title: Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey.
abstract: OBJECTIVE
  The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours).
  
  
  METHODS
  Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis.
  
  
  METHODS
  A total of 27,731 participants (age range 18-85 years) from the NHIS 2009 dataset were interviewed.
  
  
  METHODS
  Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7-8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period.
  
  
  RESULTS
  Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001).
  
  
  CONCLUSIONS
  Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis).
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Azizi A
authors.initials: AA
authors.lastname: Seixas
authors.affiliation: Sophie Davis School of Biomedical Education, City College of New York, New York, NY, USA.
authors.forename: Joao V
authors.initials: JV
authors.lastname: Nunes
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA.
authors.forename: Collins O
authors.initials: CO
authors.lastname: Airhihenbuwa
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Natasha J
authors.initials: NJ
authors.lastname: Williams
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Seithikurippu Ratnas
authors.initials: SR
authors.lastname: Pandi-Perumal
authors.affiliation: Department of Sociology, Psychology and Social Work, The University of the West Indies, Mona, Jamaica.
authors.forename: Caryl C
authors.initials: CC
authors.lastname: James
authors.affiliation: Center for Healthful Behavior Change, Department of Population Health, Division of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Girardin
authors.initials: G
authors.lastname: Jean-Louis
keywords: anxiety; depression; emotional distress; mental health; sleep; sleep duration; unhealthy sleep