is recognized and rewarded may also be relevant to sleep.

So far we’ve covered the work itself. What about the people we work with? How can they impact sleep?

Can Supportive Colleagues and Managers Help Protect Sleep?

Yes. Higher levels of workplace social support are associated with fewer future sleep disturbances. Workplace support is one of the clearest protective factors identified in the review by Linton and colleagues (2015).

Social support can involve practical assistance with difficult tasks, constructive feedback from a manager or knowing that colleagues are available when problems arise.

Across four studies involving about 11,700 employees, those reporting higher workplace support had about 26% lower odds of later sleep disturbances (Linton et al., 2015).

Jansson and Linton (2006) found that employees receiving greater support from their supervisors were less likely to develop insomnia. Interestingly, support from colleagues did not show the same statistically significant relationship in that particular study (Jansson & Linton, 2006). Magnusson Hanson et al. (2011) also found that workplace support predicted fewer sleep disturbances in a study that followed employees over time, examining work demands, control and support.

It’s important to note that the findings don’t establish that increasing support will necessarily prevent insomnia. Nevertheless, the findings suggest that workplace relationships may influence sleep outcomes over time.

The support from colleagues and managers is closely related to another aspect of the workplace: Does it make a difference to sleep whether employees believe they are being treated fairly?

Does Fair Treatment at Work Affect Sleep?

Employees who perceive greater fairness in their workplace tend to report fewer sleep disturbances later (Linton et al., 2015).

Researchers call this sense of fairness organizational justice, which refers to how fairly decisions are made, how employees are treated and how workplace resources and rewards are distributed.

Elovainio et al. (2009) examined organizational justice and sleep problems in the Whitehall II study. Employees reporting greater organizational justice experienced fewer sleep difficulties later, particularly problems maintaining sleep and waking feeling unrefreshed.

In another study, Greenberg (2006) examined what happened when nurses experienced a reduction in pay. Nurses whose pay was cut reported more insomnia than those whose pay was unchanged. But the study found that training supervisors to communicate and manage the changes more fairly reduced the insomnia response.

Across three studies, Linton et al. (2015) concluded that greater organizational justice was associated with fewer future sleep disturbances.

The importance of workplace relationships and concepts such as fairness become even clearer when considering experiences of workplace bullying and exclusion.

Can Workplace Bullying Lead to Sleep Problems?

Workplace bullying is associated with an increased likelihood of later sleep difficulties, although the strength of this relationship varies between studies (Linton et al., 2015).

In the Helsinki Health Study, Lallukka et al. (2011) examined whether experiences of workplace bullying predicted future sleep problems. Employees who reported being bullied were more likely to experience later sleep difficulties. The association was present in both men and women. In this study the reported bullying associated with about 69% higher odds of sleep problems among women and more than three times the odds among men.

Other research produced less consistent findings. For example, Pereira et al. (2013) found that workplace social exclusion was associated with some aspects of disturbed sleep, including sleep fragmentation (sleep broken up by frequent brief awakenings), but not all sleep outcomes.

The systematic review concluded that bullying and social exclusion were likely associated with future sleep disturbances, while acknowledging differences between the studies (Linton et al., 2015).

So far, the findings have mainly concerned the psychological and social aspects of work. But what about working hours themselves?

Do Long Working Hours and Shift Work Affect Sleep?

Work schedules appear relevant to sleep, particularly shift work, although the evidence about the total number of hours worked is less consistent.

Does Working Longer Hours Mean Poorer Sleep?

Working very long hours may be associated with greater sleep difficulties, but the evidence does not establish a consistent relationship between weekly working hours and future sleep disturbances (Linton et al., 2015).

Virtanen et al. (2009) examined working hours and sleep problems among employees participating in the Whitehall II study. Employees working more than 55 hours per week were more likely to experience certain sleep difficulties, particularly problems falling asleep. However, working between 41 and 55 hours per week was not linked to sleep problems.

Another study (Åkerstedt et al., 2001) examined the effects of reducing working hours from 39 to 30 per week. Although some sleep-related measures improved, the findings were mixed, with no clear improvement in insomnia complaints attributable to the reduced hours.

Because the studies used different designs and sleep measures, Linton et al. (2015) concluded that there was insufficient evidence to determine whether weekly working hours alone predicted future sleep problems.

That’s total hours worked. What about when the work is scheduled - i.e. shift work?

Is Shift Work More Disruptive Than Regular Daytime Work?

Shift work is associated with sleep disturbances, and moving away from shift work appears to be associated with improvements in sleep (Linton et al., 2015).

One reason shift work is relevant to sleep concerns our circadian rhythm, the internal biological timing system that helps regulate when we feel alert and when we feel sleepy. Our circadian rhythm follows a roughly 24-hour pattern and is strongly influenced by light and darkness. Working at unusual or changing times can create a mismatch between the times we need to be awake and the times our body is biologically prepared for sleep. The disruption can lead to a diagnosable sleep disorder: shift work sleep disorder.

Åkerstedt et al. (2010) followed workers who entered, continued or left shift work. Employees moving into shift work had increased odds of developing difficulties falling asleep. Those leaving shift work were more likely to experience improvements in difficulties falling asleep and repeated awakenings. Similarly, Niedhammer et al. (1994) found evidence of improved sleep quality among nurses who transferred from shift work to daytime work.

Interestingly, although the review identified an association between shift work and disturbed sleep, none of the studies of night work specifically found a significant link. The lack of significant results does not mean night work has no effect on sleep. Rather, the available studies did not provide enough evidence to determine the relationship between night work and future sleep disturbances (Linton et al., 2015).

These findings raise an important question about how we interpret the relationship between working conditions and sleep.

Does Workplace Stress Actually Cause Insomnia?

The evidence covered by Linton et al. (2015) suggests that stressful working conditions can come before sleep difficulties, but it does not establish that workplace stress directly causes insomnia.

One of the strengths of the review was its emphasis on prospective studies, which track people over time. This approach makes it possible to establish whether a workplace condition was present before a sleep disturbance developed.

However, establishing that one factor precedes another is not the same as demonstrating causation.

For example, employees who report difficult working conditions may also be experiencing other pressures that affect their sleep. Likewise, individual characteristics, psychological distress and circumstances outside work can potentially influence both workplace experiences and sleep outcomes.

Most of the studies also relied on self-reported sleep difficulties rather than objective measurements, such as sleep recordings. Another limitation was that the studies measured different sleep outcomes. Some examined insomnia symptoms, while others assessed difficulties falling asleep, repeated awakenings or general sleep quality. These outcomes are related but not necessarily equivalent.

The researchers also found insufficient evidence concerning several physical workplace factors, including noise, physical exertion and exposure to chemicals. This reflected a lack of suitable high-quality research rather than evidence that these exposures were harmless.

Overall, Linton et al. (2015) concluded that the psychological and social side of work, along with work schedules, were associated with future sleep disturbances. However, the researchers could not reliably say how large those effects were nor the exact underlying mechanisms.

So what does this research mean for someone experiencing insomnia?

Clinical Comment

Workplace conditions deserve consideration when investigating sleep difficulties, particularly when insomnia develops or worsens during periods of work stress.

From a Behavioral Sleep Medicine perspective, an important distinction is between the circumstances that may initially contribute to poor sleep and the factors that keep sleep difficulties going. For example, it’s common to have someone say they first experienced insomnia during a period of unusually high work demands. However, even after the workload became more manageable, their sleep problems continued.

Insomnia can continue in this way because it is not always maintained by the same circumstances that contributed to its development. Changes in sleep-related thoughts, behaviors and emotional responses can become important maintaining factors - and that’s what treatment, CBT-I or CBT for insomnia, targets.

The systematic review did not directly investigate these processes. However, its findings support considering workplace experiences when developing an understanding of someone’s sleep difficulties (Linton et al., 2015).

There are also implications for organizations. Workplace initiatives addressing excessive demands, employee control, managerial support, fairness and bullying may be very relevant to sleep health.

So if work stress has affected your sleep, where do you go from here?

Where To From Here?

If your sleep difficulties began during a stressful period at work, the work environment may be an important part of understanding what happened.

Research suggests that workload, workplace relationships, control over work and work schedules can all be relevant to later sleep problems. It also highlights why focusing exclusively on an individual’s sleep habits may overlook important contributing circumstances.

For some people, improvements in working conditions may help their sleep recover. For others, sleep difficulties can persist long after the original workplace pressures have reduced.

When insomnia becomes persistent, working with a Behavioral Sleep Medicine specialist can help identify the factors contributing to the problem and those currently maintaining it. At The Better Sleep Clinic, this involves a structured, individualized assessment and treatment approach that considers the person’s sleep patterns, psychological and behavioral responses, and relevant circumstances, including their working environment.

Understanding how work and sleep are connected can be an important part of developing an effective response to ongoing sleep difficulties.

Frequently Asked Questions About Work Stress And Sleep

Q1: Can work stress cause insomnia?

A1: Work stress is linked to later insomnia, but the research does not prove that it causes it. A systematic review of 24 studies that followed workers over time found that high work demands, job strain, effort-reward imbalance and bullying were associated with more sleep disturbances later on (Linton et al., 2015). Because poor sleep can also change how people experience work, and other factors can affect both, these studies show a link rather than cause and effect.

Q2: Does a heavy workload affect sleep?

A2: A heavy workload is one of the most consistent workplace predictors of later sleep problems. Workers with high work demands had about 48% higher odds of later sleep disturbances than those with lower demands (Linton et al., 2015). Higher demands also predicted insomnia symptoms both in employees who started out without insomnia and in those who already had it (Jansson & Linton, 2006).

Q3: Which aspects of work are linked to better sleep?

A3:  Workplace support, fair treatment and control over work are all associated with fewer sleep problems later on (Linton et al., 2015). Workers with higher workplace support had about 26% lower odds of later sleep disturbances, and support from supervisors in particular was linked to a lower chance of developing insomnia (Jansson & Linton, 2006).

Q4: Can workplace bullying affect sleep?

A4: Workplace bullying is linked to a higher chance of later sleep problems. In the Helsinki Health Study, women who reported being bullied had about 69% higher odds of sleep problems, and men more than three times the odds (Lallukka et al., 2011). Results vary between studies, but the review concluded that bullying and social exclusion are likely associated with later sleep disturbances (Linton et al., 2015).

Q5: Does shift work cause sleep problems?

A5: Shift work is associated with sleep disturbances, and leaving shift work is associated with better sleep. Workers who moved into shift work had higher odds of developing difficulty falling asleep, while those who left shift work were more likely to see that difficulty and repeated night awakenings improve (Åkerstedt et al., 2010). Studies of night shift work specifically did not find a significant link, so its effect remains uncertain (Linton et al., 2015).

Q6: Do long working hours affect sleep?

A6: Very long working hours are linked to some sleep problems, but moderately long hours appear not to be. Employees working more than 55 hours a week were more likely to have trouble falling asleep, while working 41 to 55 hours was not linked to sleep problems (Virtanen et al., 2009). Overall, there was not enough evidence to say whether weekly working hours alone predict later sleep problems (Linton et al., 2015).

Q7: Will my sleep improve once my work stress eases?

A7: Sleep can recover for some people once work pressures ease, but insomnia can also persist long after the original stress has passed. Insomnia is not always maintained by the circumstances that started it, because changes in sleep-related thoughts, behaviors and emotional responses can keep it going. When insomnia persists, a Behavioral Sleep Medicine specialist can help identify what is maintaining it.

References

Åkerstedt, T., Nordin, M., Alfredsson, L., Westerholm, P., & Kecklund, G. (2010). Sleep and sleepiness: Impact of entering or leaving shiftwork—A prospective study. Chronobiology International, 27(5), 987–996.

Åkerstedt, T., Olsson, B., Ingre, M., Holmgren, M., & Kecklund, G. (2001). A 6-hour working day—Effects on health and well-being. Journal of Human Ergology, 30(1–2), 197–202.

Elovainio, M., Ferrie, J. E., Gimeno, D., De Vogli, R., Shipley, M., Brunner, E. J., Kumari, M., Vahtera, J., Marmot, M. G., & Kivimäki, M. (2009). Organizational justice and sleeping problems: The Whitehall II study. Psychosomatic Medicine, 71(3), 334–340.

Greenberg, J. (2006). Losing sleep over organizational injustice: Attenuating insomniac reactions to underpayment inequity with supervisory training in interactional justice. Journal of Applied Psychology, 91(1), 58–69.

Jansson, M., & Linton, S. J. (2006). Psychosocial work stressors in the development and maintenance of insomnia: A prospective study. Journal of Occupational Health Psychology, 11(3), 241–248.

Lallukka, T., Rahkonen, O., & Lahelma, E. (2011). Workplace bullying and subsequent sleep problems – The Helsinki Health Study. Scandinavian Journal of Work, Environment & Health, 37(3), 204–212. https://doi.org/10.5271/sjweh.3137

Linton, S. J., Kecklund, G., Franklin, K. A., Leissner, L. C., Sivertsen, B., Lindberg, E., Svensson, A. C., Hansson, S. O., Sundin, Ö., Hetta, J., Björkelund, C., & Hall, C. (2015). The effect of the work environment on future sleep disturbances: A systematic review. Sleep Medicine Reviews, 23, 10–19. https://doi.org/10.1016/j.smrv.2014.10.010

Magnusson Hanson, L. L., Åkerstedt, T., Näswall, K., Leineweber, C., Theorell, T., & Westerlund, H. (2011). Cross-lagged relationships between workplace demands, control, support, and sleep problems. Sleep, 34(10), 1403–1410.

Niedhammer, I., Lert, F., & Marne, M.-J. (1994). Effects of shift work on sleep among French nurses: A longitudinal study. Journal of Occupational Medicine, 36(6), 667–674.

Ota, A., Masue, T., Yasuda, N., Tsutsumi, A., Mino, Y., Ohara, H., & Ono, Y. (2009). Psychosocial job characteristics and insomnia: A prospective cohort study using the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) job stress models. Sleep Medicine, 10(10), 1112–1117.

Pereira, D., Meier, L. L., & Elfering, A. (2013). Short-term effects of social exclusion at work and worries on sleep. Stress and Health, 29(3), 240–252.

Rugulies, R., Norborg, M., Sørensen, T. S., Knudsen, L. E., & Burr, H. (2009). Effort–reward imbalance at work and risk of sleep disturbances. Cross-sectional and prospective results from the Danish Work Environment Cohort Study. Journal of Psychosomatic Research, 66(1), 75–83.

Takahashi, M., Iwasaki, K., Sasaki, T., Kubo, T., Mori, I., & Otsuka, Y. (2012). Sleep, fatigue, recovery, and depression after change in work time control: A one-year follow-up study. Journal of Occupational and Environmental Medicine, 54(9), 1078–1085.

Virtanen, M., Ferrie, J. E., Gimeno, D., Vahtera, J., Elovainio, M., Singh-Manoux, A., Marmot, M. G., & Kivimäki, M. (2009). Long working hours and sleep disturbances: The Whitehall II prospective cohort study. Sleep, 32(6), 737–745.

Written By Dan Ford, DBSM, Sleep Psychologist

Published By The Better Sleep Clinic