Association of sleep duration and self-reported health status among us adults with osteoarthritis

Abstract

Purpose: : Among persons with arthritis, sleep disturbances such as insufficient sleep and issues with feeling unrested and/or fatigued after sleep are common. Sleep disorders may impact on quality of life, pain perception, and functional abilities. The aim of this study was to examine the extent to which sleep duration is associated with self-reported health status and reported days with activities affected by pain in a nationally representative sample of persons with osteoarthritis. Methods: Using cross-sectional data from the 2007-2012 National Health and Nutrition Examination Survey (NHANES), we identified 1,559 adults (weighted N= 20,866,345) with self-reported osteoarthritis. Sleep duration was assessed using the question that asked: “How much sleep do you usually get at night on weekdays or workdays?” Total hours of sleep were classified as three levels ≤6 hours, 7-8 hours, and ≥9 hours. Current health status was evaluated using two questions: 1) how many days in the past 30 days did pain make it hard for you to do the usual activities, such as self-care, work, or recreation (range: 0-30); and 2) self-reported general health status such as excellent, very good, good, fair, or poor and collapsed into fair/poor versus excellent/very good/good. According to levels of sleep duration, socio-demographic and clinical characteristics were calculated. Multivariable logistic and Poisson models were used to examine the relationship between sleep duration and self-reported health status adjusting for socio-demographic and health factors. Adjusted rate ratios (aRR) and odds ratios (aOR) with 95% confidence intervals (CI) were estimated and compared with a common reference group (sleep duration of 7-8 hours). Results: Among persons with osteoarthritis, most were aged over 50 years, women, non-Hispanic white, overweight or obese, and had at least some college education. Approximately 2 in 5 participants had sleep duration less or equal to 6 hours (40.4%, 95% CI: 37.6%-43.2%). While the average disease duration was 12.7 years in those reporting sleep duration ≤6 hours, the average disease duration was 15.3 years among those reporting sleep duration ≥9 hours. In persons with osteoarthritis, sleep duration (≤6 hours) was associated with more days with difficulty for usual activities due to pain (aRR ≤6 hours versus 7-8 hours: 1.30, 95% CI: 1.06 to 1.59). Compared with sleep duration for 7-8 hours, those with fewer sleep hours were more likely to be associated with poor/fair self-reported health status (e.g., aOR ≤6 hours versus 7-8 hours: 2.05, 95% CI: 1.38-3.04). Conclusions: In US adults with osteoarthritis, short sleep duration is common. More importantly, short sleep duration is associated with worse self-reported health status in persons with osteoarthritis. These findings may indicate that individuals with osteoarthritis may be at a higher risk for sleep disturbances. Future studies using longitudinal analysis to evaluate other factors such as sleep habits and clinical outcomes in persons with arthritis maybe needed.