Med thumb burnout

White collar, blue collar, clergy collar, shirt-optional: If you're part of the workforce, then you probably work in an industry infected by burnout, because the occupational stress disorder is a full-on epidemic, according to behavior science. Burnout might be most prevalent in healthcare — somewhere between 25 percent and 60 percent of med students and practicing doctors are, you guessed it, seriously b-ed out. But educators, social workers, lawyers, journalists, customer service reps and, well, members of the general working population, are struggling to keep their flames lit too. 

Does burnout deserve the public-health spotlight it gets? I've had my doubts. I've said things like "it's called work for a reason." But I've changed my tune. We spend more time working than doing nearly anything else in our lives (even sleep). Researchers should, by all means, analyze different work environments to understand why some optimistic workers turn into drained, dispirited sacks of DGAF. Because burnout isn't a 9-to-5 affliction. In studies, it's consistently associated with poor overall well-being and health issues — notably insomnia and other sleep disorders. In fact, one such study, recently published in the journal BMJ Open, suggests that poor shuteye explains why some workers burn out from high-demand, low-power jobs while others can totally deal. 

What leaves workers feeling like drained, detached do-nothings? They might be stuck in jobs that require too much, reward too little and don't fit their skills or personalities.

The term burnout formally showed up in research in 1974, when the psychologist Herbert Freudenberger noticed formerly idealistic volunteers at a mental health clinic exhibiting "loss of motivation, growing sense of emotional depletion, and cynicism," according to The ObserverWhile definitions for burnout vary, it's generally thought of as a state of stress defined by three things: 1) emotional exhaustion; 2) depersonalization, which describes cynical, detached feelings toward coworkers and/or clients (or patients or customers); 3) reduced personal accomplishment.

What leaves workers feeling like detached do-nothings? They might be stuck in jobs that require too much, reward too little and don't fit their personalities. One new study suggests that burnout bubbles up when employers try to impose meaning on work that employees don't authentically find meaningful. Another oft-mentioned cause of burnout is the neverending workday — the smartphone-as-a-leash syndrome. In one famous effort to give workers a break, France enacted an after-work email ban last year

Workers with a lot of job strain were also likely to report burnout, but only if they also slept poorly.

And poor sleep seems to unite burnt-out workers in all sorts of crappy, stressful job situations. Burnout has consistently been linked to sleep problems, including insomnia and non-restorative sleep disorder, which happens when people get enough sleep but still don't feel refreshed. Studies, however, differ in how they frame the relationship between burnout and sleep. Some research says insomnia triggers burnout (and not the other way around), while at least one study says the relationship is bidirectional, meaning insomnia could cause burnout or burnout could cause insomnia, and then both issues mutually reinforce each other. 

For the current study, 1,300 employees of a French financial company filled out questionnaires about job burnout, lifestyle habits and sleep, as well as underwent medical exams. In addition to exploring the insomnia-burnout link, researchers were looking at job strain, which describes a job with a lot of responsibility but disproportionately little freedom. (I.e., You do all the work, but call none of the shots.)

The results? 

  • Just over 10 percent of participants were burnt out.
  • 16 percent exhibited symptoms of full-blown insomnia, while almost everyone — 97 percent — reported non-restorative sleep, meaning sleep that doesn't leave you feeling bouncy and ready to take on the day.
  • 23 percent reported high levels of job strain.

Once researchers analyzed the results with respect to demographics, they found no direct link between job strain and burnout. Instead, insomnia emerged as the mediating link, meaning that job strain in itself did not appear to be a recipe for burnout. But, combine heavy strain and bad sleep, and burnout risk soars. 

It's possible, researchers wrote, that the accumulated stress of burnout could lead to a state of hyper-arousal, making it difficult to fall and stay asleep. But, that's only if insomnia is a result of burnout, and we don't know if it is. The study is only cross-sectional, meaning it's a snapshot of health in a given population at one point in time. The results show that different problems occur in tandem, but they don't say how the issues affect one another. Regardless, researchers said, the study does affirm insomnia as a symptom of burnout, regardless of which one's the chicken and which one's the (bad) egg.