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The relationship between chronically disrupted sleep and healthcare use.

TitleThe relationship between chronically disrupted sleep and healthcare use.
Publication TypeJournal Article
Year of Publication2002
AuthorsKapur, VK, Redline, S, F Nieto, J, Young, TB, Newman, AB, Henderson, JA
Corporate/Institutional AuthorsSleep Heart Health Research Group,
JournalSleep
Volume25
Issue3
Pagination289-96
Date Published2002 May 01
ISSN0161-8105
KeywordsAdult, Chronic Disease, Cohort Studies, Community Health Services, Cross-Sectional Studies, Disorders of Excessive Somnolence, Female, Health Status, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Polysomnography, Prevalence, Severity of Illness Index, Sleep Apnea, Obstructive, Sleep Deprivation
Abstract<p><b>STUDY OBJECTIVES: </b>To determine whether chronic sleep deprivation, sleep disruption, sleepiness, insomnia, and OSA are associated with increased healthcare use in a community-based population.</p><p><b>DESIGN: </b>Cross-sectional study.</p><p><b>SETTING/PARTICIPANTS: </b>6440 Sleep Heart Health Study (SHHS) participants recruited from ongoing cohort studies.</p><p><b>INTERVENTIONS: </b>N/A.</p><p><b>MEASUREMENTS: </b>Polysomnography results (Apnea Hypopnea Index (AHI), percent of sleep time with oxyhemoglobin saturation below 90% (CT90), arousal index) as well as data on sleep related symptoms, medication use, and chronic illness. The indirect measure of predicted healthcare utilization was the modified Chronic Disease Score (CDS) calculated from medication data.</p><p><b>RESULTS: </b>After adjustment for age, gender, BMI and study site, subjects in the highest quartiles of AHI, CT90 and Epworth score had CDS that were 6%-9% higher than the lowest quartiles. The adjusted mean CDS for subjects with sleep apnea was similar to that for subjects with hypertension, chronic bronchitis or asthma and 18% greater than the mean CDS for subjects without sleep apnea. Among subjects who did not have significant sleep-disordered breathing, complaints of insomnia, sleepiness, fatigue, and not getting enough sleep were associated with increased CDS.</p><p><b>CONCLUSIONS: </b>This study demonstrated an association between subjective complaints of daytime sleepiness, inadequate sleep time, insomnia as well as objective measures of severity of SDB, and an indirect measure of healthcare utilization in a community-based sample. Though the percent increases in healthcare utilization observed were modest, the prevalence of these factors in the general population is high, and may therefore be associated with a substantial cost burden to the healthcare system.</p>
Alternate JournalSleep
PubMed ID12003159
Grant ListU01HL53937 / HL / NHLBI NIH HHS / United States
U01153934 / / PHS HHS / United States
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
U01HL53916 / HL / NHLBI NIH HHS / United States
UO1HL53938 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States