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      Sleep duration and health status self-assessment (SF-36) in the elderly: a population-based study (ISA-Camp 2008) Translated title: Duração do sono e estado de saúde autorreferido (SF-36) em idosos: estudo de base populacional (ISA-Camp 2008)

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          Abstract

          The aim of this study was to determine the association between sleep duration and health status among the elderly. A population-based study was carried out with 1,418 elderly individuals using data from the health survey of Campinas, São Paulo State, Brazil (ISA-Camp 2008). Linear regression models were used to determine associations between the physical and mental components and subscales of the SF-36 and sleep duration. Elderly male individuals who slept > 6 hours obtained lower mean SF-36 scores for the vitality and mental health scales and the mental component summary than those who slept for seven to eight hours. All scales were negatively associated with sleep duration < 10 hours, except bodily pain. Scores for the mental health, vitality and role-emotional subscales were lower among women who slept for less than five hours. Mental health was negatively associated with < 10 hours of sleep. Sleep deprivation and excessive sleep were associated with poorer health status, with differences between genders, principally in the long duration sleep categories.

          Translated abstract

          Avaliar a associação da duração do sono com o estado de saúde autorreferido em idosos. Estudo de base populacional que utilizou dados do Inquérito de Saúde de Campinas, São Paulo, Brasil (ISA-Camp 2008), com 1.418 idosos. Modelos de regressão linear foram usados para verificar a associação entre as escalas do SF-36 versão 2 e os dois componentes de medida, com a duração do sono. Homens idosos que dormem 6 horas ou menos apresentam as menores médias dos escores do SF-36, comparando com os que dormem 7 a 8 horas, nos domínios de vitalidade e saúde mental. Todas as escalas apresentaram associação negativa com a duração do sono de 10 horas ou mais, exceto em dor. Nas mulheres, o tempo de sono > 5 horas se associou à pior situação nas escalas de saúde mental, aspectos emocionais e vitalidade. Saúde mental se associou negativamente com a duração do sono de 10 horas ou mais nessa população. A privação do sono e o excesso se associaram ao pior estado de saúde nos idosos, de maneira diferente entre os sexos, principalmente considerando o sono longo.

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          Most cited references51

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          Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies.

          Increasing evidence suggests an association between both short and long duration of habitual sleep with adverse health outcomes. To assess whether the population longitudinal evidence supports the presence of a relationship between duration of sleep and all-cause mortality, to investigate both short and long sleep duration and to obtain an estimate of the risk. We performed a systematic search of publications using MEDLINE (1966-2009), EMBASE (from 1980), the Cochrane Library, and manual searches without language restrictions. We included studies if they were prospective, had follow-up >3 years, had duration of sleep at baseline, and all-cause mortality prospectively. We extracted relative risks (RR) and 95% confidence intervals (CI) and pooled them using a random effect model. We carried out sensitivity analyses and assessed heterogeneity and publication bias. Overall, the 16 studies analyzed provided 27 independent cohort samples. They included 1,382,999 male and female participants (followup range 4 to 25 years), and 112,566 deaths. Sleep duration was assessed by questionnaire and outcome through death certification. In the pooled analysis, short duration of sleep was associated with a greater risk of death (RR: 1.12; 95% CI 1.06 to 1.18; P < 0.01) with no evidence of publication bias (P = 0.74) but heterogeneity between studies (P = 0.02). Long duration of sleep was also associated with a greater risk of death (1.30; [1.22 to 1.38]; P < 0.0001) with no evidence of publication bias (P = 0.18) but significant heterogeneity between studies (P < 0.0001). Both short and long duration of sleep are significant predictors of death in prospective population studies.
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            Association of sleep time with diabetes mellitus and impaired glucose tolerance.

            Experimental sleep restriction causes impaired glucose tolerance (IGT); however, little is known about the metabolic effects of habitual sleep restriction. We assessed the cross-sectional relation of usual sleep time to diabetes mellitus (DM) and IGT among participants in the Sleep Heart Health Study, a community-based prospective study of the cardiovascular consequences of sleep-disordered breathing. Participants were 722 men and 764 women, aged 53 to 93 years. Usual sleep time was obtained by standardized questionnaire. Diabetes mellitus was defined as a serum glucose level of 126 mg/dL or more (> or =7.0 mmol/L) fasting or 200 mg/dL or more (> or =11.1 mmol/L) 2 hours following standard oral glucose challenge or medication use for DM. Impaired glucose tolerance was defined as a 2-hour postchallenge glucose level of 140 mg/dL or more (> or =7.8 mmol/L) and less than 200 mg/dL. The relation of sleep time to DM and IGT was examined using categorical logistic regression with adjustment for age, sex, race, body habitus, and apnea-hypopnea index. The median sleep time was 7 hours per night, with 27.1% of subjects sleeping 6 hours or less per night. Compared with those sleeping 7 to 8 hours per night, subjects sleeping 5 hours or less and 6 hours per night had adjusted odds ratios for DM of 2.51 (95% confidence interval, 1.57-4.02) and 1.66 (95% confidence interval, 1.15-2.39), respectively. Adjusted odds ratios for IGT were 1.33 (95% confidence interval, 0.83-2.15) and 1.58 (95% confidence interval, 1.15-2.18), respectively. Subjects sleeping 9 hours or more per night also had increased odds ratios for DM and IGT. These associations persisted when subjects with insomnia symptoms were excluded. A sleep duration of 6 hours or less or 9 hours or more is associated with increased prevalence of DM and IGT. Because this effect was present in subjects without insomnia, voluntary sleep restriction may contribute to the large public health burden of DM.
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              Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project.

              Few studies and no international comparisons have examined the impact of multiple chronic conditions on populations using a comprehensive health-related quality of life (HRQL) questionnaire. The impact of common chronic conditions on HRQL among the general populations of eight countries was assessed. Cross-sectional mail and interview surveys were conducted. Sample representatives of the adult general population of eight countries (Denmark, France, Germany, Italy, Japan, The Netherlands, Norway and the United States) were evaluated. Sample sizes ranged from 2031 to 4084. Self-reported prevalence of chronic conditions (including allergies, arthritis, congestive heart failure, chronic lung disease, hypertension, diabetes, and ischemic heart disease), sociodemographic data and the SF-36 Health Survey were obtained. The SF-36 scale and summary scores were estimated for individuals with and without selected chronic conditions and compared across countries using multivariate linear regression analyses. Adjustments were made for age, gender, marital status, education and the mode of SF-36 administration. More than half (55.1%) of the pooled sample reported at least one chronic condition, and 30.2% had more than one. Hypertension, allergies and arthritis were the most frequently reported conditions. The effect of ischemic heart disease on many of the physical health scales was noteworthy, as was the impact of diabetes on general health, or arthritis on bodily pain scale scores. Arthritis, chronic lung disease and congestive heart failure were the conditions with a higher impact on SF-36 physical summary score, whereas for hypertension and allergies, HRQL impact was low (comparing with a typical person without chronic conditions, deviation scores were around -4 points for the first group and -1 for the second). Differences between chronic conditions in terms of their impact on SF-36 mental summary score were low (deviation scores ranged between -1 and -2). Arthritis has the highest HRQL impact in the general population of the countries studied due to the combination of a high deviation score on physical scales and a high frequency. Impact of chronic conditions on HRQL was similar roughly across countries, despite important variation in prevalence. The use of HRQL measures such as the SF-36 should be useful to better characterize the global burden of disease.
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                Author and article information

                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                September 2012
                : 28
                : 9
                : 1674-1684
                Affiliations
                [01] Campinas orgnameUniversidade Estadual de Campinas orgdiv1Faculdade de Ciências Médicas Brasil
                [02] São Paulo orgnameSecretaria do Estado de Saúde de São Paulo Brasil
                Article
                S0102-311X2012000900007 S0102-311X(12)02800900007
                90302f99-56ed-4705-8e63-fe53e8a79cf0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 25 April 2012
                : 08 May 2012
                : 24 November 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 51, Pages: 11
                Product

                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Article

                Health Status,Health of the Elderly,Sleep,Quality of Life,Nível de Saúde,Saúde do Idoso,Sono,Qualidade de Vida

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