Tadahiro OHTSU, et al: Association between Working Hours and Sleep Duration

J Occup Health 2013; 55: 307311

307

Journal of
Occupational Health

Brief Report

A Cross-sectional Study of the Association between Working

Hours and Sleep Duration among the Japanese Working
Population
Tadahiro Ohtsu1, Yoshitaka Kaneita2, Sayaka Aritake3, Kazuo Mishima4,
Makoto Uchiyama5, Tsuneto Akashiba6, Naohisa Uchimura7, Shigeyuki Nakaji8,
Takeshi Munezawa9, Akatsuki Kokaze1 and Takashi Ohida10
Department of Public Health, Showa University School of Medicine, Japan, 2Department of Public Health and
Epidemiology, Faculty of Medicine, Oita University, Japan, 3Department of Somnology, Tokyo Medical University,
Japan, 4Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and
Psychiatry, Japan, 5Department of Psychiatry, Nihon University School of Medicine, Japan, 6Department of Sleep
and Respiratory Medicine, Nihon University School of Medicine, Japan, 7Department of Neuropsychiatry, Kurume
University School of Medicine, Japan, 8Department of Social Medicine, Hirosaki University Graduate School of
Medicine, Japan, 9ADVANTAGE Risk Management Co., Ltd., Japan and 10Department of Public Health, Nihon
University School of Medicine, Japan
1

Abstract: A Cross-sectional Study of the Association between Working Hours and Sleep Duration
among the Japanese Working Population: Tadahiro
OHTSU, et al. Department of Public Health, Showa
University School of Medicine, JapanObjectives:
This study aimed to clarify the association between long
working hours and short sleep duration among Japanese workers. Methods: We selected 4,000 households from across Japan by stratied random sampling
and conducted an interview survey of a total of 662
participants (372 men; 290 women) in November 2009.
Logistic regression analyses were performed using
sleep duration <6 hours per day as a dependent variable to examine the association between working
hours/overtime hours and short sleep duration. Results:
When male participants who worked for 7 but <9 hours
per day were used as a reference, the odds ratio (OR)
for short sleep duration in those who worked for
11 hours was 8.62 (95% confidence interval [CI]:
3.9418.86). With regard to overtime hours among men,
when participants without overtime were used as a
reference, the OR for those whose period of overtime
was 3 hours but <4 hours was 3.59 (95% CI:
1.429.08). For both men and women, those with long
weekday working hours tended to have a short sleep
Received Nov 6, 2012; Accepted Apr 5, 2013
Published online in J-STAGE May 2, 2013
Correspondence to: Y. Kaneita, Department of Public Health and
Epidemiology, Faculty of Medicine, Oita University, 11 Hasamamachi Idaigaoka, Yufu City, Oita 879-5593, Japan (e-mail: kaneita.
yoshitaka@gmail.com)

duration during weekdays and holidays. Conclusions:

It is essential to avoid working long hours in order to
prevent short sleep duration.
(J Occup Health 2013; 55: 307311)
Key words: Holiday, Overtime hours, Sleep duration,
Weekday, Working hours

Van der Hulst reviewed studies published between

January 1996 and June 2001 on the association
between long working hours and health and identified 6 studies that had used sleep hours as one of the
outcome measures1). All of those studies had been
conducted in Japan; one used a longitudinal design2),
and the others used a cross-sectional design 37) .
Among them, only one focused on the association
between sleep and working hours7).
In November 2010, Kobayashi et al. conducted a
systematic review of studies published in 1998 or later
on the role played by sleep duration in the association
between working hours and cerebrovascular/cardiovascular diseases8). They found only two reports on the
association between working hours and sleep duration
(a cohort study in the UK9) and a large-scale crosssectional study in Australia 10)) and recommended
further studies on this issue8).
Here we provide new data regarding the association
between long working hours and short sleep duration,
although our approach was limited by being a crosssectional survey with a small sample size.

308

Materials and Methods

The subjects of this study were selected as
follows. A total of 4,000 households were randomly
selected across the country, and 2,206 adults were
home when the researchers visited the households;
1,224 of them (539 men and 685 women; response
rate: 55.5%) agreed to participate in the interview
survey11). Of these, 662 (372 men; 290 women) were
employed, and their data were analyzed. The duration of the survey was 1 month (November 2009).
Approval was obtained from the Ethics Committee for
Epidemiological Studies of Nihon University School
of Medicine before the study began.
The survey included the following items: (1) sex,
age, years of schooling completed (junior high/high
school/college or university) and size of the city of
residence (19 large cities/other cities/towns or villages); (2) working hours and overtime (extra working)
hours per weekday; and (3) sleep duration per day
on weekdays (workdays) and holidays (Sundays or
days off). Regarding (2) and (3), participants were
requested to select an answer about their status in
the past month from among the categorical answer
options provided. We did not ask about work patterns
or burden of housework.
In our statistical analyses of working and overtime hours per weekday and sleep duration per day
on weekdays and holidays, the composition in each
category was calculated based on sex. The univariate logistic regression analyses used sleep duration
<6 hours per day as a dependent variable and working hours or overtime hours as an explanatory variable and were performed for weekdays and holidays
according to sex. Each model was adjusted for age
class, years of schooling completed and size of the
city of residence. The significance level was set at
5% (two-sided), and the IBM SPSS Statistics 20 software package was used for statistical analysis.
In Japan, overtime is defined as extra working hours
that exceed 40 hours per week, excluding breaks, but
including working hours on holidays (according to
the Ministry of Health, Labour and Welfare integrated
measures for prevention of health problems caused by
overwork).

Results
Working hours, overtime hours and sleep duration
are shown in Table 1 (classified according to sex).
A large difference was observed between men and
women with regard to working hours and overtime
hours per weekday. The proportions of the participants with <6 hours sleep per day on weekdays and
holidays were 34.8% and 16.8%, respectively, among
men and 44.3% and 27.0%, respectively, among

J Occup Health, Vol. 55, 2013

Table 1. Gender-based working hours, overtime hours and

sleep duration
Men

Women

n=372

Working hours per weekday

<5 h
5.1
5 h, <7 h
10.8
7 h, <9 h
51.4
9 h, <11 h
21.9
11 h
10.8

27.2
22.6
36.2
6.3
7.7

Overtime hoursc per weekday

None
41.3
<2 h
30.9
2 h, <3 h
9.9
3 h, <4 h
6.6
4 h
11.3

71.8
23.2
2.5
0.7
1.8

Sleep duration on weekdaysd

<6 h
34.8
6 h, <7 h
40.4
7 h, <8 h
19.1
8 h
5.7
Sleep duration on holidayse
<6 h
16.8
6 h, <7 h
28.4
7 h, <8 h
33.2
8 h, <9 h
17.8
9 h
3.8

p valueb

n=290a

<0.001

<0.001

0.002
44.3
40.8
13.5
1.4
<0.001
27.0
39.1
22.8
6.6
4.5

(%)

In each section, the response I do not know was excluded

from the statistical analyses. b 2 test. cExtra working hours.
d
Workdays. eSundays or days off.
a

women. Thus, significant differences were observed

between men and women for sleep duration on
weekdays and holidays. The average ages (standard
deviation) of the men and women were 45.0 (13.7)
and 45.3 (12.6) years, respectively, and no significant
age-related difference was observed (Mann-Whitney U
test; p=0.491).
The results of the logistic regression analyses using
sleep duration <6 hours per day as a dependent variable are shown in Table 2. When participants working
7 but <9 hours per day were used as a reference, the
odds ratio (OR) for sleep duration <6 hours per day
on weekdays was significantly higher among those
working 9 hours per weekday. In the same group of
participants, the OR for holidays was also significantly high. With regard to overtime hours, when participants without overtime were used as a reference, the
OR for having sleep duration <6 hours per day on

309

Tadahiro OHTSU, et al: Association between Working Hours and Sleep Duration

Table 2. Logistic regression analyses using sleep duration <6 hours per day as a dependent variablea
Sleep duration on weekdaysb
Explanatory variables

nd

Men
Working hours per weekday
<7 h
58
7 h, <9 h
190
9 h, <11 h
81
11 h
40
e
Overtime hours per weekday
None
150
<2 h
111
2 h, <3 h
36
3 h, <4 h
24
4 h
41

Sleep duration on holidaysc

AOR

95% CI

p value

nd

AOR

95% CI

p value

1.67
1.00
2.76
8.62

0.833.36
Reference
1.574.86
3.9418.86

0.152

3.69
1.00
2.71
5.59

1.598.55
Reference
1.275.79
2.4312.86

0.002

<0.001
<0.001

57
190
81
40

0.010
<0.001

1.00
0.91
1.05
3.59
3.46

Reference
0.521.62
0.462.37
1.429.08
1.647.30

0.757
0.912
0.007
0.001

150
111
35
24
41

1.00
0.55
0.28
2.02
1.45

Reference
0.251.18
0.061.28
0.735.62
0.623.41

0.123
0.101
0.179
0.396

1.13
1.58
1.00
2.51

0.602.10
0.833.03
Reference
1.175.39

0.018

78
65
104
40

1.45
1.46
1.00
2.23

0.712.94
0.703.06
Reference
0.975.12

1.00
1.58
0.68

Reference
0.882.82
0.212.20

0.125
0.520

203
66
14

1.00
1.31
0.71

Reference
0.692.49
0.182.76

Women
Working hours per weekday
<5 h
78
5 h, <7 h
65
7 h, <9 h
104
9 h
40
Overtime hourse per weekday
None
203
<2 h
66
2 h
14

0.709
0.167

0.308
0.318
0.060

0.417
0.620

Working hours and overtime hours were used as explanatory variables (univariate analysis). Each model was
adjusted for age class, years of schooling completed and size of the city of residence. bWorkdays. cSundays or
days off. dIn each section, the response I do not know was excluded from the statistical analyses. eExtra working
hours. AOR, adjusted odds ratio; CI, confidence interval.
a

weekdays was 3.59 (95% confidence interval [CI]:

1.429.08) among those working 3 but <4 hours
overtime and 3.46 (95% CI: 1.647.30) among those
working 4 hours overtime, indicating significantly
high ORs. No significant OR was observed regarding
holidays. Among women, the OR for sleep duration <6 hours per day on weekdays was significantly
higher among those working 9 hours per day and
that for holidays among the same group was 2.23 (95%
CI: 0.975.12). There was no significant OR with
regard to overtime hours.

Discussion
The results of this study show that the OR for sleep
duration <6 hours per day was significantly higher
among men working 9 hours per day or 3 hours
overtime. The overall total of overtime was equivalent to >60 hours per month. In Japan, an amendment to the relevant law in 2005 made it obligatory
for overworked workers to receive health guidance via

an interview with a physician12). According to this

legislation, 80 hours overtime per month (approximately 4 hours overtime per day) would prevent workers from sleeping the required total of approximately
6 hours per day13). The results of our study suggest a
need to review this claim and are therefore noteworthy. Kageyama and colleagues reported a significant
negative association between 60 hours overtime per
month in the previous 3 months and sleep length on
weekdays among Japanese white-collar workers7).
Almost half of the women in this study worked
<7 hours per day, and most appeared to be parttime workers. For this group of women, the OR for
having <6 hours sleep was high among those working 9 hours, as seen in men. In addition, although
more than 70% of women did not work overtime, the
proportions of those with <6 hours sleep on weekdays
and holidays were higher than in men. The burden of
doing housework in addition to employed work may
explain this result. From our results, it is unclear to

310

what extent long working hours were associated with

short sleep duration among women.
A cohort study conducted in the UK reported
that the OR for short sleep duration (<7 hours) was
3.24 (95% CI: 1.457.27) among subjects working
>55 hours per week when those with 3540 working hours per week were used as a reference9). In
addition, large-scale cross-sectional studies conducted
in Australia10) and the USA14) indicated that short
sleep duration was associated with working long
hours. The findings of these overseas studies appear
to support our results, although the classifications of
working hours and sleep duration differed.
In the present study, both men and women with
long weekday working hours tended to have a short
sleep duration (<6 hours) on weekdays as well as
holidays. Two possible explanations for this are (1)
that people working long hours on weekdays spend
holidays attending to personal matters that cannot be
taken care of on weekdays and (2) that they became
accustomed to a short sleep duration. Kageyama and
colleagues reported that the amount of overtime was
positively correlated with the amount of time spent
sleeping on the nights before holidays4); however, a
later report stated that sleep length before holidays
was inversely correlated with overtime7). This latter
result concurs with that of our study.
This study had some limitations. First, the
response rate was not particularly high (55.5%). It is
possible that only respondents with enough spare time
tended to participate in this survey. Thus, working
hours may have been underestimated. In addition, as
the ORs in Table 2 for both male and female participants working <7 hours per day were >1, selection
bias caused by the low response rate would have led
to underestimation of the present findings. Second,
the types of jobs varied, and we did not investigate
items that might have affected sleep duration, such
as presence/absence of shift work, commuting time
and family composition. Third, questions on whether
participants worked full-time or part-time and had
housework burdens such as child-rearing and nursing care were not asked; these issues are particularly
relevant to women. Belenky and colleagues stated
in a recent report that occupational sleep medicine
is a new field within sleep medicine15). We hope to
design a survey investigating sleep problems in terms
of occupational health, in which the aforementioned
limitations will be corrected.
This study examined the associations between working hours and sleep duration. Long working hours
were associated with short sleep duration (<6 hours).
In men, the OR for short sleep duration was significantly higher among participants with 3 hours of
overtime per day. In addition, sleep duration was

J Occup Health, Vol. 55, 2013

short on weekdays as well as on holidays among

people with long working hours. It is essential to
avoid working long hours in order to prevent short
sleep duration.
Acknowledgments: This study was supported
by a Health Science Research Grant from the
Japanese Ministry of Health, Labour and Welfare
(H20-Junkankitou-Ippan-002). The authors are very
grateful to Dr. Hideyasu Aoyama, professor emeritus
at Okayama University, for providing us with strong
motivation while developing this report.

References
1) van der Hulst M. Long workhours and health. Scand
J Work Environ Health 2003; 29: 17188.
2) Nakanishi N, Nakamura K, Ichikawa S, Suzuki K,
Tatara K. Lifestyle and the development of hypertension: a 3-year follow-up study of middle-aged
Japanese male office workers. Occup Med 1999; 49:
10914.
3) Hayashi T, Kobayashi Y, Yamaoka K, Yano E. Effect
of overtime work on 24-hour ambulatory blood
pressure. J Occup Environ Med 1996; 38: 100711.
4) Kageyama T, Nishikido N, Kobayashi T, Kurokawa Y,
Kaneko T, Kabuto M. Long commuting time, extensive overtime, and sympathodominant state assessed
in terms of short-term heart rate variability among
male white-collar workers in the Tokyo megalopolis.
Ind Health 1998; 36: 20917.
5) Sasaki T, Iwasaki K, Oka T, et al. Effect of working
hours on cardiovascular-autonomic nervous functions in engineers in an electronics manufacturing
company. Ind Health 1999; 37: 5561.
6) Sasaki T, Iwasaki K, Oka T, Hisanaga N.
Association of working hours with biological indices related to the cardiovascular system among
engineers in a machinery manufacturing company.
Ind Health 1999; 37: 45763.
7) Kageyama T, Nishikido N, Kobayashi T, Kawagoe
H. Estimated sleep debt and work stress in Japanese
white-collar workers. Psychiatry Clin Neurosci
2001; 55: 2179.
8) Kobayashi T, Takao S, Doi H. Review of the literature on the role of sleep duration in the association
between working hours and cerebrovascular/cardiovascular diseases. Occupational Health Journal 2011;
34: 6671 (in Japanese).
9) Virtanen M, Ferrie JE, Gimeno D, et al. Long
working hours and sleep disturbances: the Whitehall
II prospective cohort study. Sleep 2009; 32: 73745.
10) Magee CA, Iverson DC, Caputi P. Factors associated with short and long sleep. Prev Med 2009; 49:
4617.
11) Ohtsu T, Kaneita Y, Aritake S, et al. Preferable
forms of relaxation for health promotion, and the
association between recreational activities and selfperceived health. Acta Med Okayama 2012; 66:
4151.

Tadahiro OHTSU, et al: Association between Working Hours and Sleep Duration

12) Iwasaki K, Takahashi M, Nakata A. Health problems due to long working hours in Japan: working
hours, workers compensation (Karoshi), and preventive measures. Ind Health 2006; 44: 53740.
13) Wada O. Occupational and life-style risk factors
and prevention of Karoshi. Occupational Health
Review 2002; 14: 183213 (in Japanese).

311

14) Krueger PM, Friedman EM. Sleep duration in the

United States: a cross-sectional population-based
study. Am J Epidemiol 2009; 169: 105263.
15) Belenky G, Wu LJ, Jackson ML. Occupational sleep
medicine: practice and promise. Prog Brain Res
2011; 190: 189203.