Relationship between Sleep Disorders and Health Related Quality of Life—Results from the Georgia SOMNUS Study

Abstract

The extent to which sleep disorders are associated with impairment of health-related quality of life (HRQoL) is poorly described in the developing world. We investigated the prevalence and severity of various sleep disorders and their associations with HRQoL in an urban Georgian population. 395 volunteers (20–60 years) completed Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, STOP-Bang questionnaire, Insomnia Severity Index, Beck Depression Inventory-Short Form, and Short Form Health Survey (SF-12). Socio-demographic data and body mass index (BMI) were obtained. The prevalence of sleep disorders and their association with HRQoL was considerable. All SF-12 components and physical and mental component summaries (PCS, MCS) were significantly lower in poor sleepers, subjects with daytime sleepiness, apnea risk, or insomnia. Insomnia and apnea severity were also associated with lower scores on most SF-12 dimensions. The effect of insomnia severity was more pronounced on MCS, while apnea severity—on PCS. Hierarchical analyses showed that after controlling for potential confounding factors (demographics, depression, BMI), sleep quality significantly increased model’s predictive power with an R2 change (ΔR2) by 3.5% for PCS (adjusted R2 = 0.27) and by 2.9% for MCS (adjusted R2 = 0.48); for the other SF-12 components ΔR2 ranged between 1.4% and 4.6%. ESS, STOP-Bang, ISI scores, all exerted clear effects on PCS and MCS in an individual regression models. Our results confirm and extend the findings of studies from Western societies and strongly support the importance of sleep for HRQoL. Elaboration of intervention programs designed to strengthen sleep-related health care and thereof HRQoL is especially important in the developing world.

The mediating role of sleep quality in the association between nocturia and health-related quality of life

“…Notwithstanding, poor sleep quality is a common complaint among people with nocturia [6]. A study in the US reported that poor sleep quality can have a serious impact on the ability to function and daytime functioning, leading to impaired HRQOL [6, 7].…”

The Relationship between the Number of Daily Health-Related Behavioral Risk Factors and Sleep Health of the Elderly in China

“…Existing studies provide several socio-ecological explanations of sleep, which generally believe that sleep can be influenced by psychological and physiological factors, environment, financial status, and other social factors [16][17][18][19][20]. Anxiety could directly lead to poor sleep quality, and there is a strong association between depression symptoms and sleep disturbances [21].…”

A Multifactorial Approach to Sleep and Its Association with Health-Related Quality of Life in a Multiethnic Asian Working Population: A Cross-Sectional Analysis

“…The significant association between daytime dysfunction and mental health-related quality of life is not surprising as the daytime dysfunction subscale comprises of one question regarding fatigue and motivation and another question about trouble staying awake and daytime sleepiness, both of which may indicate depressive symptomatology. It is also well documented that individuals experiencing daytime dysfunction as a result of sleepiness are more likely to present depressive symptoms [18,22,33,46]. One cause of daytime dysfunction is insufficient sleep, and participants in our study averaged 5.8 h of sleep a night, more than an hour short of the 7 to 9 h recommended for optimal health [47].…”

“…Unlike PSG, it allows for prolonged continuous periods of sleep evaluation in the subject’s natural work and sleep environments without being labor-intensive [15,16]. A number of studies have reported on the association between subjectively assessed parameters of sleep and health-related quality of life [17,18,19,20,21,22,23,24,25], while fewer have examined their relationship with objective measurements of sleep [26]. Given the difference in cost, accessibility, and ease of administration, it is understandable that subjective assessments of sleep are often opted for over objective measurements, however, the extant literature has demonstrated inconsistencies between subjectively and objectively measured sleep [27,28,29], and therefore studies that include both methods are warranted.…”