Clustering of health behaviors in male workers and comparisons of incidences of insomnia, sleep apnea, and depression between non-restorative sleep and restorative sleep

Promoting sleep health among workers is essential. This study examined the differential risks of developing insomnia, sleep apnea, and depression due to health behaviors underlying non-restorative sleep (NRS) and restorative sleep (RS). This study included 51,351 male Japanese workers aged 40 to 59 years who had undergone national health check-ups in 2015. The workers were clustered based on health behaviors, such as frequency and amount of alcohol consumption, smoking, and exercise, and body mass index (BMI), to identify patterns in health behaviors. These clusters were then stratified into those with NRS and those with RS. Follow-up surveys were conducted to calculate the incidence rates of insomnia, sleep apnea, and depression and to compare disease onset risks. The follow-up period was from the date of the health checkup to May 2018. Four clusters of health behaviors were identified in the male workers: cluster 1, drinking and rarely smoking; cluster 2, rarely consuming alcohol; cluster 3, high BMI and occasional heavy drinking; and cluster 4, daily alcohol consumption and smoking. The incidence of sleep apnea was higher in the NRS and RS groups of cluster 3 and the NRS group of cluster 1. The incidence of depression was higher in the NRS group of cluster 2 and in the NRS group of cluster 4. The incidence of insomnia did not differ among the clusters of health behaviors. Health behaviors underlying NRS/RS explain differences in the risks of developing sleep apnea and depression.