Chest
Volume 91, Issue 4, April 1987, Pages 540-546
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Clinical Investigations
Prevalence of Reported Sleep Disturbances in a General Adult Population and their Relationship to Obstructive Airways Diseases

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In order to determine the prevalence of reported sleep disturbances in a general adult population and the relationship of these complaints to age, gender and coexistent obstructive airways disease, 2,187 subjects in the Tucson Epidemiologic Study of Obstructive Airways Disease were surveyed in 1985 regarding their sleep symptoms. At least one symptom of disturbed sleep was present in 41.4 percent of all subjects. Women generally reported a significantly higher prevalence of both disorders of initiating and maintaining sleep (DIMS) and nightmares (NMXp<.001). Before age 64 years, the prevalence of complaints of excessive daytime sleepiness (EDS) among men and women were similar. However, the frequency of EDS was significantly higher in men than women after age 64 years. Prevalence of at least one sleep symptom and DIMS increased with advancing age. The prevalence of nightmares appeared to be age-related only among women, who displayed a declining prevalence with advancing age. EDS increased only after age 64 years. There was a significant relationship between DIMS and EDS with coexistent chronic bronchitis, concomitant asthma and chronic bronchitis, and emphysema, but not asthma as a solitary diagnosis. Nightmares were reported with much greater frequency among subjects with asthma, asthma and chronic bronchitis, and emphysema but not in subjects with chronic bronchitis alone. The presence of coexistent asthma and chronic bronchitis was associated with particularly high prevalence of complaints of DIMS, EDS and nightmares. We conclude that, in the general adult population, sleep disorder symptoms increase with age and usually are greater in women. Furthermore, there is an increased prevalence of sleep symptoms among adults with chronic airways obstructive disease, especially those with coexistent asthma and chronic bronchitis.

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METHODS

Data were obtained from the 1984 and 1985 surveys of subjects participating in the Tucson Epidemiologic Study of Obstructive Airways Disease, a prospective longitudinal study of the natural history of obstructive lung disease which was begun in 1972. The study sample represents a random, stratified sample of the white, non-Mexican-American population of Tucson, Arizona. A detailed description of the methodology of population selection has been published.8 Since inception of the study, an

Description of General Population

Using our analysis criteria, survey data were available from 2,187 of 2,639 potential subjects, a questionnaire return rate of 82.9 percent. Of the remaining possible subjects, 57.3 percent were lost to follow-up, 29.8 percent refused to participate, and 12.9 percent were ill and unable to complete the questionnaire. The mean age of these individuals (47.1 ±22.4 yrs) was not different from the study population (49.1±19.7 yrs, p>0.05). Age distribution of the study population was as follows: 1)

DISCUSSION

This study demonstrates that complaints of sleep disturbances are common in the general adult population. The prevalence increases as a function of age, and is higher in women compared to men. Furthermore, complaints of sleep disturbance occur even more frequently in persons suffering from chronic obstructive airways disease.

Of the 2,639 subjects eligible for inclusion in our study population, we obtained a participation rate of over 80 percent. Age and gender comparisons between our study

ACKNOWLEDGMENTS

The authors wish to thank Mr. Walter Kaltenborn for his assistance in the statistical analysis of this data, Dr. Benjamin Burrows for his review of the manuscript, and Mrs. Sandra Testa for her help in the manuscript preparation.

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  • Cited by (0)

    Supported by Specialized Center of Research Grant HL-14136.

    Presented in part at the Annual Meeting, American Thoracic Society, May 12, 1986, Kansas City, Missouri.

    Manuscript received July 14; revision accepted September 29.

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