Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019

Lima, Margareth Guimarães; Barros, Marilisa Berti de Azevedo; Malta, Deborah Carvalho; Medina, Lhais de Paula Barbosa; Szwarcwald, Célia Landmann

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Brasil

Epidemiologia e Serviços de Saúde

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Original article • Epidemiol. Serv. Saúde 31 (spe 1) • 2022 • https://doi.org/10.1590/SS2237-9622202200007.especial copy

Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex.

Methods:

This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex.

Results:

This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males.

Conclusion:

NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.

Keywords:
Sleep; Non-communicable Diseases; Morbidity; Health Survey; Sex Distribution

Variables	n	Prevalence (95%CI^f)
Variables	n	Total	Female	Male
Total	88,531	100.0	53.2 (52.6;53.8)	46.8 (46.2;47.4)
Age group (years)
18 to 2	15,394	22.1 (21.5;22.7)	21.0 (20.2;21.7)	23.4 (22.5;24.3)
30 to 49	34,752	39.2 (38.5;39.8)	39.2 (38.3;40.0)	39.2 (38.3;40.0)
50 to 59	15,657	17.1 (16.7;17.5)	16.8 (16.3;17.4)	17.5 (16.8;18.1)
60 to 69	12,555	12.2 (11.8;12.5)	12.8 (12.3;13.2)	11.5 (11.0;12.0)
≥ 70	10,173	9.4 (9.1;9.8)	10.3 (9.8;10.8)	8.5 (8.0;9.0)
Self-reported sleep problems	16,491	18.6 (18.1;19.2)	23.1 (22.4;23.8)	13.6 (13.0;14.3)
Non-communicable diseases
Hypertension	23,819	25.4 (24.9;25.9)	29.2 (28.5;30.0)	21.1 (20.4;21.8)
Diabetes	7,358	8.0 (7.7;8.4)	9.0 (6.6;9.5)	6.9 (6.5;7.4)
Heart Disease	4,711	5.3 (5.0;5.6)	5.6 (5.3;6.0)	4.9 (4.6;5.3)
Stroke (CVA^b)	1,974	2.0 (1.8;2.1)	2.0 (1.8;2.2)	2.0 (1.7;2.2)
Asthma or asthmatic bronchitis	4,294	5.3 (5.0;5.5)	6.1 (5.7;6.5)	4.4 (4.0;4.8)
Other pulmonary disease (emphysema, chronic bronchitis or COPD^c)	1,258	1.7 (1.5;1.8)	1.7 (1.5;2.0)	1.6 (1.4;1.8)
Arthritis or rheumatism	7,199	7.6 (7.2;7.9)	11.0 (10.4;11.5)	3.7 (3.4;4.1)
Spinal condition or chronic back pain	19,029	21.6 (21.0;22.1)	24.5 (23.7;25.2)	18.3 (17.6;19.0)
Work-related musculoskeletal disorders (WRMDs^d)	1,710	2.5 (2.3;2.8)	3.2 (2.8;3.6)	1.7 (1.5;2.0)
Depression	8,242	10.2 (9.9;10.6)	14.7 (14.1;15.4)	5.1 (4.7;5.5)
Other mental illness (anxiety disorder, panic disorder, schizophrenia, bipolar disorder, psychosis or OCD^e)	4,792	6.5 (6.1;6.8)	8.6 (8.1;9.1)	4.1 (3.8;4.5)
Cancer	2,314	2.6 (2.4;2.7)	2.9 (2.7;3.2)	2.1 (1.9;2.4)
Chronic kidney disease	1,280	1.5 (1.3;1.6)	1.6 (1.4;1.8)	1.4 (1.2;1.6)
Number of chronic diseases among the 13 studied
0	41,266	47.2 (46.5;47.8)	41.6 (40.8;42.5)	53.4 (52.6;54.3)
1 or 2	36,794	40.6 (40.0;41.2)	41.8 (41.0;42.7)	39.2 (38.4;40.1)
3 or more	10,471	12.2 (11.8;12.7)	16.5 (15.8;17.2)	7.4 (6.9;7.8)

Variables	Prevalence (%)	95%CI^f
Sex
Male	13.6	13.0;14.3
Female	23.1	22.4;23.8
Age group (years)
18 to 29	12.6	11.6;13.6
30 to 49	17.0	16.3;17.8
50 to 59	22.4	21.2;23.7
60 to 69	23.8	22.5;25.1
≥ 70	26.1	24.6;27.6
Non-communicable diseases
Hypertension	27.2	26.2;28.4
Diabetes	30.2	28.4;32.2
Heart Disease	36.3	33.9;38.7
Stroke (CVA^b)	39.0	35.1;43.1
Asthma or asthmatic bronchitis	29.2	26.8;31.7
Other pulmonary disease (emphysema, chronic bronchitis or COPD^c)	38.7	33.6;44.1
Arthritis or rheumatism	37.6	35.5;39.8
Spinal condition or chronic back pain	31.1	29.9;32.4
Work-related musculoskeletal disorders (WRMDs^d)	29.3	26.2;32.7
Depression	48.6	46.7;50.6
Other mental illness (anxiety disorder, panic disorder, schizophrenia, bipolar disorder, psychosis or OCD^e)	48.5	46.1;51.0
Cancer	32.6	29.4;36.0
Chronic kidney disease	36.2	31.9;40.7
Number of chronic diseases among the 13 studied
0	9.2	8.7;9.8
1 or 2	21.0	21.2;22.9
3 or more	43.8	42.1;45.7

Variables	PR^f (95%CI^g)
Variables	Total	Female	Male	Interaction (sex x NCDs^a,h)
Non-communicable diseases
Hypertension	1.50 (1.41;1.59)	1.40 (1.30;1.51)	1.48 (1.34;1.63)
Diabetes	1.43 (1.33;1.54)	1.32 (1.21;1.43)	1.59 (1.38;1.83)	1.22 (1.04;1.42)
Heart Disease	1.76 (1.64;1.89)	1.74 (1.60;1.89)	1.76 (1.52;2.02)
Stroke (CVA^b)	1.76 (1.57;1.97)	1.69 (1.47;1.95)	1.95 (1.63;2.32)
Asthma or asthmatic bronchitis	1.67 (1.53;1.83)	1.62 (1.47;1.78)	1.56 (1.28;1.90)
Other pulmonary disease (emphysema, chronic bronchitis or COPD^c)	1.96 (1.70;2.26)	1.76 (1.44;2.14)	2.34 (1.93;2.84)	1.34 (1.02;1.76)
Arthritis or rheumatism	1.89 (1.76;2.02)	1.68 (1.57;1.81)	1.81 (1.54;2.12)
Spinal condition or chronic back pain	1.89 (1.79;1.99)	1.79 (1.68;1.91)	1.87 (1.70;2.05)
Work-related musculoskeletal disorders (WRMD^d)	1.52 (1.35;1.70)	1.35 (1.17;1.55)	1.64 (1.30;2.07)
Depression	3.07 (2.91;3.23)	2.61 (2.46;2.76)	3.58 (3.24;3.95)	1.38 (1.23;1.54)
Other mental illness (anxiety disorder, panic disorder, schizophrenia, bipolar disorder, psychosis or OCD^e)	3.04 (2.87;3.22)	2.54 (2.37;2.72)	3.79 (3.41;4.22)	1.49 (1.31;1.69)
Cancer	1.48 (1.33;1.64)	1.38 (1.22;1.57)	1.61 (1.33;1.90)
Chronic kidney disease	1.77 (1.56;2.00)	1.52 (1.31;1.77)	2.40 (1.81;2.77)	1.49 (1.15;1.93)
Number of chronic diseases among the 13 studied
0	1.00	1.00	1.00	-
1 or 2	2.37 (2.22;2.54)	2.18 (2.00;2.38)	2.48 (2.22;2.77)
3 or more	4.73 (4.37;5.11)	3.99 (3.62;4.41)	5.07 (4.44;5.77)	1.26 (1.09;1.46)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Corresponding
Margareth Guimarães Lima. mglima@unicamp.br