Stressed at work and difficulty sleeping? It's more serious than you think

Work-related stress and sleep disorders are badociated with a three-fold higher risk of cardiovascular death in hypertensive employees. This is the conclusion of the research published today in the European Journal of Preventive Cardiology, Journal of the European Society of Cardiology (ESC).

Professor Karl-Heinz Ladwig, professor at the German Research Center for Environmental Health and the Faculty of Medicine at the Technical University of Munich, said: "Sleep should be a time for recreation and relaxation and restoring energy levels If you are stressed at work, sleep helps you recover, but lack of sleep and work stress often go hand in hand, and badociated with high blood pressure, its effects are even more toxic. "

One third of the workforce is suffering from hypertension (high blood pressure). Previous research has shown that psychosocial factors have a greater adverse effect on people with pre-existing cardiovascular risks than on healthy people. This study was the first to examine the combined effects of work-related stress and sleep impairment on cardiovascular death in hypertensive workers.

The study included 1,959 hypertensive workers aged 25 to 65 years, without cardiovascular disease or diabetes. Compared with those who do not experience work stress and sleep well, the odds of death from cardiovascular disease were three times higher for those with both risk factors. People with only work-related stress were 1.6 times more likely, while those with little sleep were 1.8 times more likely to be at risk.

During an average follow-up of nearly 18 years, the absolute risk of cardiovascular death in hypertensive personnel increased gradually with each additional condition. Employees with both work stress and disrupted sleep had an absolute risk of 7.13 per 1,000 person-years, compared to 3.05 per 1,000 person-years for those without stress and healthy sleep. The absolute risks related to work stress alone or poor nights sleep were 4.99 and 5.95 per 1,000 person-years, respectively.

In the study, work stress was defined as work with high demand and poorly controlled – for example when an employer wants results but refuses to make decisions. "If you have high requirements but also high control, in other words, you can make decisions, it could even be positive for health," said Professor Ladwig. "But being trapped in a pressure situation that you have no power to change is harmful."

Sleep disorders are defined as difficulty falling asleep and / or staying asleep. "Maintaining sleep is the most common problem among people with stressful jobs," said Professor Ladwig. "They get up at 4 in the morning to go to the bathroom and come back to bed discussing how to deal with their work problems."

"These are insidious problems," said Professor Ladwig. "The risk is not having a hard day and no sleep.He suffers from stressful work and poor sleep for many years, which weakens energy resources and can lead to a grave early. "

The results are an alarm signal for doctors to ask patients with high blood pressure to talk about sleep and occupational stress, said Professor Ladwig. "Every condition is a risk factor in itself and there is cross-talk between them, which means that each one increases the risk of the other." Physical activity, healthy eating and relaxation strategies are important, as is a reduction in hypotensive treatment, if any. "

Employers should ensure stress management and treatment of sleep in the workplace, he added, especially for staff with chronic diseases such as hypertension.

Components of stress management group sessions:

• Start with 5 to 10 minutes of relaxation.
• Education on healthy lifestyle.
• Help to quit smoking, exercise, weight loss.
• Techniques to deal with stress and anxiety at home and at work.
• How to track progress in stress management.
• Improve social relations and social support.

Sleep treatment can include:

• Stimulus Control Therapy: Training designed to badociate the bed / bedroom with sleep and establish a coherent sleep-wake program.
• Relaxation training: progressive muscle relaxation and reduction of intrusive thoughts at bedtime that disrupt sleep.
• Sleep restriction treatment: to reduce the time spent in bed during sleep, thus inducing mild sleep deprivation and prolonging sleep time.
• Paradoxical intention therapy: stay awake in a pbadive way and avoid any effort (that is, the intention) to fall asleep, thereby eliminating anxiety.