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Quality of Life Research

, Volume 23, Issue 2, pp 613–625 | Cite as

Sleep characteristics and health-related quality of life among a national sample of American young adults: assessment of possible health disparities

  • Xiaoli Chen
  • Bizu Gelaye
  • Michelle A. Williams
Article

Abstract

Purpose

The aim of the study is to examine the associations of sleep characteristics with health-related quality of life (HRQOL) and sleep health disparities among US young adults using national survey data.

Methods

The study sample consisted of 2,391 young adults aged 20–39 years from the National Health and Nutrition Examination Survey 2005–2008. HRQOL was assessed using the Centers for Disease Control and Prevention’s HRQOL-4 scale. Multivariable logistic regression models were applied to evaluate the sleep–HRQOL associations. Stratified analyses were conducted to examine whether the associations varied by sociodemographic characteristics.

Results

Approximately 35.6 % of young adults slept <7 h, 41.9 % had insomnia, 4.4 % had sleep disorder, and 8.5 % had sleep apnea. More females had insomnia than males (48.6 vs. 35.9 %, P < 0.001). US-born young adults had more sleep disturbances than their foreign-born counterparts. Compared with those sleeping 7–8 h, the adjusted odds ratio of poor general health was 1.60 (95 % confidence interval, 1.08–2.35) for individuals sleeping 6–7 h and 1.88 (1.23–2.86) for those sleeping <6 h. Similar results were found for low mental HRQOL and overall HRQOL. Insomnia, long sleep latency, troubling falling asleep, daytime sleepiness, and frequent sleeping pill use were significantly associated with low mental HRQOL and overall HRQOL. The associations between sleep disturbances and low HRQOL varied little by sex, race/ethnicity, and country of birth.

Conclusions

Sleep disturbances are common among US young adults and are significantly associated with low HRQOL. Objective measures of sleep are warranted to confirm our findings.

Keywords

Sleep Health-related quality of life Health disparities Young adults National survey 

Abbreviations

BMI

Body mass index

BRFSS

Behavioral Risk Factor Surveillance System

CDC

Centers for Disease Control and Prevention

CI

Confidence interval

HRQOL

Health-related quality of life

NCHS

National Center for Health Statistics

NHANES

National Health and Nutrition Examination Survey

NSF

National Sleep Foundation

OR

Odds ratio

PIR

Poverty/income ratio

RLS

Restless legs syndrome

Notes

Acknowledgments

This study was supported by grants from NIH/NIMHD (T37-MD001449) and NIH/NCRR/NCATS (8UL1TR000170).

Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose.

References

  1. 1.
    US Department of Health and Human Services, National Institutes of Health. National Heart, Lung, and Blood Institute, National Center on Sleep Disorders Research. (2003). National sleep disorders research plan. Available at: http://www.nhlbi.nih.gov.ezp-prod1.hul.harvard.edu/health/prof/sleep/res_plan/sleep-rplan.pdf. Accessed August 1, 2012.
  2. 2.
    Lund, H. G., Reider, B. D., Whiting, A. B., & Prichard, J. R. (2010). Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of Adolescent Health, 46(2), 124–132.PubMedCrossRefGoogle Scholar
  3. 3.
    Veldi, M., Aluoja, A., & Vasar, V. (2005). Sleep quality and more common sleep-related problems in medical students. Sleep Medicine, 6(3), 269–275.PubMedCrossRefGoogle Scholar
  4. 4.
    Angelone, A. M., Mattei, A., Sbarbati, M., & Di Orio, F. (2011). Prevalence and correlates for self-reported sleep problems among nursing students. Journal of Preventative Medicine & Hygiene, 52(4), 201–208.Google Scholar
  5. 5.
    Chen, X., Beydoun, M. A., & Wang, Y. (2008). Is sleep duration associated with childhood obesity? A systematic review and meta-analysis. Obesity (Silver Spring), 16(2), 265–274.CrossRefGoogle Scholar
  6. 6.
    Yaggi, H. K., Araujo, A. B., & McKinlay, J. B. (2006). Sleep duration as a risk factor for the development of type 2 diabetes. Diabetes Care, 29(3), 657–661.PubMedCrossRefGoogle Scholar
  7. 7.
    Redline, S., & Foody, J. (2011). Sleep disturbances: Time to join the top 10 potentially modifiable cardiovascular risk factors? Circulation, 124(19), 2049–2051.PubMedCrossRefGoogle Scholar
  8. 8.
    Kripke, D. F., Garfinkel, L., Wingard, D. L., Klauber, M. R., & Marler, M. R. (2002). Mortality associated with sleep duration and insomnia. Archives of General Psychiatry, 59(2), 131–136.PubMedCrossRefGoogle Scholar
  9. 9.
    Kessler, R. C., Berglund, P. A., Coulouvrat, C., Hajak, G., Roth, T., Shahly, V., et al. (2011). Insomnia and the performance of US workers: Results from the America insomnia survey. Sleep, 34(9), 1161–1171.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Gaultney, J. F. (2011). The prevalence of sleep disorders in college students: Impact on academic performance. Journal of American College Health, 59(2), 91–97.CrossRefGoogle Scholar
  11. 11.
    Taylor, D. J., & Bramoweth, A. D. (2010). Patterns and consequences of inadequate sleep in college students: Substance use and motor vehicle accidents. Journal of Adolescent Health, 46(6), 610–612.PubMedCrossRefGoogle Scholar
  12. 12.
    Curcio, G., Ferrara, M., & De Gennaro, L. (2006). Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews, 10(5), 323–337.PubMedCrossRefGoogle Scholar
  13. 13.
    Williams, A. F., Tefft, B. C., & Grabowski, J. G. (2012). Graduated driver licensing research, 2010–present. Journal of Safety Research, 43(3), 195–203.PubMedCrossRefGoogle Scholar
  14. 14.
    Leger, D., Scheuermaier, K., Philip, P., Paillard, M., & Guilleminault, C. (2001). SF-36: Evaluation of quality of life in severe and mild insomniacs compared with good sleepers. Psychosomatic Medicine, 63(1), 49–55.PubMedGoogle Scholar
  15. 15.
    Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.PubMedCrossRefGoogle Scholar
  16. 16.
    Strine, T. W., & Chapman, D. P. (2005). Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep Medicine, 6(1), 23–27.PubMedCrossRefGoogle Scholar
  17. 17.
    Montez, J. K., & Eschbach, K. (2008). Country of birth and language are uniquely associated with intakes of fat, fiber, and fruits and vegetables among Mexican-American women in the United States. Journal of the American Dietetic Association, 108(3), 473–480.PubMedCrossRefGoogle Scholar
  18. 18.
    Eldeirawi, K. M., & Persky, V. W. (2006). Associations of acculturation and country of birth with asthma and wheezing in Mexican American youths. Journal of Asthma, 43(4), 279–286.PubMedCrossRefGoogle Scholar
  19. 19.
    Sundquist, J., & Winkleby, M. (2000). Country of birth, acculturation status and abdominal obesity in a national sample of Mexican-American women and men. International Journal of Epidemiology, 29(3), 470–477.PubMedCrossRefGoogle Scholar
  20. 20.
    Seicean, S., Neuhauser, D., Strohl, K., & Redline, S. (2011). An exploration of differences in sleep characteristics between Mexico-born US immigrants and other Americans to address the Hispanic paradox. Sleep, 34(8), 1021–1031.PubMedCentralPubMedGoogle Scholar
  21. 21.
    Centers for Disease Control and Prevention, National Center for Health Statistics National Health and Nutrition Examination Survey data. Accessed July 9, 2012.Google Scholar
  22. 22.
    Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. Journal of the American Medical Association, 307(5), 491–497.PubMedCrossRefGoogle Scholar
  23. 23.
    Saydah, S., Bullard, K. M., Imperatore, G., Geiss, L., & Gregg, E. W. (2013). Cardiometabolic risk factors among US adolescents and young adults and risk of early mortality. Pediatrics, 131(3), e679–e686.PubMedCrossRefGoogle Scholar
  24. 24.
    Unruh, M. L., Redline, S., An, M. W., Buysse, D. J., Nieto, F. J., Yeh, J. L., et al. (2008). Subjective and objective sleep quality and aging in the sleep heart health study. Journal of the American Geriatrics Society, 56(7), 1218–1227.PubMedCrossRefGoogle Scholar
  25. 25.
    Chasens, E. R., Ratcliffe, S. J., & Weaver, T. E. (2009). Development of the FOSQ-10: A short version of the Functional Outcomes of Sleep Questionnaire. Sleep, 32(7), 915–919.PubMedCentralPubMedGoogle Scholar
  26. 26.
    Roth, T. (2007). Insomnia: Definition, prevalence, etiology, and consequences. Journal of Clinical Sleep Medicine, 3(5 Suppl), S7–S10.PubMedCentralPubMedGoogle Scholar
  27. 27.
    National Sleep Foundation. ‘Sleep in Americapoll. Available at: http://www.sleepfoundation.org. Accessed August 1, 2012.
  28. 28.
    Plantinga, L., Rao, M. N., & Schillinger, D. (2012). Prevalence of self-reported sleep problems among people with diabetes in the United States, 2005–2008. Preventing Chronic Disease, 9, E76.PubMedCentralPubMedGoogle Scholar
  29. 29.
    Li, C., Ford, E. S., Zhao, G., Croft, J. B., Balluz, L. S., & Mokdad, A. H. (2010). Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005–2006. Preventive Medicine, 51(1), 18–23.PubMedCrossRefGoogle Scholar
  30. 30.
    Hennessy, C. H., Moriarty, D. G., Zack, M. M., Scherr, P. A., & Brackbill, R. (1994). Measuring health-related quality of life for public health surveillance. Public Health Reports, 109(5), 665–672.PubMedCentralPubMedGoogle Scholar
  31. 31.
    Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The Centers for Disease Control and Prevention’s Healthy Days Measures—Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1, 37.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Ounpuu, S., Chambers, L. W., Chan, D., & Yusuf, S. (2001). Validity of the US behavioral risk factor surveillance system’s health related quality of life survey tool in a group of older Canadians. Chronic Diseases in Canada, 22(3–4), 93–101.PubMedGoogle Scholar
  33. 33.
    Ford, E. S., & Li, C. (2008). Metabolic syndrome and health-related quality of life among US adults. Annals of Epidemiology, 18(3), 165–171.PubMedCrossRefGoogle Scholar
  34. 34.
    Andresen, E. M., Catlin, T. K., Wyrwich, K. W., & Jackson-Thompson, J. (2003). Retest reliability of surveillance questions on health related quality of life. Journal of Epidemiology and Community Health, 57(5), 339–343.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Ford, E. S., Mannino, D. M., Homa, D. M., Gwynn, C., Redd, S. C., Moriarty, D. G., et al. (2003). Self-reported asthma and health-related quality of life: Findings from the behavioral risk factor surveillance system. Chest, 123(1), 119–127.PubMedCrossRefGoogle Scholar
  36. 36.
    Harper, S., & Lynch, J. (2007). Trends in socioeconomic inequalities in adult health behaviors among US states, 1990–2004. Public Health Reports, 122(2), 177–189.PubMedCentralPubMedGoogle Scholar
  37. 37.
    Ali, M. K., Bullard, K. M., Beckles, G. L., Stevens, M. R., Barker, L., Narayan, K. M., et al. (2011). Household income and cardiovascular disease risks in US children and young adults: Analyses from NHANES 1999–2008. Diabetes Care, 34(9), 1998–2004.PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Davis, N. J., Vaughan, C. P., Johnson, T. M., II, Goode, P. S., Burgio, K. L., Redden, D. T., et al. (2013). Caffeine Intake and its Association with Urinary Incontinence in United States men: Results from National Health and Nutrition Examination Surveys 2005–2006 and 2007–2008. Journal of Urology, 189(6), 2170–2174.Google Scholar
  39. 39.
    National Institutes of Health. (1998). Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: The evidence report. Washington, DC: National Institutes of Health.Google Scholar
  40. 40.
    Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Luckhaupt, S. E., Tak, S., & Calvert, G. M. (2010). The prevalence of short sleep duration by industry and occupation in the National Health Interview Survey. Sleep, 33(2), 149–159.PubMedCentralPubMedGoogle Scholar
  42. 42.
    Lohsoonthorn, V., Khidir, H., Casillas, G., Lertmaharit, S., Tadesse, M. G., Pensuksan, W. C., et al. (2012). Sleep quality and sleep patterns in relation to consumption of energy drinks, caffeinated beverages, and other stimulants among Thai college students. Sleep and Breathing (in press).Google Scholar
  43. 43.
    Singh, V., Pandey, S., Singh, A., Gupta, R., Prasad, R., & Singh Negi, M. P. (2012). Study pattern of snoring and associated risk factors among medical students. Bioscience Trends, 6(2), 57–62.PubMedGoogle Scholar
  44. 44.
    Pullman, A. W., Masters, R. C., Zalot, L. C., Carde, L. E., Saraiva, M. M., Dam, Y. Y., et al. (2009). Effect of the transition from high school to university on anthropometric and lifestyle variables in males. Applied Physiology, Nutrition and Metabolism, 34(2), 162–171.CrossRefGoogle Scholar
  45. 45.
    Sing, C. Y., & Wong, W. S. (2011). Prevalence of insomnia and its psychosocial correlates among college students in Hong Kong. Journal of American College Health, 59(3), 174–182.CrossRefGoogle Scholar
  46. 46.
    Steptoe, A., Peacey, V., & Wardle, J. (2006). Sleep duration and health in young adults. Archives of Internal Medicine, 166(16), 1689–1692.PubMedCrossRefGoogle Scholar
  47. 47.
    Redline, S., Tishler, P. V., Schluchter, M., Aylor, J., Clark, K., & Graham, G. (1999). Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems. American Journal of Respiratory and Critical Care Medicine, 159((5 Pt 1)), 1527–1532.PubMedCrossRefGoogle Scholar
  48. 48.
    Peppard, P. E., Young, T., Palta, M., Dempsey, J., & Skatrud, J. (2000). Longitudinal study of moderate weight change and sleep-disordered breathing. Journal of the American Medical Association, 284(23), 3015–3021.PubMedCrossRefGoogle Scholar
  49. 49.
    Harris, T. (2003). Depression in women and its sequelae. Journal of Psychosomatic Research, 54(2), 103–112.PubMedCrossRefGoogle Scholar
  50. 50.
    Dzaja, A., Arber, S., Hislop, J., Kerkhofs, M., Kopp, C., Pollmacher, T., et al. (2005). Women’s sleep in health and disease. Journal of Psychiatric Research, 39(1), 55–76.PubMedCrossRefGoogle Scholar
  51. 51.
    Hislop, J., & Arber, S. (2003). Understanding women’s sleep management: Beyond medicalization–healthicization? Sociology of Health & Illness, 25(7), 815–837.CrossRefGoogle Scholar
  52. 52.
    Stranges, S., Dorn, J. M., Shipley, M. J., Kandala, N. B., Trevisan, M., Miller, M. A., et al. (2008). Correlates of short and long sleep duration: A cross-cultural comparison between the United Kingdom and the United States: The Whitehall II Study and the Western New York Health Study. American Journal of Epidemiology, 168(12), 1353–1364.PubMedCentralPubMedCrossRefGoogle Scholar
  53. 53.
    Jean-Louis, G., Kripke, D. F., & Ancoli-Israel, S. (2000). Sleep and quality of well-being. Sleep, 23(8), 1115–1121.PubMedGoogle Scholar
  54. 54.
    Ayas, N. T., White, D. P., Manson, J. E., Stampfer, M. J., Speizer, F. E., Malhotra, A., et al. (2003). A prospective study of sleep duration and coronary heart disease in women. Archives of Internal Medicine, 163(2), 205–209.PubMedCrossRefGoogle Scholar
  55. 55.
    Floyd, J. A., Medler, S. M., Ager, J. W., & Janisse, J. J. (2000). Age-related changes in initiation and maintenance of sleep: A meta-analysis. Research in Nursing & Health, 23(2), 106–117.CrossRefGoogle Scholar
  56. 56.
    Katz, D. A., & McHorney, C. A. (2002). The relationship between insomnia and health-related quality of life in patients with chronic illness. Journal of Family Practice, 51(3), 229–235.PubMedGoogle Scholar
  57. 57.
    Hatoum, H. T., Kong, S. X., Kania, C. M., Wong, J. M., & Mendelson, W. B. (1998). Insomnia, health-related quality of life and healthcare resource consumption. A study of managed-care organisation enrollees. Pharmacoeconomics, 14(6), 629–637.PubMedCrossRefGoogle Scholar
  58. 58.
    Paine, S. J., Gander, P. H., Harris, R. B., & Reid, P. (2005). Prevalence and consequences of insomnia in New Zealand: Disparities between Maori and non-Maori. Australian and New Zealand Journal of Public Health, 29(1), 22–28.PubMedCrossRefGoogle Scholar
  59. 59.
    Dowd, J. B., & Todd, M. (2011). Does self-reported health bias the measurement of health inequalities in US adults? Evidence using anchoring vignettes from the Health and Retirement Study. Journals of Gerontology Series B, Psychological Sciences and Social Sciences, 66(4), 478–489.CrossRefGoogle Scholar
  60. 60.
    Manocchia, M., Keller, S., & Ware, J. E. (2001). Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill. Quality of Life Research, 10(4), 331–345.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Xiaoli Chen
    • 1
  • Bizu Gelaye
    • 1
  • Michelle A. Williams
    • 1
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA

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