title: The health-related quality-of-life impact of nocturnal awakenings in the middle-aged and older Finnish population.
abstract: OBJECTIVE
  The aim of the study is to examine the health-related quality-of-life (HRQOL) impact of the nocturnal awakenings and the duration of the sleep in the Finnish middle-aged and older population.
  
  
  METHODS
  Cross-sectional sample consisted of 823 community-dwelling persons aged 55-75 living in a single municipality in a rural area of Eastern Finland. Frequency of the nocturnal awakenings was dichotomized as reporting "frequent," if the participant reported subjectively awakening "often" or "very often," and "infrequent" if the participant reported awakening "sometimes" or less frequently. HRQOL was measured with a preference-based HRQOL-index instrument, 15D. Analyses were adjusted for gender, BMI, morbidities, depression, employment and marital status, current smoking and drinking, exercise, recommendation to exercise from a health care professional, and subjective opinion about own exercise habits.
  
  
  RESULTS
  Frequent nocturnal awakenings had statistically and clinically significant negative impact on HRQOL, the mean (SE) adjusted marginal HRQOL impact being -0.0416 (0.006). More than 10 and less than 6.5 h of daily sleep were associated with higher probability of having low HRQOL, adjusted odd ratios (95 % CI) being 2.65 (1.11-6.33) and 2.65 (1.55-4.52), respectively. However, the changes in daily sleep duration did not have noticeable influence on the significance or magnitude of the negative HRQOL impact of the frequent nocturnal awakenings.
  
  
  CONCLUSIONS
  Nocturnal awakenings displayed a strong independent association with decreased HRQOL. The findings suggest that both clinicians and researchers should pay closer attention to nocturnal awakenings and other sleep problems in order to find ways to improve the quality of life in individuals with such conditions.
authors.affiliation: Pharmacoeconomics & Outcomes Research Unit (PHORU), School of Pharmacy, Social Pharmacy, University of Eastern Finland, B.O.Box 1627, 70211, Kuopio, Finland, saku.vaatainen@uef.fi.
authors.forename: Saku
authors.initials: S
authors.lastname: Väätäinen
authors.forename: Henri
authors.initials: H
authors.lastname: Tuomilehto
authors.forename: Jouko
authors.initials: J
authors.lastname: Saramies
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: Hannu
authors.initials: H
authors.lastname: Uusitalo
authors.forename: Esko
authors.initials: E
authors.lastname: Hussi
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.forename: Janne
authors.initials: J
authors.lastname: Martikainen
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012424:Rural Population; D018434:Sickness Impact Profile; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014851:Wakefulness; D055815:Young Adult
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