Comorbid sleep disorders among patients presenting with insomnia who underwent polysomnography

Objective@#The aim of this study was to determine the comorbid sleep disorders on Polysomnography (PSG) of patients complaining of insomnia symptoms.@*Methodology@#This is a retrospective study among patients who underwent diagnostic and split-night polysomnography from April 2014 to February 2019. Those who had at least one of the following insomnia symptoms of difficulty initiating sleep, difficulty maintaining sleep and early morning awakening with or without a history of sleep aide use were identified as patients with insomnia. Polysomnography sleep parameters and outcome were tabulated and statistical analysis was done using SPSS v 20.0.@*Results@#Out of the 302 patients who were included in the study, 34.4% of subjects had a family history of sleep disorder and 70.4% had a history of sleep aide use. Among the medical comorbidities, 47.7% of the subjects were diagnosed with hypertension while 10.65% were diagnosed with psychiatric disorder. Most of the patients complained of both difficulty initiating sleep and early morning awakening. PSG sleep parameters showed that patients did not experience excessive daytime sleepiness or delayed sleep latency. On the other hand, poor sleep efficiency could be due to increased arousal index. Half of the patients turned out to have severe obstructive sleep apnea (52%) while 2.3% of the patients had periodic limb movement disorder. Among those diagnosed with severe OSA, 53.3% had a history of sleep aide use.@*Conclusion@#The study showed the importance of screening patients with insomnia for underlying comorbid sleep disorders. The American Academy of Sleep Medicine (AASM) treatment guidelines for chronic insomnia emphasized the need to have a high index of suspicion for this population in order to recommend diagnostic procedures such as polysomnography. Diagnosing a patient with insomnia to have an underlying sleep apnea and/or periodic limb movement disorder would change the course of management among patients with chronic insomnia and eventually avoid prescribing medications that could actually worsen the patient’s condition.

Long Commute Time and Sleep Problems with Gender Difference in Work–Life Balance: A Cross-sectional Study of More than 25,000 Workers

BACKGROUND: There is a lack of statistical analysis investigating the relationship between sleep problems and commute time in Korea. We aimed to analyze the association between representative health symptoms, sleep disturbances, and commute time according to working hours in Korea.METHODS: The 4th Korean Working Conditions Survey data were used for analysis, and unpaid family workers and workers who work fewer than three days in a week were excluded. Commute time, working hours, and sleep hours were assessed using self-reported questionnaires. Odds ratios (ORs) with 95% confidence intervals (CIs) for sleep problems were calculated using a multivariate logistic regression model with ≤10 min commute time as the reference group.RESULTS: Among a total of 28,804 workers (men = 14,945, women = 13,859), 2.6% of men and 3.2% of women experienced sleep problems. In both sexes, long commute time (51–60 minutes and >60 minutes) showed an increased OR [men, 2.03 (CI = 1.32–3.13) and 2.05 (CI = 1.33–3.17); women, 1.58 (CI = 1.05–2.39) and 1.63 (CI = 1.06–2.50), respectively]. In stratification analysis of working hours, long commute time (51–60 and > 60 minutes) showed an increased OR in men working >40 hours/week [2.08 (CI = 1.16–3.71) and 1.92 (CI = 1.08–3.41), respectively]. Furthermore, long commute time (41–50, 51–60, and >60 minutes) showed an increased OR in women working >40 hours/week [2.40 (CI = 1.27–4.55), 2.28 (CI = 1.25–4.16), and 2.19 (CI = 1.17–4.16), respectively]. Moreover, commute time >60 minutes showed an increased OR in women working ≤40 hours/week [1.96 (CI = 1.06–3.62)].CONCLUSION: This large cross-sectional study highlights that long commute time is related to sleep problems in both sexes. Shorter commute times and decreased working hours are needed to prevent sleep problems in workers.

Behavioral intervention for sleep problems in childhood: a Brazilian randomized controlled trial

Abstract Background: Sleep problems are common in children and can have an effect on behavioral and emotional functioning. Despite the importance of sleep for children's health, there is a lack of studies on this topic in Brazil. The aim of this study was to evaluate the efficacy of behavioral intervention for sleep problems in young children and to investigate the effects on their daytime behavior. Methods: Sixty-two children (ages 1-5; M = 2.3, SD= 1.3) with bedtime problems and night waking were randomized to a parent-based intervention or a wait list control group. After the waiting period, the wait list participants were offered treatment. The intervention was composed of five sessions over 2 months, during which the parents were educated on their child's sleep and received guidance on the establishment of sleeping schedules and routines and on the use of extinction and positive reinforcement techniques. Sleep patterns and behavior problems were assessed with parent-report measures. Sleep patterns were also assessed with actigraphy. Assessments were completed at pre-intervention, post-intervention, 1-month follow-up, and 6-month follow-up. Results: Children who received intervention showed greater baseline to post-treatment improvements in sleep latency, night waking, behavior such as resisting going to bed, the desire to sleep with their parents, and daytime behavior than the control group. These improvements were maintained at follow-up. Conclusions: We concluded that behavioral parent-based intervention is effective in improving the quality of sleep and the diurnal behavior of children. This study provides initial support for use of this protocol in psychology clinics/schools. Brazilian clinical trials registration, RBR-4kxxd5. Retrospectively registered on December 13, 2016.

Children's Sleep Habits Questionnaire - Infant Version / Questionário de Hábitos de Sono das Crianças - Versão de Neonatos

Abstract Objectives This study proposed a version of the Children's Sleep Habits Questionnaire for infants under 12 months (CSHQ-I). Methods The sample was comprised of 299 infants, aged between 2 weeks and 12 months. Results Exploratory factor analysis revealed four subscales: Bedtime Resistance, Sleep Anxiety, Positive Sleep Habits, and Daytime Sleepiness. The CSHQ-I total scale presented good test-retest reliability and internal consistency. The CSHQ-I also showed good concurrent validity, with significant associations found between the CSHQ-I total scale and subscales and a measure of infant sleep-wake behaviors. Conclusions The present study suggested the CSHQ-I as a reliable instrument to assess sleep problems in infants during the first year of life.

Resumo Objetivos Este estudo propôs uma versão do Questionário de Hábitos de Sono das Crianças para bebés com menos de 12 meses (CSHQ-I). Métodos Amostra composta de 299 bebés, entre duas semanas e 12 meses. Resultados A análise fatorial exploratória revelou quatros subescalas: resistência a ir para a cama, ansiedade do sono, hábitos de sono positivos e sonolência diurna. A escala completa do CSHQ-I apresentou boa confiabilidade teste-reteste e consistência interna. O CSHQ-I também mostrou boa validade concorrente, com associações significativas encontradas entre a escala completa e subescalas do CSHQ-I e uma medida de comportamentos de sono-vigília dos bebés. Conclusões O presente estudo sugeriu o CSHQ-I como um instrumento confiável para avaliar os problemas de sono em bebés durante o primeiro ano de vida.

Sleep problems in children and adolescents at pediatric clinics / 소아과

PURPOSE: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. METHODS: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. RESULTS: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children 2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. CONCLUSION: Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health.

Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011–2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality.

Prevalence Of Sleep Problems Among Those With Internet Gaming Disorder In Singapore

Internet gaming disorder (IGD) involves the excessive use of Internet games that can cause negative consequences like sleep problems, psychological distress, depression and anxiety. It is widely assumed that IGD is closely related with sleep problems, but studies on the topic are scant. Our study aims to explore the association between IGD and sleep problems. Methods: A total of 1085 participants, aged 13-40 years old reported playing Internet games in this self-administered, web-based survey. The instruments used for the study were socio-demographic questions, IGD Questionnaire, Life Satisfaction Scale, General Health Questionnaire-12 and Insomnia Severity Index. The cut-off point of 10 and above was used to establish the prevalence of sleep problems in this study. Logistic regression analysis was used to explore the association between socio-demographic factors, IGD and sleep problems. Results: The prevalence of sleep problems among those with IGD was 28.2%. Female online gamers (adjusted odds ratio, OR=0.7, 95% confidence interval (CI) = 0.5-0.9) were more likely to have sleep problems than males. Participants with secondary education (adjusted OR=1.9, 95% CI=1.2-3.0) and post- secondary education (adjusted OR=2.7, 95% CI= 1.2-6.0) were more likely to have sleep problems than those who had completed university. Participants with DSM-5 IGD were more likely to have sleep problems. Psychological distress (adjusted OR 4.8, 95% CI=3.6-6.7) and life satisfaction (B = -3.1, 95% CI= -4.0 to -2.2) was associated with sleep problems. Conclusion: Prevalence of sleep problems with IGD is higher among female gamers and is associated with increased psychological distress and decreased life satisfaction. Integrated health management is needed to promote good sleep hygiene among those diagnosed with IGD. ASEAN Journal of Psychiatry, Vol. 17 (1): July – December 2016: XX XX.

Prevalence of Self Reported Sleep Problems among Patients with HIV Infection in Sokoto, Nigeria.

Background: Sleep disturbance results in physical, mental and emotional disturbances among patients with HIV infection. In spite of these observations, studies of sleep problems among HIV patients from Sub-Saharan Africa are limited. Aim: To determine prevalence of sleep problems among patients with HIV infection in a north western Nigeria. Methodology: This is a cross sectional study among patients with HIV infection (n = 159) conducted in VCT (Voluntary Counselling and Testing) center of a teaching hospital in Sokoto, Nigeria. Questionnaire comprising of three sections including sociodemographic, sleep pattern, and psychiatric morbidity were administered to the subjects. Sleep pattern was assessed using clinical assessment variables such as early, middle, and late insomnia, presence of nightmare and non-restorative sleep. Psychiatric morbidity was assessed through the use of Hospital Anxiety and Depression Scale. Statistical analysis was performed with frequency distribution and Pearson’s chi square test to test for associations. A significance level of 5% was established. Results: The prevalence of sleeping problems among the subjects was 20%. Non-restorative sleep is the most prevalent sleep problem among the patients. Factors associated with sleep problems included being employed and presence of psychiatric morbidity. Conclusion: This study suggested that the prevalence of sleep problems among the patients with HIV infection is high. Routine screening for sleep problems is suggested.

Pediatric Polysomnographic Studies at a Tertiary-care Hospital in Singapore.

Objectives: To investigate the indications for conducting polysomnography studies and their outcomes. Methods: Retrospective analysis of pediatric polysomnography studies performed over a four-year period (2009-2012). Results: 425 diagnostic studies and 100 non-invasive positive-pressure ventilation titration studies were conducted. Of these, 389 were performed in male children. Obstructive sleep apnea was the most common diagnosis; 49.6% (211 studies). Other diagnoses included central apnea, narcolepsy, and periodic limb movement disorder. Night time symptoms (snoring, frequent night awakenings, restless sleep) were present in 294 children, and 161 children had daytime symptoms (excessive daytime sleepiness, early morning fatigue, poor concentration at school). 13 studies (2.5%) were inadequate for analysis, reflecting the challenges of conducting studies in children. Conclusion: Dedicated pediatric sleep laboratories with properly trained staff are important to minimize failure rates and diagnose these conditions accurately.

Relations between problems on sleeping and suicidal behaviors in middle school students / 中华流行病学杂志

Objective To understand the epidemiological characteristics and possible associations between sleeping problems and suicidal behaviors among middle school students.Methods A total of 13 817 middle school students were selected in Shenyang,Xinxiang,Chongqing and Guangzhou cities and cluster sampling method was used.Questionnaires would include information on demographics,quality of sleep,psychopathological status and suicidal behaviors.Pittsburgh Sleep Quality index (PSQI)and Adolescent Multidimensional Sub-health Questionnaire (MSQA) were used to assess the quality of sleep and psychosomatic symptoms,respectively.Rates on sleeping problems and suicidal behaviors were compared in students with specific characteristics.Effects related to sleeping problems and suicidal behaviors were analyzed,using the multivariate logistic regression model.Results The overall prevalence of problems related to sleeping among middle school students was 26.5％.28.2％ of the girls and 35.2％ of senior students reported as having more sleeping problems.Rates on suicide related ideation,planning and attempts were 16.6％,9.6％ and 4.7％,respectively.Girls reported more suicide ideation than boys.However,no gender differences were found in suicide planning or attempted suicide.It also suggested that the incidence of the suicidal behavior among students with sleeping problems was significantly higher than students without sleeping problems.Data from Multivariable logistic regression analysis showed that sleeping problems appeared as independent risk factors on suicidal behavior.Higher PSQI scores seemed coincide with the increased risk of suicidal behaviors.Students having sleeping time less than 5 hours per day showed higher risk of suicidal behaviors.Conclusion Problems on sleeping seemed a strong risk factor for suicidal behaviors among middle school students.Improvement on the quality of sleep and reasonable arrangement of sleeping time could help prevent related suicidal behaviors among middle school students.

Sueño: características generales: Patrones fisiológicos y fisiopatológicos en la adolescencia / Sleep: General Characteristics: Physiological and Pathophysiological Patterns in Adolescence / Sono: Características Gerais: Patrões fisiológicos e fisiopatológicos na adolescência

La adolescencia es una etapa crítica del desarrollo que se acompaña de múltiples cambios que afectan diversas funciones fisiológicas y psicológicas, dentro de las cuales se encuentra el sueño. En este estadio ocurre el cambio de los patrones de sueño de la infancia hacia el sueño del adulto. El sueño es un fenómeno complejo resultante de la interacción entre el funcionamiento del sistema neuroendocrino, los relojes biológicos y procesos bioquímicos, con aspectos ambientales, culturales y sociales que adquieren especial relevancia en esta etapa de la vida. La homeostasis de estos sistemas asegura al adolescente un crecimiento y desarrollo dentro de los parámetros fisiológicos esperados para esta etapa. La función reparadora del sueño y las consecuencias que su alteración produce en las funciones cognoscitivas, el desempeño diurno y la salud en general, ameritan ser estudiadas. Es necesario detectar tempranamente las alteraciones, problemas o trastornos del sueño en esta etapa vital, estudiar las posibles causas e intervenir oportunamente para evitar las consecuencias de una pobre calidad de sueño. Este artículo resume los resultados encontrados en la literatura científica actualizada sobre las características del sueño en la adolescencia y sus problemas más comunes.

Adolescence is a critical development period, related to multiple changes in physiological and psychological functions. Sleep is one of these important functions. At this stage, the childhood sleep pattern changes to the adult sleep pattern. Sleep is a complex phenomenon, resulting from the interaction between the neuroendocrine system function, the biological clock and biochemical processes, and environmental, social and cultural elements of special significance at this stage in life. The homeostasis of these systems ensures the adolescent's growth and development within the expected physiological parameters for this stage. The restorative function of sleep and the consequences of its alteration on cognition, daytime performance and health in general, ought to be studied. At this stage of life, it is necessary to detect sleep problems or disorders and to explore possible causes. Early therapeutic intervention is needed in order to avoid the consequences of poor sleep quality. This article summarizes the results found in the current scientific literature on sleep characteristics in adolescence and their common problems.

A adolescência é uma etapa crítica do desenvolvimento que se acompanha de múltiplas mudanças que afetam diversas funções fisiológicas e psicológicas, dentro das quais se encontra o sono. Neste estádio ocorre a mudança dos patrões de sono da infância para o sono de adulto. O sono é um fenômeno complexo resultante da interação entre o funcionamento do sistema neuroendócrino, os relógios biológicos e processos bioquímicos, com aspectos ambientais, culturais e sociais que adquirem relevância especial nesta etapa da vida. A homeostase destes sistemas assegura ao adolescente um crescimento e desenvolvimento dentro dos parâmetros fisiológicos esperados para esta etapa. A função reparadora do sono e as consequências que sua alteração produz nas funções cognoscitivas, o desempenho diurno e a saúde em geral, merecem ser estudadas. É necessário detectar precocemente as alterações, problemas ou transtornos do sono nesta etapa vital, estudar as possíveis causas e intervir oportunamente para evitar as consequências de uma pobre qualidade de sono. Este artigo resume os resultados encontrados na literatura científica atualizada sobre as características do sono na adolescência e seus problemas mais comuns.

The mediating role of mindfulness level on relationship between perceived stress and sleep problems / 中华行为医学与脑科学杂志

Objective To investigate the relationships among perceived stress,mindfulness level,and sleep problems,and to indicate the mediating role of mindfulness level in the relationship between perceived stress and sleep problems.Methods For 179 undergraduate students,the Five Facet Mindfulness Questionnaire (FFMQ),Chinese Perceived Stress Scales (CPSS) and Athens Insomnia Scale (AIS) were used to measure.Results The scores of the scales were (120.43 ± 1 1.23) for FFMQ,(40.17 ± 6.86) for CPSS and (5.28 ± 4.04)for AIS.Pearson correlation analysis showed that perceived stress was negatively correlated to mindfulness level (r =-0.602,P =0.000) and positively correlated to sleep problems (r =0.459,P =0.000) and that there was significant negative correlation between mindfulness level and sleep problems (r =-0.427,P =0.000).Hierarchical linear modeling showed significant partial mediation of mindfulness level on the association between perceived stress and sleep problems.Conclusion Mindfulness level partly mediated the positive link between perceived stress and sleep problems.

Sleep problems in children with developmental behavioral disorder / 国际儿科学杂志

It has been showed that sleep problems are prevalent in children,affecting children's cognitive and neurobehavioral development.This paper reviews currently available evidence on sleep characteristics in children with attention deficit hyperactivity disorder,Tourette's Syndrome,emotional disorders and autism spectrum disorders,in order to understand the relationship between these developmental behavioral disorders and sleep problems,and the present therapies for these children.

Sleep Problems in Preschool and School Aged Rural Indian Children.

We assessed 513 children (2-6 y = 252; 7-12 y = 261) who visited the pediatric outpatient of a rural medical college hospital, for sleep problems using ‘BEARS’ tool. Sleep problems detected in the BEARS domains for preschool (2-6 years, n=252) and school children (7-12 years, n=261) were as follows: bedtime problems (33.3% vs 14.9%, P<0.001), excessive daytime sleepiness (32.5% vs 1.9%, P<0.001), awakening during night (25% vs 11.87%, P<0.001), regularity and duration of sleep (19.84% vs 4.98%, P<0.001), and sleep disordered breathing (4.8% vs 5%, P=0.1). We conclude that sleep problems are common among rural Indian children and should be routinely screened for during health visits.

Impact of television-watching and computer-using on sleep patterns and sleep problems of school-aged children in Shanghai / 上海第二医科大学学报

Objective To investigate the effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems of school-aged children in Shanghai. Methods A total of 4 108 school-aged children from 10 primary schools of Shanghai were enrolled by multi-stage cluster sampling and surveyed by questionnaires. The information of television-watching and computer-using, family and personal condition was investigated by self-prepared questionnaire, and the Chinese version of Children's Sleep Habits Questionnaire was employed to survey the sleep behaviors of children. The effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems were analyzed by multiple linear regression analysis and Logistic regression analysis. Results The percentage of children who watched television≥2 h per day was 4.1% during weekdays, and that came to 49.2% during weekends. In terms of frequency of computer-using, most children reported "rarely" (88.2%, 0-1 time/week), followed by "often" (11.0%, 2-4 times/ week) and "usually" (0.8%, 5-7 times/week). With the age increase, the percentages of children who watched television≥2 h per day and those who "often" used computer gradually increased. It was revealed by multiple linear regression analysis and Logistic regression analysis that television-watching and computer-using were not only positively correlated with later bedtime, later wake time and shorter sleep duration but also significantly associated with sleep problems such as bedtime resistance, sleep onset delay, sleep duration disorder, sleep anxiety and parasomnia. Conclusion Television-watching and computer-using exert influences on sleep behaviors of sleep/wake patterns, sleep duration and sleep problems. Concerns about the potential negative effects of television-watching and computer-using on sleep behaviors may help to promote healthy sleep patterns and improve sleep quality.

Investigation in sleep problems of infants and analysis of its influencing factors / 中国实用护理杂志

ObJective To acknowledge the sleep status of infants and analyze the influencing factors of sleep problems in them. Methods The sleep status of 136 infants and its influencing factors were investigat-ed using questionnaires, the results underwent descriptive analysis, single-factor analysis and multifactor anal-ysis. Results Difficulty in falling asleep was the major sleep problems, then was frequent night awakening. The influencing factors included: family type, education degree of the parents, inhabited environment, the feed-ing mode after birth, the period of supplementary protein dietary addition, the times of taking food through the night, and the sleep position, the bed, the emotion when falling asleep, etc. Conclusions Sleep problems is ubiquity in infants,and the unproper child rearing behaviors is the major influencing factor. In order to prevent sleep problems in infants and improve the quality of sleep in them, the parents need health guidance.

Combined Effects of Individual Background, Work Shift and Job Stress on the Prevalence of Sleep Problems in Hospital Employers

BACGROUND: The accuracy and efficiency of a job performed by hospital employee can be linked directly with patients' health and life. It is considered that their irregular work and stress are relatively high as compared with other workplaces. In this article we tried to look into how job stress, working environment and factors of life-style influence sleep problems in hospital employees. METHODS: This research was conducted among 248 workers of a hospital in Busan on April, 2002. Sleep problems were categorized into insomnia, sleep deprivation, daytime sleepiness and snoring on the basis of the factor analysis of 11-item questions. The job stress was proposed by Karasek, etc., and measured by 14-item modified questions. The statistical analysis was conducted using Chi-square test and multiple logistic regression analysis. RESULTS: Statistically insomnia, sleep deprivation and daytime sleepiness showed a significant increase in women (OR:2.1/2.69/3.16) and shift workers (OR:4.67/3.28/1.98) and snoring showed a significant increase in obesity (OR:5.0) and smokers (OR:2.34). CONCLUSION: This research showed that many hospital employees perceive sleep disorders as critical. Especially, work shift seemed to be an important risk factor for sleep disorders.

Combined effects of job strain, shift work and life style on the prevalence of sleep problems in middle aged men

BACKGROUND: There are a few studies on the effects of job strain on the prevalence of sleep problems in the foreign countries. In Korea, it has not been studied till now. In this article, the combined effects of job strain, shift work and some life style on the prevalence of sleep proplems were studied among workers in middle aged men. METHODS: 998 cases were chosen from 1109 men who visited health screening center from October to November, 1999. Sleep problems were categorized to insomnia, sleep deprivation, daytime sleepiness and snoring on the base of result of factor analysis of 11 questions. Job strain was measured by 11 questions which developed by Karasek and Theorell. All data set were analyzed using Chi square test and multiple logistic regression analysis. RESULTS: The 4 sleep proplems were analyzed by multiple logistic regression analysis in relation to job strain, shift work, occupation, obesity, sedentary life style, smoking, drinking. Insomnia was increased significantly from highest job strain group(Odds ratio (OR:2.02)) and non exercise group(OR:2.05). In these groups, daytime sleepiness was increased significantly(OR=1.92 in the highest job strain group, OR=1.72 in non exercise group). Sleep deprivation was increased in the highest job strain group(OR=2.18), managers & clerks(OR:1.67) and non exercise group(OR:1.78). Snoring was increased from BMI(Body mass index)> OR =25(OR=1.77), BMI> OR =27(OR=2.80) and non exercise group(OR:1.87). CONCLUSION: In the highest job strain group, insomnia, sleep deprivation and daytime sleepiness was increased significantly. And sedentary life style increased all sleep problems.