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职业倦怠中的睡眠与生物学参数:一项心理生理学特征研究。

Sleep and biological parameters in professional burnout: A psychophysiological characterization.

作者信息

Metlaine Arnaud, Sauvet Fabien, Gomez-Merino Danielle, Boucher Thierry, Elbaz Maxime, Delafosse Jean Yves, Leger Damien, Chennaoui Mounir

机构信息

Université Paris Descartes, Sorbonne Paris Cité, Hôtel Dieu, Paris, France.

APHP, Hôtel Dieu, Centre du sommeil et de la vigilance, Paris, France.

出版信息

PLoS One. 2018 Jan 31;13(1):e0190607. doi: 10.1371/journal.pone.0190607. eCollection 2018.

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.

摘要

职业倦怠综合征已被描述为与失眠以及代谢、炎症和免疫相关因素有关。我们调查了在白领中探索与倦怠症状相关的生物学参数和睡眠障碍的意义。将54名有倦怠症状的参与者与86名健康对照参与者在职业等级水平、睡眠、工作压力(Karasek问卷)、社会支持、焦虑和抑郁(HAD量表)方面进行了比较。评估了空腹血糖、糖化血红蛋白(HbA1C)、总胆固醇、甘油三酯、C反应蛋白(CRP)、促甲状腺激素(TSH)、25-羟基维生素D(25[OH]D)和白细胞(WBC)计数的浓度。进行方差分析和向前逐步多元逻辑回归以确定倦怠的预测因素。除了报告更多的工作压力(特别是工作控制,p = 0.02)、更高水平的焦虑(p<0.001)以及与失眠相关的睡眠障碍(OR = 21.5,95%CI = 8.8 - 52.3)外,有倦怠症状的参与者还表现出更高水平的HbA1C、血糖、CRP,更低水平的25(OH)D,更高数量的白细胞、中性粒细胞和单核细胞(所有P<0.001)以及更高的总胆固醇(P = 0.01)。特别是,当HbA1c>3.5%时,倦怠的患病率从16.6%增加到60.0%(OR = 4.3,95%CI = 2.8 - 6.9)。HbA1C与倦怠的两个维度(情感耗竭和去个性化,r = 0.79和r = 0.71,p<0.01)之间存在强显著正相关。包括工作压力、工作满意度、焦虑和失眠的模型不能预测倦怠(p = 0.30和p = 0.50)。然而,当纳入HbA1C水平时,倦怠的预测变得显著(P = 0.03)。我们的研究结果表明睡眠和生物学参数,特别是HbA1C水平,在职业倦怠的特征描述方面具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c709/5791983/73fa07717f89/pone.0190607.g001.jpg

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