Comparison of workplace impairment and daily activity impairment in acute and chronic insomnia disorder: a study of Chinese adults.

Abstract

BACKGROUND: Insomnia is a common condition that adversely affects work productivity, and a significant proportion of individuals with acute insomnia disorder (AID) eventually develop chronic insomnia disorder (CID). However, it remains unclear whether workplace impairment and daily activity impairment occur early in the course of insomnia. METHODS: This cross-sectional study included 295 AID and 305 CID participants. Multiple linear regression was used to assess associations between insomnia, workplace and daily activity impairment, and related factors (daytime sleepiness, depressive and anxiety symptoms). Restricted cubic spline (RCS) analysis was also conducted to explore nonlinear relationships. Mediation analysis was performed to assess the potential mediating effects of daytime sleepiness and depressive and anxiety symptoms between insomnia and workplace and daily activity impairment. RESULTS: No significant differences were found between the AID and CID groups in presenteeism or productivity-loss costs (P>0.05). Insomnia severity, daytime sleepiness, and depressive and anxiety symptoms were the correlated factors of workplace and daily activity impairment (P<0.05). A nonlinear relationship between depressive symptoms and presenteeism, as well as between daytime sleepiness and daily activity impairment, was identified in both groups (P_overall<0.01, P_nonlinearity<0.05). Mediation analysis showed that in the AID group, depressive symptoms mediated the effects on absenteeism and daily activity impairment (mediation proportions: 37.02% and 28.61%, respectively). In the CID group, anxiety symptoms had a greater mediating effect on presenteeism and daily activity impairment (mediation proportions: 53.01% and 31.70%, respectively). CONCLUSIONS: Presenteeism and productivity-loss costs occur in AID and are comparable with those resulting from CID. Depressive and anxiety symptoms are also important mediators of workplace and daily activity impairment in AID. We recommend investing in portable and effective interventions to improve work productivity.