Association between disability, sleep and chronic conditions

Background:  Adults with disabilities are more likely to report chronic conditions than are adults without disabilities. Sleep is critical to health and well-being, though little is known about whether adults with disabilities have better health outcomes depending on their amount of sleep.

Methods:  We analyzed data from 20 states that used the sleep module in the 2009-2010 Behavioral Risk Factor Surveillance System to determine hours of sleep and chronic disease by disability status.  We performed logistic regression to determine moderating effects of amount of sleep (categorized as ≤5, 6, 7, 8 and 9+ hours in a 24 hour period) on the association between disability and 5 chronic conditions (stroke, hypertension, obesity, diabetes and high cholesterol).

Results:  The associations between disability and stroke (aOR: 4.1, 95% CI: 3.2, 5.4; 6 hours of sleep) and disability and hypertension (aOR: 2.6, 95% CI: 1.9, 3.4; ≤5 hours of sleep) were both strongest among those reporting fewer hours of sleep.  The association between disability and obesity was weakest among those reporting 9+ hours of sleep (aOR: 1.61, 95% CI: 1.34, 1.94).  The association between disability and diabetes was similar across all levels of sleep (aOR range:  1.93 to 2.33).  Finally, the association between disability and high cholesterol was weakest among those reporting 7 hours of sleep (aOR: 1.33, 95% CI: 1.12, 1.57).

Conclusion:  The strength of the association between disability and chronic conditions varied by hours of sleep.  Programs promoting the health of people with disabilities may benefit from promoting the importance of sleep.