Association of multiple symptoms with sleep quality and duration: a cross-sectional population-based study of older men in Sweden

Objective: To evaluate any association of the presence and severity of nine major symptoms (pain, tiredness, drowsiness, nausea, appetite, breathlessness, depression, anxiety, and perceived well-being) with sleep quality and duration in elderly men. 

Design and setting: Cross-sectional analysis within the population-based VAScular and Chronic Obstructive Lung disease study (VASCOL) conducted in southern Sweden in 2019. 

Participants: A total of 838 older men aged 73 years. 

Measures: Severity of the symptoms was self-reported between 0 and 10 on a numerical rating scale. Breathlessness was also assessed using the Multidimensional Dyspnoea Profile and Dyspnoea-12. Sleep quality was reported on a 5-point Likert scale from € very well' to € very bad'and sleep duration on a 7-point scale from € less than 4 hours' to € more than 10 hours'. Associations of each symptom score with having worse sleep quality ( € bad' or € very bad') and/or shorter sleep duration (<6 hour/night) were analysed using logistic regression, adjusted for common confounders. 

Results: Of 838 men analysed, 11% had worse sleep quality, 8% had shorter sleep duration and 5% had both. Higher severity of each symptom was associated with worse sleep quality (adjusted odds ratios (aOR) ranging 1.12-1.61) and shorter sleep duration (aORs ranging 1.10-1.49). 

Conclusions: A wide range of symptoms is associated with worse sleep quality and shorter sleep duration in elderly men, suggesting that clinicians should assess sleep when these symptoms are present and vice versa.