EDITORIAL http://dx.doi.org/10.5665/sleep.3826
Work-life Balance
Commentary on Salo et al. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. SLEEP 2014;37:1217-1225. James E. Gangwisch, PhD Department of Psychiatry, Division of Experimental Therapeutics, Columbia University, College of Physicians and Surgeons, New York, NY
Adequate quality work is vital for personal income and to fulfill human needs such as shaping personal identity, securing social status, and giving structure and purpose to daily life.1 We have always had to work, but the character of our work has changed dramatically since our ancestors lived as hunter-gatherers. Although the lives of hunter-gatherers were rather tenuous and short, their workloads were relatively modest, requiring only about 20 hours per week to acquire and prepare food, and to make tools, clothing, and shelter. They had a lot of latitude in how and when they performed their duties. It was not uncommon for men to spend five or six days hunting and then taking a week or two off for rest and leisure. Women could often collect enough plant foods in one day to feed their families for three days. Hunter-gatherer band societies were pretty egalitarian, had little social stratification, and ascribed equal status to hunters who were typically men and gatherers who were normally women.2 They received abundant social support by working within groups with strong kinship ties. The work lives of our ancestors were preferable in many respects to those in modern society. A standard workweek now is 40 hours, but in addition we commonly have long commute times and heavy family commitments that are often disproportionately born by women. How we perform our duties is often highly prescribed, allowing little latitude in when and how to accomplish our tasks. Paid vacation time off in Asian countries and the United States lags well behind those in Europe and Latin America. Specialization of labor has contributed toward social stratification with many jobs being ascribed lower status, pay, benefits, and job security. Adequate social support is lacking in many positions. The volume and nature of the work we perform today place us at increased risk for work-related stress and negative health outcomes. Allowing flexible working hours is one strategy to help employees lower stress and improve health. Flexible working hours has been defined as involving a continuous choice on behalf of employers, employees, or both, regarding the amount and the temporal distribution of working hours.3 Approximately 34% of workers in the European Union have some control over their working schedules, with large
differences between countries.4 In the United States, about 28% of individuals are able to vary the time they begin and end their work.5 Some of the more common types of flexible work schedules include flexible scheduling of shift work, flextime, overtime, scheduling of vacations and personal time, and taking unpaid leave. In this issue of SLEEP, Salo and colleagues6 report their findings from the Finnish Public Sector Study with of over 68,000 participants on the relationship between work time control and sleep disturbances. The present study has the largest sample size of any study so far in this area of research. The investigators found less control over work to be associated with greater sleep disturbances. The results are in agreement with previous studies that have shown lack of control over work time to be associated with less favorable health and psychosocial outcomes.1,7 There are a number of potential explanations for the association between lack of control over work time and sleep disturbances. Control over work time could allow individuals to better balance their work responsibilities with their private obligations, social lives, and leisure activities. Obtaining adequate social support outside of work could help lessen the impact of work related stress on sleep. Conversely, if employees are getting quality social support at work, then perhaps they would be able to tolerate longer work hours.8 Time for leisure activities can help with unwinding from a difficult day, and thereby facilitate sleep onset and sleep maintenance. Work time control could allow employees to regularize their circadian rhythms and practice the commonly recommended sleep hygiene technique of maintaining a regular sleep-wake schedule. High employee control over work time can also have negative unintended consequences. To accommodate other concerns, employees could choose to accumulate working hours into periods of increasing length without adequate intermediate rest periods.7 Workers may put too much emphasis on meeting shortterm outside social needs, resulting in compressed and irregular work schedules that increase the risk for disturbed sleep and sleepiness.9 One study found that low variability in working times in combination with high personal control over work time was associated with better sleep quality, fatigue recovery, and work-life balance.10 The present study by Salo found very high work time control to be associated with disturbed sleep in individuals who worked long hours, defined as working more than 40 hours per week.6 The authors theorized that those with very high work time control may have chosen to work longer hours and therefore allocate inadequate time to recuperate and unwind before going to sleep. If work time control is implemented primarily for the benefit of the employer, then the risk for negative consequences for
Submitted for publication May, 2014 Accepted for publication May, 2014 Address correspondence to: James E. Gangwisch, PhD, Department of Psychiatry, Division of Experimental Therapeutics, Columbia University, College of Physicians and Surgeons, New York, NY; Tel: (646) 774-8433; Fax: (212) 543-5200; E-mail: [email protected] SLEEP, Vol. 37, No. 7, 2014
1159
Editorial—Gangwisch
REFERENCES
the employees increases. Employers may choose to employ a flexible work schedule to decrease costs, maximize workflow, or to respond to production requirements.1 Employer initiated flexible labor contracts such as temporary, contingent, and part-time work often pay less, do not offer fringe benefits such as healthcare coverage, provide less job security, and include impaired working conditions. These flexible labor contracts disproportionately employ racial minorities, migrants, women, and those with lower credentials and incomes.11 Social inequalities have been found in the impact of some forms of flexible employment contracts on health and psychosocial outcomes.12 One of the limitations of the current study by Salo was that the sample comprised primarily female, white, Finnish civil servants, precluding the ability to explore inequalities, but the study was able to control for a range of different occupations.6 The findings of the study by Salo lend support to the hypothesis that increased control over work time by employees could improve sleep quality. Given the need for adequate sleep to properly recuperate from demanding work, implementing flexible work schedules could benefit employers by increasing employee productivity and morale.
1. Joyce K, Pabayo R, Critchley JA, Bambra C. Flexible working conditions and their effects on employee health and wellbeing. Cochrane Database Syst Rev 2010:CD008009. 2. Bates DG. Cultural anthropology. Needham Heights, MA: Allyn and Bacon, 1996. 3. Costa G, Akerstedt T, Nachreiner F, et al. As time goes by – flexible work hours, health and well-being. Final report for SALTSA. Stockholm: National Institute for Working Life, 2003. (Working Life Research in Europe, 8). 4. Burchell B, Fagan C, O’Brien C, Smith M. Working conditions in the European Union: the gender perspective. European Foundation for the Improvement of Living and Working Conditions, 2007. http://www. eurofound.europa.eu/publications/htmlfiles/ef07108.htm. 5. US Department of Labor. Bureau of Labor Statistics. Workers on flexible and shift schedules in 2004 Summary. July 1, 2005. http://www.bls.gov/ news.release/flex.nr0.htm. 6. Salo P, Ala-Mursula L, Rod NH, et al. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. Sleep 2014;37:1217-25. 7. Janssen D, Nachreiner F. Health and psychosocial effects of flexible working hours. Rev Saude Publica 2004;38 Suppl:11-8. 8. Tucker P, Rutherford C. Moderators of the relationship between long work hours and health. J Occupational Health Psychol 2005;10:465-76. 9. Costa G, Akerstedt T, Nachreiner F, et al. Flexible working hours, health, and well-being in Europe: some considerations from a SALTSA project. Chronobiol Int 2004;21:831-44. 10. Kubo T, Takahashi M, Togo F, et al. Effects on employees of controlling working hours and working schedules. Occup Med 2013;63:148-51. 11. Benach J, Amable M, Muntaner C, and Benavides F. The consequences of flexible work for health: are we looking at the right place? J Epidemiol Community Health 2002;56:405-6. 12. Artazcoz L, Benach J, Borrell C, Cortez I. Social inequalities in the impact of flexible employment on different domains of psychosocial health. J Epidemiol Community Health 2005;59:761-7.
CITATION Gangwisch JE.Work-life balance. SLEEP 2014;37(7):1159-1160. DISCLOSURE STATEMENT Dr. Gangwisch has indicated no financial conflicts of interest.
SLEEP, Vol. 37, No. 7, 2014
1160
Editorial—Gangwisch
Work-life Balance
Commentary on Salo et al. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. SLEEP 2014;37:1217-1225. James E. Gangwisch, PhD Department of Psychiatry, Division of Experimental Therapeutics, Columbia University, College of Physicians and Surgeons, New York, NY
Adequate quality work is vital for personal income and to fulfill human needs such as shaping personal identity, securing social status, and giving structure and purpose to daily life.1 We have always had to work, but the character of our work has changed dramatically since our ancestors lived as hunter-gatherers. Although the lives of hunter-gatherers were rather tenuous and short, their workloads were relatively modest, requiring only about 20 hours per week to acquire and prepare food, and to make tools, clothing, and shelter. They had a lot of latitude in how and when they performed their duties. It was not uncommon for men to spend five or six days hunting and then taking a week or two off for rest and leisure. Women could often collect enough plant foods in one day to feed their families for three days. Hunter-gatherer band societies were pretty egalitarian, had little social stratification, and ascribed equal status to hunters who were typically men and gatherers who were normally women.2 They received abundant social support by working within groups with strong kinship ties. The work lives of our ancestors were preferable in many respects to those in modern society. A standard workweek now is 40 hours, but in addition we commonly have long commute times and heavy family commitments that are often disproportionately born by women. How we perform our duties is often highly prescribed, allowing little latitude in when and how to accomplish our tasks. Paid vacation time off in Asian countries and the United States lags well behind those in Europe and Latin America. Specialization of labor has contributed toward social stratification with many jobs being ascribed lower status, pay, benefits, and job security. Adequate social support is lacking in many positions. The volume and nature of the work we perform today place us at increased risk for work-related stress and negative health outcomes. Allowing flexible working hours is one strategy to help employees lower stress and improve health. Flexible working hours has been defined as involving a continuous choice on behalf of employers, employees, or both, regarding the amount and the temporal distribution of working hours.3 Approximately 34% of workers in the European Union have some control over their working schedules, with large
differences between countries.4 In the United States, about 28% of individuals are able to vary the time they begin and end their work.5 Some of the more common types of flexible work schedules include flexible scheduling of shift work, flextime, overtime, scheduling of vacations and personal time, and taking unpaid leave. In this issue of SLEEP, Salo and colleagues6 report their findings from the Finnish Public Sector Study with of over 68,000 participants on the relationship between work time control and sleep disturbances. The present study has the largest sample size of any study so far in this area of research. The investigators found less control over work to be associated with greater sleep disturbances. The results are in agreement with previous studies that have shown lack of control over work time to be associated with less favorable health and psychosocial outcomes.1,7 There are a number of potential explanations for the association between lack of control over work time and sleep disturbances. Control over work time could allow individuals to better balance their work responsibilities with their private obligations, social lives, and leisure activities. Obtaining adequate social support outside of work could help lessen the impact of work related stress on sleep. Conversely, if employees are getting quality social support at work, then perhaps they would be able to tolerate longer work hours.8 Time for leisure activities can help with unwinding from a difficult day, and thereby facilitate sleep onset and sleep maintenance. Work time control could allow employees to regularize their circadian rhythms and practice the commonly recommended sleep hygiene technique of maintaining a regular sleep-wake schedule. High employee control over work time can also have negative unintended consequences. To accommodate other concerns, employees could choose to accumulate working hours into periods of increasing length without adequate intermediate rest periods.7 Workers may put too much emphasis on meeting shortterm outside social needs, resulting in compressed and irregular work schedules that increase the risk for disturbed sleep and sleepiness.9 One study found that low variability in working times in combination with high personal control over work time was associated with better sleep quality, fatigue recovery, and work-life balance.10 The present study by Salo found very high work time control to be associated with disturbed sleep in individuals who worked long hours, defined as working more than 40 hours per week.6 The authors theorized that those with very high work time control may have chosen to work longer hours and therefore allocate inadequate time to recuperate and unwind before going to sleep. If work time control is implemented primarily for the benefit of the employer, then the risk for negative consequences for
Submitted for publication May, 2014 Accepted for publication May, 2014 Address correspondence to: James E. Gangwisch, PhD, Department of Psychiatry, Division of Experimental Therapeutics, Columbia University, College of Physicians and Surgeons, New York, NY; Tel: (646) 774-8433; Fax: (212) 543-5200; E-mail: [email protected] SLEEP, Vol. 37, No. 7, 2014
1159
Editorial—Gangwisch
REFERENCES
the employees increases. Employers may choose to employ a flexible work schedule to decrease costs, maximize workflow, or to respond to production requirements.1 Employer initiated flexible labor contracts such as temporary, contingent, and part-time work often pay less, do not offer fringe benefits such as healthcare coverage, provide less job security, and include impaired working conditions. These flexible labor contracts disproportionately employ racial minorities, migrants, women, and those with lower credentials and incomes.11 Social inequalities have been found in the impact of some forms of flexible employment contracts on health and psychosocial outcomes.12 One of the limitations of the current study by Salo was that the sample comprised primarily female, white, Finnish civil servants, precluding the ability to explore inequalities, but the study was able to control for a range of different occupations.6 The findings of the study by Salo lend support to the hypothesis that increased control over work time by employees could improve sleep quality. Given the need for adequate sleep to properly recuperate from demanding work, implementing flexible work schedules could benefit employers by increasing employee productivity and morale.
1. Joyce K, Pabayo R, Critchley JA, Bambra C. Flexible working conditions and their effects on employee health and wellbeing. Cochrane Database Syst Rev 2010:CD008009. 2. Bates DG. Cultural anthropology. Needham Heights, MA: Allyn and Bacon, 1996. 3. Costa G, Akerstedt T, Nachreiner F, et al. As time goes by – flexible work hours, health and well-being. Final report for SALTSA. Stockholm: National Institute for Working Life, 2003. (Working Life Research in Europe, 8). 4. Burchell B, Fagan C, O’Brien C, Smith M. Working conditions in the European Union: the gender perspective. European Foundation for the Improvement of Living and Working Conditions, 2007. http://www. eurofound.europa.eu/publications/htmlfiles/ef07108.htm. 5. US Department of Labor. Bureau of Labor Statistics. Workers on flexible and shift schedules in 2004 Summary. July 1, 2005. http://www.bls.gov/ news.release/flex.nr0.htm. 6. Salo P, Ala-Mursula L, Rod NH, et al. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. Sleep 2014;37:1217-25. 7. Janssen D, Nachreiner F. Health and psychosocial effects of flexible working hours. Rev Saude Publica 2004;38 Suppl:11-8. 8. Tucker P, Rutherford C. Moderators of the relationship between long work hours and health. J Occupational Health Psychol 2005;10:465-76. 9. Costa G, Akerstedt T, Nachreiner F, et al. Flexible working hours, health, and well-being in Europe: some considerations from a SALTSA project. Chronobiol Int 2004;21:831-44. 10. Kubo T, Takahashi M, Togo F, et al. Effects on employees of controlling working hours and working schedules. Occup Med 2013;63:148-51. 11. Benach J, Amable M, Muntaner C, and Benavides F. The consequences of flexible work for health: are we looking at the right place? J Epidemiol Community Health 2002;56:405-6. 12. Artazcoz L, Benach J, Borrell C, Cortez I. Social inequalities in the impact of flexible employment on different domains of psychosocial health. J Epidemiol Community Health 2005;59:761-7.
CITATION Gangwisch JE.Work-life balance. SLEEP 2014;37(7):1159-1160. DISCLOSURE STATEMENT Dr. Gangwisch has indicated no financial conflicts of interest.
SLEEP, Vol. 37, No. 7, 2014
1160
Editorial—Gangwisch
