Elsevier

Sleep Medicine

Volume 6, Issue 1, January 2005, Pages 23-27
Sleep Medicine

Original article
Associations of frequent sleep insufficiency with health-related quality of life and health behaviors

https://doi.org/10.1016/j.sleep.2004.06.003Get rights and content

Abstract

Background and purpose: Sleep-related problems, which affect 50–70 million Americans, involve all areas of life, including cognitive performance, emotional well-being, work and leisure-time activities, and general physical and mental well-being. We examined the association of insufficient sleep with health-related quality of life (HRQOL) and health behaviors.

Patients and methods: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing, state-based, random-digit telephone survey of the non-institutionalized US population aged ≥18 years. In 2002, HRQOL measures were administered in 18 states and the District of Columbia, yielding complete responses to questions regarding sleep and demographic characteristics from 98% of study participants (n=79,625).

Results: An estimated 26% of adults reported frequent (≥14 days in the past 30 days) sleep insufficiency. They were significantly more likely than those without frequent sleep insufficiency to report fair/poor general health, frequent physical distress, frequent mental distress, activity limitations, depressive symptoms, anxiety, and pain. In addition, they were significantly more likely to smoke, to be physically inactive, to be obese, and, among men, to drink heavily.

Conclusion: Insufficient sleep is associated with a variety of adverse health behaviors and impairment in all HRQOL domains investigated. Accordingly, assessment of sleep appears to be an important component of general medical care. Moreover, expanded assessment of sleep in the general population may provide a better understanding of prevalence of impaired sleep and its many implications.

Introduction

Sleep-related problems affect 50–70 million persons in the United States [1]. Two adults in five sleep less than 7 hours each weeknight and for three adults in eight, their sleepiness during the day interferes with daily activities at least a few times a month [2]. Insufficient sleep not only affects the ability to function optimally but is also associated with an increased risk of psychiatric disorders [3], [4]. Sleep disturbance can also exacerbate chronic conditions, disrupt medical treatment, and add to the social disability associated with a chronic illness [5], [6], [7]. Yet, nearly two-thirds of US adults have never been asked by a physician how well they sleep [8]. Given the impact of insufficient sleep on well-being, we examined the association of insufficient sleep with health-related quality of life (HRQOL) measures and health behaviors in the general US population using the Behavioral Risk Factor Surveillance System (BRFSS).

Section snippets

Methods

The BRFSS is an ongoing, state-based, random-digit telephone survey of non-institutionalized persons aged 18 years or older in the United States, Guam, Puerto Rico, and the Virgin Islands. The BRFSS is a state-based surveillance system supported by the Centers for Disease Control and Prevention, which collects data on many of the behaviors and conditions increasing the risk of chronic disease among adults (aged ≥18 years) [9]. Trained telephone interviewers collect data monthly using an

Results

An estimated 25.9% (95% CI; 25.3%–26.5%) of adults reported frequent sleep insufficiency. The odds of frequent sleep insufficiency were significantly greater for women than men; adults aged less than 55 years than those 55 years or older, persons previously married (vs those who are currently married); and persons who were employed, unable to work, or a homemaker or student (vs those who were retired) (Table 1). In addition, persons with frequent sleep insufficiency were significantly less

Discussion

Our results corroborate previous research indicating that insufficient sleep is a major public health problem [1], [2], [3], [4], [5], [6], [7], as we found over one-fourth of US adults reported frequent sleep insufficiency. Insufficient sleep is associated with impairments in numerous areas of life including physical and mental health, as well as performance of work and leisure activities [5]. Our results extend these findings to a non-clinical population and provide additional evidence that

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