We cannot change what we do not measure: A case for assessing sleep in the California Health Interview Survey

Sleep complaints are prevalent in older adults (57%) and are associated with a variety of medical and psychiatric comorbidities, poor health behaviors, and increased medication use. Numerous studies show that self-report indicators of poor sleep (e.g., nightly hours of sleep) are associated with poor health outcomes, low quality of life, and elevated mortality risk. Healthy People 2020 includes sleep as a national health objective; yet, few state-level health surveys measure sleep-related variables. The current analysis explored factors known to be related to poor sleep among older (age≥65) respondents to the 2005 California Health Interview Survey (CHIS). 22.8% of respondents were 65 or older. Among factors known to be related to sleep apnea, high blood pressure (60.1%), anti-hypertensive use (53.8%), obesity/overweight (53.9%), and heart disease (23.6%) were commonly reported. Among factors known to be related to insomnia, arthritis (50.2%), limited activity/sedentary lifestyle (72.2%), and low health-related quality of life (42.0%) were commonly reported. Only 20.2% had discussed health behaviors with a doctor. These findings suggest a high number of older CHIS respondents report factors known to be associated with poor sleep; however, the role of poor sleep in overall health and quality of life remains unclear. To understand the role poor sleep may play, sleep itself must be measured in statewide surveys. Since there are clear evidence-based treatments for poor sleep, and treatment of sleep disorders is known to improve health and quality of life, the addition of sleep-related items to statewide surveys is recommended.