The longitudinal course and impact of non-restorative sleep: A five-year community-based follow-up study

Abstract

Background: There is a dearth of data on the longitudinal course and outcome of non-restorative sleep (NRS). Methods: A total of 2291 middle-aged adults (mean [SD] = 46.3 [5.1] years old, 50.0% males at follow-up) were recruited into a 5-year follow-up study. NRS was defined as morning unfreshness after getting up ≥3. times/week over the past 12. months. Socio-demographics, other concurrent sleep complaints, and daytime symptoms were measured at baseline. Chronic medical problems in the past one year were additionally assessed at follow up. Results: Several sleep problems (including other insomnia subtypes, snoring, and nightmares) and daytime symptoms were strongly associated with NRS at baseline. NRS had considerable persistence (31.9%), partial remission (22.7%), and incidence rate (5.2%). New incidence of NRS was predicted by female gender (AOR = 1.67), preferring not to get up in the morning (AOR = 1.96), fatigue (AOR = 2.18), and short sleep duration (AOR = 1.87), whereas persistence of NRS was predicted by difficulty initiating sleep (AOR = 2.36). In the fully adjusted models, baseline NRS was significantly associated with multiple medical disorders at follow-up, including frequent allergic rhinitis (AOR = 1.62) and laryngopharyngitis (AOR = 2.47), diabetes mellitus (AOR = 2.63), gastroesophageal reflux disease (AOR = 2.03), eye problems (AOR = 2.45), eczema (AOR = 2.18), and poor mental health (AOR = 1.68). Conclusions: The persistent course and independent association of NRS with adverse medical and mental outcomes argue for a distinct nosological status and the need for rigorous medical attention. © 2012 Elsevier B.V.