Abstract
Objectives
The Centers for Disease Control and Prevention emphasizes conceptualizing sleep as
a healthy behavior. Although a large literature exists documenting the morbidity or
mortality of suboptimal sleep, fewer investigations have examined the burden of disease
in a single number combining morbidity and mortality. This study examined the morbidity,
as measured by health-related quality of life (HRQOL), mortality, and quality-adjusted
life years (QALY) due to suboptimal (inadequate or excessive) sleep.
Design and participants
We ascertained respondents' HRQOL scores and mortality status from the 2005 to 2008
National Health and Nutrition Examination Survey (NHANES) with mortality follow-up
data through December 31, 2011 for respondents aged 65 and older (n = 2380). We estimated mean QALY according to duration of sleep, minutes to fall asleep,
number of sleeping problems, and daytime impact.
Results
More than one third of participants reported a suboptimal sleep duration. Short sleep
duration had a greater adverse impact on morbidity, with reductions in HRQOL, while
long sleep duration had a greater adverse impact on mortality. Compared to participants
who reported between 7 and 9 hours of sleep per night, mean QALYs were significantly
lower among participants who slept 10 or more hours a night (7.8 QALY; decrease of
9.8 QALY).
Conclusions
This study confirmed the association between suboptimal sleep and greater burden of
disease among the elderly US population. Our findings provide support for treating
sleep as a healthy (health risk) behavior, thereby having implications for primary
care providers and public health surveillance.
Keywords
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Article info
Publication history
Published online: January 15, 2018
Accepted:
November 8,
2017
Received in revised form:
November 3,
2017
Received:
June 23,
2017
Identification
Copyright
© 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
