To estimate associations of broadly defined
insomnia (i.e., meeting inclusion criteria for International Classification of Diseases, Tenth Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or Research Diagnostic Criteria/International Classification of
Sleep Disorders, Second Edition (RDC/ICSD-2) diagnosis) with workplace/nonworkplace
injuries controlling for comorbid conditions among workers in the America
Insomnia Survey (AIS).
DESIGN/SETTING: Cross-sectional telephone survey.
PARTICIPANTS: National sample of 4,991 employed health plan subscribers (age 18 yr and older).
INTERVENTIONS: None.
MEASUREMENTS AND RESULTS: Broadly defined
insomnia with duration of at least 12 mo was assessed with the Brief
Insomnia Questionnaire (BIQ).
Injuries in the 12 mo before interview were assessed with a standard self-report measure of
injuries causing role impairment or requiring medical attention. Eighteen comorbid condition clusters were assessed with medical/pharmacy claims records and self-reports.
Insomnia had significant gross associations (odds ratios,
ORs) with both workplace and nonworkplace
injuries (OR 2.0 and 1.5, respectively) in logistic regression analyses before controlling for comorbid conditions. The significant population attributable risk proportions (PARPs) of total
injuries with
insomnia was 4.6% after controlling for comorbid conditions. Only 2 other conditions had PARPs exceeding those of
insomnia. The associations of
insomnia with
injuries did not vary significantly with worker age, sex, or education, but did vary significantly with comorbid conditions. Specifically,
insomnia was significantly associated with workplace and nonworkplace
injuries (OR 1.8 and 1.5, respectively) among workers having no comorbid conditions, with workplace but not nonworkplace
injuries (OR 1.8 and 1.2, respectively) among workers having 1 comorbid condition, and with neither workplace nor nonworkplace
injuries (OR 0.9 and 1.0, respectively) among workers having 2 or more comorbid conditions.
CONCLUSIONS: