Sleep Quality – A Potential Link in the Relation Between Occupational Stress and Inflammation

Job stress by effort-reward imbalance (ERI) is a predictor of burnout. Job stress is associated with inflammation, that is a forerunner of distal outcomes, including mortality. Sleep quality, an important association between job stress and inflammation has not been extensively studied. A cross-sectional study was conducted to examine the relationship between job stress, sleep quality, and inflammation among female nurses. As the primary outcome measure, a composite inflammation score was constructed from five interleukins (IL-6, 8, 10, 1β, TNF-α). Among fifty participants (mean age 32±7 years, work experience 105±8 months), there was poor sleep quality among the high ERI group (p=0.021). Overcommitment(OC), an intrinsic component of the ERI, was related to poor sleep quality (β =0.21, p =0.025). High OC (β =2.4, p = 0.025) and increased sleep latency (β = 8.3, p =0.027) were associated with elevated inflammation. There was a significant interaction between ERI and OC on inflammation (β =5.186, p =0.017) and conditional effects of ERI on OC to inflammation only in the high ERI group (p =0.002), not in the low ERI group (p = 0.839). Composite inflammation scores from various inflammatory markers may be potential indicators of adverse outcomes in burnout studies among healthcare workers.