Background
Although sleep is a necessity, about 60 million Americans are affected by chronic sleep disorders and sleep problems that can impair physical well-being and cognitive functioning. A growing body of evidence strongly suggests that self-reported sleep durations are correlates of diabetes, cardiovascular disease, obesity, depression and anxiety. These include a cross-sectional study, prospective cohort studies, and an intervention study. However, underlying mechanisms of this relationship are still widely discussed.
Recently, the Centers for Disease Control and Prevention (CDC) expanded the information collected on sleep health in the U.S. national surveillance systems based on recommendations from the Institute of Medicine. Thus, the Behavioral Risk Factor Surveillance System (BRFSS), the largest telephone health survey in the world, began collecting data on perceived insufficient sleep, defined by the number of days the respondent felt that he/she did not get enough rest or sleep during the past 30 days. Although polysomnography in a sleep clinic provides a more objective measure of sleep loss and sleep quality than a subjective measure of insufficient sleep, it is not feasible for large national surveillance systems. Furthermore, perceived insufficient sleep is similar to a sleep complaint measure provided in a primary care setting to indicate a concern or problem with sleep quality and quantity such as sleep disturbance and other symptoms of sleep disorders. Several reports on insufficient sleep in BRFSS to date have addressed the prevalence of insufficient sleep and the association between perceived insufficient rest/sleep and cardiovascular disease, diabetes mellitus, obesity and smoking habits. In contrast to self-reported sleep duration, insufficient sleep is a less studied dimension of sleep experience which may provide additional important information for understanding the role of sleep in general health at the population level. As depression and obesity are associated with impaired sleep and several health outcomes, the present study aims to examine the relationships between perceived insufficient sleep and other chronic diseases such as high blood pressure, arthritis, and asthma, and to assess whether the relationships between perceived insufficient sleep and chronic disease may be attenuated by frequent mental distress (FMD) and obesity.