Over-indebtedness and its association with sleep and sleep medication use.


Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
17 Jul 2019
Historique:
received: 08 11 2018
accepted: 24 06 2019
entrez: 19 7 2019
pubmed: 19 7 2019
medline: 12 10 2019
Statut: epublish

Résumé

Over-indebtedness is currently rising in high-income countries. Millions of citizens are confronted with the persistent situation when household income and assets are insufficient to cover payment obligations and living expenses. Previous research shows that over-indebtedness increases the risk of various adverse health effects. However, its association with sleep problems has not yet been examined. The objective of this study was to investigate the association between over-indebtedness and sleep problems and sleep medication use. A cross-sectional study on over-indebtedness (OID survey) was conducted in 70 debt advisory centres in Germany in 2017 that included 699 over-indebted respondents. The survey data were combined with the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). We limited analyses to participants with complete data on all sleep variables (OID: n = 538, DEGS1: n = 7447). Descriptive analyses and logistic regression analyses were used to examine the association between over-indebtedness and difficulty initiating and maintaining sleep, and sleep medication use. A higher prevalence of sleep problems and sleep medication use was observed among over-indebted individuals compared to the general population. After adjustment for socio-economic and health factors (age, sex, education, marital status, employment status, subjective health status and mental illness), over-indebtedness significantly increased the risk of difficulties with sleep onset (adjusted odds ratio (aOR) 1.79, 95%-confidence interval (CI) 1.45-2.21), sleep maintenance (aOR 1.45, 95%-CI 1.17-1.80) and sleep medication use (aOR 3.94, 95%-CI 2.96-5.24). Evidence suggests a strong association between over-indebtedness and poor sleep and sleep medication use independent of conventional socioeconomic measures. Considering over-indebtedness in both research and health care practice will help to advance the understanding of sleep disparities, and facilitate interventions for those at risk. German Clinical Trials Register: DRKS00013100 (OID survey, ArSemü); Date of registration: 23.10.2017; Date of enrolment of the first participant: 18.07.2017, retrospectively registered.

Sections du résumé

BACKGROUND BACKGROUND
Over-indebtedness is currently rising in high-income countries. Millions of citizens are confronted with the persistent situation when household income and assets are insufficient to cover payment obligations and living expenses. Previous research shows that over-indebtedness increases the risk of various adverse health effects. However, its association with sleep problems has not yet been examined. The objective of this study was to investigate the association between over-indebtedness and sleep problems and sleep medication use.
METHODS METHODS
A cross-sectional study on over-indebtedness (OID survey) was conducted in 70 debt advisory centres in Germany in 2017 that included 699 over-indebted respondents. The survey data were combined with the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). We limited analyses to participants with complete data on all sleep variables (OID: n = 538, DEGS1: n = 7447). Descriptive analyses and logistic regression analyses were used to examine the association between over-indebtedness and difficulty initiating and maintaining sleep, and sleep medication use.
RESULTS RESULTS
A higher prevalence of sleep problems and sleep medication use was observed among over-indebted individuals compared to the general population. After adjustment for socio-economic and health factors (age, sex, education, marital status, employment status, subjective health status and mental illness), over-indebtedness significantly increased the risk of difficulties with sleep onset (adjusted odds ratio (aOR) 1.79, 95%-confidence interval (CI) 1.45-2.21), sleep maintenance (aOR 1.45, 95%-CI 1.17-1.80) and sleep medication use (aOR 3.94, 95%-CI 2.96-5.24).
CONCLUSIONS CONCLUSIONS
Evidence suggests a strong association between over-indebtedness and poor sleep and sleep medication use independent of conventional socioeconomic measures. Considering over-indebtedness in both research and health care practice will help to advance the understanding of sleep disparities, and facilitate interventions for those at risk.
TRIAL REGISTRATION BACKGROUND
German Clinical Trials Register: DRKS00013100 (OID survey, ArSemü); Date of registration: 23.10.2017; Date of enrolment of the first participant: 18.07.2017, retrospectively registered.

Identifiants

pubmed: 31315596
doi: 10.1186/s12889-019-7231-1
pii: 10.1186/s12889-019-7231-1
pmc: PMC6637586
doi:

Substances chimiques

Sleep Aids, Pharmaceutical 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

957

Subventions

Organisme : Landeszentrum Gesundheit Nordrhein-Westfalen
ID : not available

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Auteurs

Jacqueline Warth (J)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. jacqueline.warth@ukbonn.de.

Marie-Therese Puth (MT)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

Judith Tillmann (J)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

Johannes Porz (J)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

Ulrike Zier (U)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

Klaus Weckbecker (K)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

Eva Münster (E)

Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.

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