Tea Lallukka1, Børge Sivertsen2, Erkki Kronholm3, Yu Sun Bin4, Simon Øverland5, Nick Glozier6. 1. Finnish Institute of Occupational Health, P.O. Box 18, FIN 00032 Helsinki, Finland; Department of Public Health, P.O. Box 20 (Tukholmankatu 8 B), FIN-00014, University of Helsinki, Finland; Sydney Medical School, Sleep Group, D17 - Charles Perkins Centre, University of Sydney NSW, Australia 2006. Electronic address: tea.lallukka@ttl.fi. 2. Department of Research and Innovation, Helse-Fonna HF Haugesund Hospital, Postbox 2170, 5504, Haugesund, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgate 7, 5015 Bergen, Norway. 3. Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FI-20032, Turku, Finland. 4. Sydney Medical School, Sleep Group, D17 - Charles Perkins Centre, University of Sydney NSW, Australia 2006. 5. Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgate 7, 5015 Bergen, Norway; Department of Psychosocial Science, University of Bergen, Postboks 7807, 5020 Bergen, Norway. 6. Sydney Medical School, Sleep Group, D17 - Charles Perkins Centre, University of Sydney NSW, Australia 2006; Brain and Mind Centre, University of Sydney, Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
Abstract
OBJECTIVES: We aimed to evaluate the interaction of two key determinants of sleep health, quantity and quality, with physical, emotional, and social functioning, in the general population. DESIGN: Nationally-representative Australian cross-sectional study. SETTING: General population. PARTICIPANTS: 14,571 people aged 15 or older in Household, Income and Labor Dynamics in Australia (HILDA) in 2013. MEASUREMENTS: The associations of sleep quality (good/poor) in combination with mid-range (6-8 hours), short (<6) or long (>8) sleep duration with functioning, determined from the SF-36, were evaluated using logistic regression adjusting for sociodemographic, relationships, health behaviors, obesity, pain, and mental and physical illness confounders. RESULTS: After adjusting for gender, and age, poor sleep quality in combination with short, mid-range and long sleep was associated with worse physical, emotional and social functioning. Pain and comorbid illness explained much of these associations, while attenuation from other covariates was minor. The associations of poor sleep quality with worse functioning remained after full adjustment regardless of sleep duration, while among people with good quality sleep, only those with long sleep duration reported poorer functioning. CONCLUSIONS: Poor sleep quality has robust associations with worse functioning regardless of total duration in the general population. There appears to be a substantial number of functional short sleepers with good quality sleep.
OBJECTIVES: We aimed to evaluate the interaction of two key determinants of sleep health, quantity and quality, with physical, emotional, and social functioning, in the general population. DESIGN: Nationally-representative Australian cross-sectional study. SETTING: General population. PARTICIPANTS: 14,571 people aged 15 or older in Household, Income and Labor Dynamics in Australia (HILDA) in 2013. MEASUREMENTS: The associations of sleep quality (good/poor) in combination with mid-range (6-8 hours), short (<6) or long (>8) sleep duration with functioning, determined from the SF-36, were evaluated using logistic regression adjusting for sociodemographic, relationships, health behaviors, obesity, pain, and mental and physical illness confounders. RESULTS: After adjusting for gender, and age, poor sleep quality in combination with short, mid-range and long sleep was associated with worse physical, emotional and social functioning. Pain and comorbid illness explained much of these associations, while attenuation from other covariates was minor. The associations of poor sleep quality with worse functioning remained after full adjustment regardless of sleep duration, while among people with good quality sleep, only those with long sleep duration reported poorer functioning. CONCLUSIONS: Poor sleep quality has robust associations with worse functioning regardless of total duration in the general population. There appears to be a substantial number of functional short sleepers with good quality sleep.
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