Sleep and biological parameters in professional burnout: A psychophysiological characterization.
Study Design
- Тип исследования
- Observational Study
- Размер выборки
- 140
- Вмешательство
- Sleep and biological parameters in professional burnout: A psychophysiological characterization.
- Препарат сравнения
- Placebo
- Направление эффекта
- Positive
- Риск систематической ошибки
- Moderate
Abstract
Professional burnout syndrome has been described in association with insomnia and metabolic, inflammatory and immune correlates. We investigated the interest of exploring biological parameters and sleep disturbances in relation to burnout symptoms among white-collar workers. Fifty-four participants with burnout were compared to 86 healthy control participants in terms of professional rank level, sleep, job strain (Karasek questionnaire), social support, anxiety and depression (HAD scale). Fasting concentrations of glycaemia, glycosylated hemoglobin (HbA1C), total-cholesterol, triglycerides, C-reactive protein (CRP), thyroid stimulating hormone (TSH), 25-hydroxyvitamin D (25[OH]D), and white blood cell (WBC) counts were assessed. Analysis of variance and a forward Stepwise Multiple Logistic Regression were made to identify predictive factors of burnout. Besides reporting more job strain (in particular job control p = 0.02), higher levels of anxiety (p<0.001), and sleep disorders related to insomnia (OR = 21.5, 95%CI = 8.8-52.3), participants with burnout presented higher levels of HbA1C, glycaemia, CRP, lower levels of 25(OH)D, higher number of leukocytes, neutrophils and monocytes (P<0.001 for all) and higher total-cholesterol (P = 0.01). In particular, when HbA1c is > 3.5%, the prevalence of burnout increases from 16.6% to 60.0% (OR = 4.3, 95%CI = 2.8-6.9). Strong significant positive correlation existed between HbA1C and the two dimensions (emotional exhaustion and depersonalization (r = 0.79 and r = 0.71, p<0.01)) of burnout. Models including job strain, job satisfaction, anxiety and insomnia did not predict burnout (p = 0.30 and p = 0.50). However, when HbA1C levels is included, the prediction of burnout became significant (P = 0.03). Our findings demonstrated the interest of sleep and biological parameters, in particular HbA1C levels, in the characterization of professional burnout.
Full Text
Figures
Tables
Table 1
| Control | Burnout | Anova p-value | χ2, OR (95% CI) | |
|---|---|---|---|---|
| Number, n | 86 | 54 | ||
| Women, n (%) | 45 (52.2%) | 24 (44.4%) | NS | |
| Age, yr | 30.8 ± 7.1 | 31.7 ± 7.4 | 0.51 | |
| Weight, Kg | 68.3 ± 13.4 | 67.0 ± 13.1 | 0.55 | |
| BMI, kg/m2 | 22.7 ± 3.2 | 22.4 ± 3.2 | 0.57 | |
| Rank /Level, n (%) | ||||
| Assistant | 6 (7.0%) | 4 (7.4%) | NS | |
| Associate | 2 (2.3%) | 2 (3.7%) | NS | |
| Director | 3 (3.4%) | 2 (3.7%) | NS | |
| Senior | 59 (68.6%) | 33 (61.1%) | NS | |
| Senior manager | 11 (12.8%) | 9 (16.6%) | NS | |
| Emotional exhaustion | 10.2 ± 3.5 | 37.9 ± 6.0 | ||
| Depersonalization | 6.6 ± 2.7 | 17.8 ± 3.9 | ||
| Accomplishment | 40.2 ± 2.0 | 29.6 ± 4.1 | ||
| Job strain | ||||
| Job control | 64.2 ± 8.4 | 67.7 ± 9.3 | ||
| Job demand | 27.1 ± 3.6 | 27.2 ± 3.5 | 0.5 | |
| Social support | 22.2 ± 4.3 | 22.1 ± 3.8 | ||
| Job satisfaction | 7.1 ± 1.5 | 5.7 ±1.9 | ||
| Quality of life (VAS) | 7.38 ± 1.29 | 7.07 ± 1.85 | 0.25 | |
| HAD anxiety | 7.1 ± 2.0 | 10.1 ± 3.4 | ||
| Score HADa > 10 | 30 (34.8%) | 7 (12.9%) | 35.9 | |
| HAD depression | 5.5 ± 2.4 | 6.7 ± 3.4 | ||
| Score HADd > 10 | 0 | 5 (100%) |
Table 2
| Control | Burnout | ANOVA p-value | χ2, OR (95% CI) | |
|---|---|---|---|---|
| TST, h | 6.9 ± 0.7 | 6.7 ± 0.8 | 0.16 | |
| TST week, h | 6.7 ± 0.8 | 6.5 ± 0.9 | 0.23 | |
| TST week end, h | 8.9 ± 1.1 | 8.8 ± 1.1 | 0.37 | |
| Difference, h | 2.3 ± 1.2 | 2.3 ± 1.5 | 0.98 | |
| Epworth Sleepiness Scale (ESS) (/24) | 9.7 ± 4.0 | 9.4 ± 4.8 | 0.67 | |
| ESS >10, n (%) | 46 (53.5%) | 28 (51.9%) | NS | |
| ESS > 12, n (%) | 26 (30.2%) | 17 (31.5%) | NS | |
| ESS > 14, n (%) | 16 (18.6%) | 11(20.4%) | NS | |
| ESS > 16, n (%) | 10 (11.6%) | 6 (11.0%) | NS | |
| Insomnia n (%) | ||||
| Insomnia | 11 (12.8%) | 41 (75.9%) | 57 | |
| Nb. troubles DSM 5 | 0.2 ± 0.7 | 1.6 ± 1.3 | ||
| Sleep latency disorder | 3 (3.5%) | 11 (29.6%) | 19 | |
| Nocturnal awaking | 7 (8.1%) | 21 (38.9%) | 20 | |
| Early awaking | 3 (3.5%) | 19 (35.2%) | 25 | |
| Non-restorative sleep | 7 (8.1%) | 27 (50.0%) | 32 | |
| Nap, n (%) | 11 (20.3%) | 18 (20.9%) | NS | |
| Snoring n (%) | 14 (25.9%) | 20 (28.3%) | NS |
Table 3
| Control | Burnout | p | χ2, OR (95% CI) | |
|---|---|---|---|---|
| Glycaemia, g/L | 0.82 ± 0.13 | 0.89 ± 0.14 | 0.001 | |
| Glycaemia > 0.8 g/L | 41 (47.7%) | 40 (70.1%) | 8.4 | |
| HbA1C, (% | 3.0 ± 0.51 | 4.66 ± 0.57 | <0.001 | |
| HbA1C > 3.5% | 14 (16.6%) | 52 (60.0%) | 78.4 | |
| CRP, mg/L | 1.2 ± 0.9 | 2.07 ± 1.8 | 0.001 | |
| CRP ≥ 3 mg/L | 7 (8.3%) | 14 (25.1%) | 6.9 | |
| TSH, mUI/L | 1.95 ± 0.63 | 1.95 ± 0.80 | 0.999 | |
| 25(OH)D, ng/mL | 28.9 ± 4.9 | 17.7 ± 6.9 | <0.001 | |
| 25(OH)D<20 ng/mL | 4 (4.7%) | 33 (58.9%) | 51.3 | |
| Total-cholesterol, mmol/L | 1.66 ± 0.33 | 1.81 ± 0.38 | 0.01 | |
| Triglycerides, mmol/L | 0.68 ± 0.35 | 0.74 ± 0.36 | 0.37 | |
| HDL, mmol/L | 0.62 ± 0.16 | 0.63 ± 0.15 | 0.48 | |
| LDL, mmol/L | 0.98 ± 0.32 | 1.03 ± 0.34 | 0.35 | |
| LDL/HDF | 0.70 ± 0.28 | 0.68 ± 0.28 | 0.78 | |
| Leukocytes, / mm3 | 5110 ± 535 | 6184 ± 1295 | <0.001 | |
| Neutrophils, / mm3 | 2460 ± 420 | 3418 ± 1248 | <0.001 | |
| Eosinophils, / mm3 | 155 ± 99 | 174 ± 126 | 0.32 | |
| Basophils, / mm3 | 39.5 ± 17.5 | 41.1± 19.8 | 0.61 | |
| Lymphocytes, / mm3 | 2002 ± 488 | 2068 ± 444 | 0.42 | |
| Monocytes, / mm3 | 463 ± 115 | 514 ± 133 | <0.001 | |
| Platelets, x 103 / mm3 | 253 ± 49 | 249 ± 44 | 0.68 |
Table 4
| Emotional Exhaustion | Depersonalization | Personal accomplishment | |
|---|---|---|---|
| Age | 0.01 | 0.02 | -0.1 |
| Job demand | 0.08 | 0.04 | 0.02 |
| Job control | 0.17 | 0.18 | -0.12 |
| Job satisfaction | -0.04 | -0.31 | 0.33 |
| Social support | -0.05 | -0.12 | 0.09 |
| Nb. sleep troubles (DSM 5) | 0.65 | 0.45 | -0.51 |
| ESS | 0.01 | -0.02 | -0.02 |
| TST | -0.1 | -0.01 | 0.09 |
| HADS Anxiety | 0.52 | 0.45 | -0.50 |
| HADS Depression | 0.26 | 0.18 | -0.28 |
| Leucocytes | 0.46 | 0.44 | -0.44 |
| PNN | 0.45 | 0.47 | -0.39 |
| Glycaemia | 0.28 | 0.21 | -0.26 |
| HBA1C | |||
| Total-cholesterol | 0.22 | 0.19 | -0.17 |
| 25(OH)D | -0.59 | 0.60 | |
| CRP | 0.28 | 0.15 | -0.20 |
Table 5
| 0.14 | 0.11 | -0.47 | 0.48 | |||
| 0.14 | 0.17 | -0.43 | 0.56 | |||
| 0.27 | 0.10 | -0.30 | 0.08 | |||
| 0.36 | 0.35 | |||||
| -0.25 | 0.12 | |||||
| -0.13 |
Table 6
| Ind. variable | Coefficient | Standard Error | Wald Statistic | p | OR | 95%CI |
|---|---|---|---|---|---|---|
| Job satisfaction | -0.46 | 0.14 | 9.745 | 0.002 | 0.62 | (0.41–0.84) |
| HADS anxiety | 0.41 | 0.11 | 13.506 | <0.001 | 1.51 | (1.21–1.88) |
| Job control | 0.08 | 0.02 | 7.657 | 0.006 | 1.08 | (1.02–1.15) |
| Job demand | -0.02 | 0.06 | 0.143 | 0.70 | 0.98 | (0.86–1.11) |
Table 7
| Ind. variable | Coefficient | Standard Error | Wald Statistic | p | OR | 95%CI |
|---|---|---|---|---|---|---|
| Job satisfaction | -0.41 | 0.17 | 5.93 | 0.02 | 0.67 | (0.48–0.92) |
| HADS anxiety | 0.38 | 0.13 | 7.28 | 0.007 | 1.40 | (1.02–1.79) |
| Job control | 0.08 | 0.03 | 6.30 | 0.01 | 1.09 | (1.02–1.16) |
| Job demand | -0.05 | 0.08 | 0.40 | 0.53 | 0.95 | (0.82–1.11) |
| Insomnia | 1.26 | 0.29 | 19.02 | <0.001 | 3.52 | (1.21–6.2) |
Table 8
| Ind. variable | Coefficient | Standard Error | Wald Statistic | p | OR | 95%CI |
|---|---|---|---|---|---|---|
| Job satisfaction | -0.17 | 0.31 | 0.31 | 0.58 | 0.84 | (0.46–1.54) |
| HADS anxiety | 0.42 | 0.21 | 4.00 | 0.05 | 1.52 | (1.01–2.30) |
| Job control | 0.04 | 0.05 | 0.62 | 0.42 | 1.04 | (0.94–1.15) |
| Job demand | -0.12 | 0.12 | 0.89 | 0.34 | 0.89 | (0.69–1.13) |
| HbA1C | 5.05 | 1.08 | 22.0 | <0.001 | 156 | (19.2–1293) |
Table 9
| Ind. variable | Coefficient | Standard Error | Wald Statistic | p | OR | 95%CI |
|---|---|---|---|---|---|---|
| Job satisfaction | -0.02 | 0.34 | 0.03 | 0.95 | 0.98 | (0.50–1.91) |
| HADS anxiety | 0.34 | 0.23 | 2.22 | 0.13 | 1.41 | (0.89–2.20) |
| Job control | 0.052 | 0.05 | 1.06 | 0.30 | 1.05 | (0.95–1.16) |
| Job demand | -0.19 | 0.14 | 1.84 | 0.17 | 0.83 | (0.69–1.13) |
| Insomnia | 0.96 | 0.47 | 4.17 | 0.04 | 0.2.6 | (1.11–6.5) |
| HbA1C | 5.42 | 1.40 | 14.9 | <0.001 | 226 | (14.4–3325) |
References
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