Abstract
This study aims to describe the prevalence of sleep disturbances and daytime fatigue and their association with socio-demographic and behavioral factors. Data from the Brazilian National Health Survey conducted in 2013 with 60,202 adults (≥ 18 years old) were used. The outcomes evaluated were self-reported sleep disturbances and daytime fatigue in the last two weeks. Sleep disturbance was defined as the presence of difficulty to fall asleep, frequently waking up during the night or sleeping more than usual; daytime fatigue was defined as the presence of not feeling rested and motivated during the day, feeling tired and lacking energy. Sociodemographic, lifestyle and chronic health aspects were explored as exposures for both outcomes. Prevalence of sleep disturbances and daytime fatigue were 14.9% (14.4-15.4) and 11.9% (11.4-12.3), respectively. Both outcomes were more common in women, older people, people with no formal education, smokers and among physically inactive individuals. The association with education was inverse (the highest the level of education the lower the prevalence ratio - PR - of sleep disturbances and daytime fatigue; adjusted p-value for trend < 0.001). Prevalence of sleep disturbances combined with daytime fatigue was 6.7% (6.4-7.1) and was about 6 times higher among those with three or more chronic health disturbances (PR = 6.2; 95%CI: 5.3-7.2). Strategies to decrease the prevalence of sleep disturbances and daytime fatigue should be encouraged and focused on chronically ill individuals that share other modifiable risk factors.
Highlights
Sleep is a physiological human need, essential for organic basic functions, such as hormonal secretion, metabolism, tissues restoration and immunological system [1,2,3]
This study showed that about 15% and 12% of the Brazilian adult population reported sleep disturbances and daytime fatigue, respectively
The frequency of simultaneous occurrence of sleep disturbances and daytime fatigue decreased as the education level increased and increased as the number of health problems increased
Summary
Sleep is a physiological human need, essential for organic basic functions, such as hormonal secretion, metabolism, tissues restoration and immunological system [1,2,3]. Sleep disturbances are associated to higher risks of work-related accidents and car crashes due to daytime sleepiness as a result of poor sleep nights 11. Population-based studies have shown that several sleep disturbances affect people worldwide. In a study performed in Finland (2014), 16% of the sample presented difficulty in initiating sleep 14. A large study carried out in eight countries of Africa and Asia found a point prevalence (last 30 days) of 16.6% nocturnal sleep disturbances, defined as difficulty in falling asleep, frequently waking up during the night, waking up too early in the morning, and not feeling rested and refreshed during the day 15. A study conducted in 2012 showed that 21% of Brazilian workers presented poor sleep quality, with sleep disturbances being more frequent among physically inactive individuals, in those with higher alcohol consumption levels, and with diabetes mellitus or arterial hypertension 17
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