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25.10.2022 | Epidemiology • Original Article

Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India

verfasst von: Partha Haldar, Kameshwar Prasad, Shashi Kant, Sada Nand Dwivedi, Deepti Vibha, Awadh Kishor Pandit, Achal Kumar Srivastava, Amit Kumar, M Arfan Ikram, Tiemeier Henning

Erschienen in: Sleep and Breathing | Ausgabe 4/2023

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Abstract

Study objectives

To determine if metabolic risk factors are associated with poor sleep quality and obstructive sleep apnea–like symptoms (OSA symptoms) independent of psychosocial problems and demographic and lifestyle factors in older Indian adults.

Methodology

We analyzed baseline data from adults (≥ 50 years) from a population-based cohort, the LoCARPoN study, in India. Variables were grouped as (a) demographic and lifestyle factors such as smoking, alcohol use, and physical activity; (b) psychosocial problems including symptoms of depression, anxiety, and perceived stress; and (c) metabolic risk factors including glycated hemoglobin, high-density lipoprotein, low-density lipoprotein, total cholesterol, body mass index, and hypertension. Variables were examined as predictors of poor sleep quality and OSA symptoms. Groups of variables were added stepwise to a logistic regression. Variance explained by nested models was quantified using McFadden’s pseudo R², and change was formally tested with the log-likelihood ratio test.

Results

Among 7505 adults, the prevalence of poor sleep quality was 16.9% (95% CI: 16.0, 17.7), and OSA symptoms were present in 7.0% (95% CI: 6.4, 7.6). Psychosocial problems had a strong independent association with both poor sleep quality (pseudo R² increased from 0.10 to 0.15, p < 0.001) and more OSA symptoms (pseudo R² increased from 0.08 to 0.10, p < 0.001). Metabolic risk factors had a modest independent association with sleep quality (pseudo R² increased from 0.14 to 0.15, p < 0.01), but a strong association with OSA symptoms (pseudo R² increased from 0.08 to 0.10, p < 0.001).

Conclusion

Psychosocial and metabolic risk factors were independently associated with sleep quality and OSA symptoms. This fact implied that OSA symptoms may affect both mental health and physical health. Our findings have public health implications because the number and proportion of the elderly in India is increasing, while the prevalence of metabolic risk factors and psychosocial problems is high already. These facts have the potential to exacerbate not only the burden of sleep disorders and OSA symptoms but also associated cardiovascular and neurologic sequelae, further stretching the Indian health-care system.

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Titel: Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India
verfasst von: Partha Haldar
Kameshwar Prasad
Shashi Kant
Sada Nand Dwivedi
Deepti Vibha
Awadh Kishor Pandit
Achal Kumar Srivastava
Amit Kumar
M Arfan Ikram
Tiemeier Henning
Publikationsdatum: 25.10.2022
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2023
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-022-02725-9

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Metabolic risk factors and psychosocial problems independently explain poor sleep quality and obstructive sleep apnea symptoms among adults in urban India