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

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 (BRQOL) 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 greater than or equal to 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 ( greater than or equal to 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. (C) 2004 Elsevier B.V. All rights reserved.