The association of sleep-disordered breathing and Sleep symptoms with quality of life in the Sleep Heart Health Study

• Published in: Sleep (New York, N.Y.) Vol. 24; no. 1; pp. 96 - 105
• Main Authors: BALDWIN, Carol M, GRIFFITH, Kent A, JAVIER, F. NIETO, O'CONNOR, George T, WALSLEBEN, Joyce A, REDLINE, Susan
• Format: Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01.02.2001
• Subjects: Adult; Biological and medical sciences; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Chronic Disease; Circadian Rhythm; Disorders of Excessive Somnolence - diagnosis; Disorders of Excessive Somnolence - epidemiology; Disorders of Excessive Somnolence - etiology; Female; Health Status; Humans; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Polysomnography; Population Surveillance; Prevalence; Quality of Life; Risk Factors; Severity of Illness Index; Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - diagnosis; United States - epidemiology; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; United States; Human; Questionnaire; Investigation method; Upper respiratory tract; Risk factor; Sex; Sleep disorder; ENT disease; Cardiovascular disease; Polysomnography; Obstruction; Quality of life
• DOI: 10.1093/sleep/24.1.96
• ISSN: 0161-8105

This study assessed the extent to which sleep-disordered breathing (SDB), difficulty initiating and maintaining sleep (DIMS), and excessive daytime sleepiness (EDS) were associated with impairment of quality of life (QoL) using the SF-36. Participants (n=5,816; mean age=63 years; 52.5% women) were enrolled in the nation-wide population-based Sleep Heart Health Study (SHHS) implemented to investigate sleep-disordered breathing as a risk factor in the development of cardiovascular disease. Each transformed SF-36 scale was analyzed independently using multiple logistic regression analysis with sleep and other potential confounding variables (e.g., age, ethnicity) included as independent variables. Men (11.6%) were significantly more likely to have SDB compared to women (5.6%), while women (42.4%) were significantly more likely to report DIMS than men (32.5%). Vitality was the sole SF-36 scale to have a linear association with the clinical categories of SDB (mild, moderate, severe SDB). However, individuals with severe SDB indicated significantly poorer QoL on several SF-36 scales. Both DIMS and EDS were strongly associated with reduced QoL even after adjusting for confounding variables for both sexes. Findings suggest 1) mild to moderate SDB is associated with reduced vitality, while severe SDB is more broadly associated with poorer QoL, 2) subjective sleep symptoms are comprehensively associated with poorer QoL, and 3) SF-36 mean score profiles for SDB and sleep symptoms are equivalent to other chronic diseases in the U.S. general population.