title: Association between visual impairment and sleep duration: analysis of the 2009 National Health Interview Survey (NHIS).
abstract: BACKGROUND
  Visual impairment (VI) is associated with increased mortality and health factors such as depression and cardiovascular disease. Epidemiologic studies consistently show associations between sleep duration with adverse health outcomes, but these have not systematically considered the influence of VI. The aim of this study was to ascertain the independent association between VI and sleep duration using the National Health Interview Survey (NHIS) data. We also examined whether race/ethnicity influenced these associations independently of sociodemographic and medical characteristics.
  
  
  METHODS
  Our analysis was based on the 2009 NHIS, providing valid sleep and vision data for 29,815 participants. The NHIS is a cross-sectional household interview survey utilizing a multistage area probability design. Trained personnel from the US census bureau gathered data during face-to-face interview and obtained socio-demographic, self-reported habitual sleep duration and physician-diagnosed chronic conditions.
  
  
  RESULTS
  The mean age of the sample was 48 years and 56% were female. Short sleep and long sleep durations were reported by 49% and 23% of the participants, respectively. Visual impairment was observed in 10%. Multivariate-adjusted logistic regression models showed significant associations between VI and short sleep (OR = 1.6, 95% CI = 1.5-1.9 and long sleep durations (OR = 1.6, 95% CI = 1.3-1.9). These associations persisted in multivariate models stratified by race-ethnic groups.
  
  
  CONCLUSIONS
  Visual impairment was associated with both short and long sleep durations. Analysis of epidemiologic sleep data should consider visual impairment as an important factor likely to influence the amount of sleep experienced habitually.
authors.forename: Alberto R
authors.initials: AR
authors.lastname: Ramos
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Wallace
authors.forename: Natasha J
authors.initials: NJ
authors.lastname: Williams
authors.forename: David Warren
authors.initials: DW
authors.lastname: Spence
authors.forename: Seithikurippu Ratnas
authors.initials: SR
authors.lastname: Pandi-Perumal
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Zizi
authors.affiliation: Center for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, NYU Langone Medical Center, 227 East 30th Street, Floor # 6-615, New York, NY 10016, USA. Girardin.Jean-Louis@nyumc.org.
authors.forename: Girardin
authors.initials: G
authors.lastname: Jean-Louis
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000208:ethnology* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000208:ethnology* / Q000503:physiopathology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D044465:White People / Q000208:ethnology*