Original Article Job stress, burnout, and job satisfaction in sleep apnea patients Ottavia Guglielmi a, *, Bernabé Jurado-Gámez b,c , Francisco Gude d , Gualberto Buela-Casal a a Sleep Unit, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain b Sleep Unit, Department of Respiratory Medicine, Reina Sofia University Hospital, Cordoba, Spain c Instituto Maimónides de Investigación Biomédica de Cordoba (IMIBIC), Cordoba, Spain d Clinical Epidemiology Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain A R T I C L E I N FO Article history: Received 27 January 2014 Received in revised form 2 April 2014 Accepted 5 May 2014 Available online 11 June 2014 Keywords: Obstructive sleep apnea syndrome Job stress Burnout Job satisfaction Sleep apnea Occupational health A B ST R AC T Objective: To assess job stress, burnout, and job satisfaction in patients with obstructive sleep apnea syn- drome (OSAS). Methods: A total of 182 patients with OSAS and 71 healthy individuals completed the Job Content Ques- tionnaire, the Maslach Burnout Inventory – General Survey, the Index of Job Satisfaction, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index. All participants were assessed with full-night polysomnography. Results: Survey scores of patients diagnosed with OSAS only differed from those of the control group in the emotional exhaustion dimension (P = 0.015). According to a multivariate analysis, the apnea– hypopnea index (AHI) was only correlated with perceived support at work (β coefficient = 0.142; P = 0.048). Associations were found between subjective sleep quality, perceived support from coworkers, and su- pervisors (β = 0.157; P = 0.025), psychological demands (β = 0.226; P = 0.001), emotional exhaustion (β = 0,405; P = 0.000), and cynicism (β = 0.224; P = 0.002). The study also revealed associations between excessive daytime sleepiness and the burnout dimensions emotional exhaustion (β = 0.232; P = 0.000) and cyni- cism (β = 0.139; P = 0.048). Conclusion: Objective parameters of OSAS such as the AHI seem to have limited influence on the psy- chosocial aspects of the occupational life of patients with OSAS. There is evidence of significant asso- ciations between the subjective symptoms of the disease, such as daytime sleepiness, subjective sleep quality, job stress, and burnout. © 2014 Elsevier B.V. All rights reserved. 1. Introduction Obstructive sleep apnea syndrome (OSAS) is a chronic breath- ing disorder characterized by repeated episodes of limited air flow during individuals’ sleep that lead to a decrease in nocturnal oxygen saturation and micro-awakenings [1]. In western societies, this syn- drome has a prevalence of 24% in middle-aged men and 9% in middle-aged women [2], and is associated with the development of hypertension, cardiovascular and cerebrovascular disorders and abnormalities in glucose metabolism [3]. OSAS has a variety of symptoms such as snoring, apneas re- ported by the bed partner, frequent awakenings and sleep agita- tion and fragmentation. Patients with OSAS experience fatigue and the feeling of having had non-restorative sleep. They often report morning headaches, mood changes (e.g. depression and anxiety [4,5]), cognitive difficulties (e.g. loss of short-term memory and longer reaction times [6,7]), and sexual problems [8]. Most of the functional difficulties reported by patients with OSAS are secondary to excessive daytime sleepiness (EDS), which is the symptom with the greatest impact of patients’ everyday life [9]. Due to EDS and its above-mentioned repercussions on patients’ phys- ical and cognitive function, such patients have a greater number of traffic accidents [10] and accidents at the workplace [11]. People diagnosed with OSAS or who exhibit symptoms of this disease have been found to have higher levels of absenteeism and work disabil- ity compared with controls [12], and EDS is often the most impor- tant factor determining the high prevalence of sick leave and the productivity decrease observed in such patients [13–15]. Some authors have explored the relationship between sleep dis- orders, job stress, and burnout syndrome. Workers who have a sleep disorder such as insomnia or OSAS have reported higher job stress compared with that of healthy individuals [16].A ˚ ´ kerstedt et al. [17] argue that sleep may be involved in the development of burnout, as individuals with symptoms of burnout also report sleep fragmentation. People with high levels of burnout syndrome are * Corresponding author at: Sleep unit, Brain and Behavior Research Centre (CIMCYC), Campus de Cartuja s/n, Universidad de Granada, 18011 Granada, Spain. Tel.: +34 615 944 645; fax: +34 958 16 17 08. E-mail address: ottavia@ugr.es (O. Guglielmi). http://dx.doi.org/10.1016/j.sleep.2014.05.015 1389-9457/© 2014 Elsevier B.V. All rights reserved. Sleep Medicine 15 (2014) 1025–1030 Contents lists available at ScienceDirect Sleep Medicine journal homepage: www.elsevier.com/locate/sleep