Association between Sleep Duration and Self-Reported Health Status: Findings from the Bhutan's Gross National Happiness Study

Study Objectives: Short and long sleep durations have been found to be associated with chronic conditions like diabetes mellitus, hypertension and cardiovascular disease. However, most studies were conducted in developed countries and the results were inconsistent. The aim of this study is to investigate the association between sleep duration and self-reported health status in a developing country setting. Methods: We conducted secondary data analysis of the 2010 Gross National Happiness study of Bhutan, which was a nationwide cross sectional study with representative samples from rural and urban areas. The study included 6476 participants aged 15-98 y. The main outcome variable of interest was self-reported health status. Sleep duration was categorized as <= 6 h, 7 h, 8 h, 9 h, 10 h, and >= 11 h. Multiple logistic regressions were conducted to investigate the association between sleep duration and self-reported health status. Results: The mean sleep duration was 8.5 (+/- 1.65) h. Only 9% of the respondents slept for 7 h; 6% were short sleepers (<= 6 h) and 84% were long sleepers (21%, 8 h; 28%, 9 h; 22%, 10 h; 13%, >= 11 h). We found that both short (<= 6 h) and long sleep duration (>= 11 h) were independently associated with poor self-reported health status. Conclusions: This study found that people with shorter and longer sleep durations were more likely to report poorer health status.