A new study led by Carol M. Baldwin, PhD, RN, FAAN, shows that having a sleep disturbance is associated with clinically meaningful reductions in health-related quality of life, and the magnitude of this effect varies by race and sleep disorder.
Results indicate that physical health-related quality of life in African-Americans who snored frequently, had insomnia symptoms, or reported excessive daytime sleepiness was significantly worse than in Caucasians. African-Americans with insomnia also had significantly more physical limitations than Hispanics. However, when mental health-related quality of life was evaluated, it was Hispanics with frequent snoring, insomnia symptoms, or excessive daytime sleepiness who had significantly greater mental distress than Caucasians. African-Americans with insomnia also had significantly worse mental health than Caucasians.
"The study highlights the increased disparities among African- and Latino-Americans compared with Caucasians even in the sleep and health-related quality of life domain," said lead author Carol M. Baldwin, PhD, RN, FAAN, Southwest Borderlands Scholar and director of the Center for World Health Promotion and Disease Prevention in the College of Nursing and Health Innovation at Arizona State University, Phoenix.
The study found that sleep disturbances were common, with 46% of people having at least mild sleep apnea, 34% reporting frequent snoring, 30% having insomnia symptoms, and 25% reporting excessive daytime sleepiness. Frequent snoring was significantly more common among Hispanics (41%), and excessive daytime sleepiness was significantly more common among African-Americans (32%). There were no statistically significant differences in the distribution of obstructive sleep apnea or insomnia symptoms by race.
According to Baldwin, the study could help reduce health disparities and improve outcomes by advancing "tailored care" in sleep medicine.
"These findings support the need for sleep clinicians to use culturally responsive sleep education, assessment, and intervention approaches, as well as depression, anxiety, and other relevant mood and socioeconomic-status measures," she said.
The authors cautioned that the correlational nature of the study did not allow for an analysis of causality. Baldwin added that the causes of differences in health-related quality of life can be complex and may include such factors as lifestyle and activity patterns, diet, sleep architecture, and access to health care.
However, the study, published in the April 15 issue of the Journal of Clinical Sleep Medicine, suggests that the impact of sleep disorders on daily living and general well-being may be similar to that of other chronic conditions. The mean score profiles for health-related quality of life in people with sleep apnea and other sleep symptoms were similar to those that have been previously reported for patients with hypertension and type 2 diabetes.
