Poor Sleep Quality in Jamaican Adults With Sickle Cell Disease: Prevalence, Risk Factors, and Association With Quality of Life

Abstract

Poor sleep and chronic illnesses have a bidirectional relationship where presence of one can worsen the other. Sickle cell disease (SCD) is associated with significant morbidity and early mortality. In this study, we examine sleep quality, its predictors, and its association with quality of life in Jamaican adults with SCD. This cross-sectional study evaluated 177 well adult SCD patients for sleep quality using The Pittsburgh Sleep Quality Index (PSQI) and quality of life using the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me). Multiple linear regression models examined the predictors of poor sleep quality. The mean global PSQI score was 6.9 (SD 4.2) with 56.5% having poor sleep quality. Women had significantly worse scores for sleep efficiency (p 0.005), sleep latency (p 0.03) and higher use of sleeping medications (p 0.02). Those overweight/obese had significantly worse subjective sleep quality (p 0.001) and sleep efficiency (p 0.05). In multivariate regression analysis, overweight individuals had poorer sleep quality (OR: 2.9; 95% C.I.: 1.07, 7.88) than those with normal weight whereas those unemployed and looking for a job had lower prevalence of poor sleep quality (OR 0.2; 95% C.I.: 0.05, 0.77) compared to employed individuals. Participants with good sleep quality had significantly better functioning in all 5 domains of the ASCQ-Me. In conclusion, persons with SCD who are overweight or obese are at increased risk of poor sleep which can negatively affect quality of life. Patient populations and healthcare providers will need to manage the emerging burden of overweight/obesity.

Keywords:

• Sickle cell disease
• Jamaica
• sleep quality
• sleep components
• PSQI
• ASCQ-Me

Acknowledgements

The authors are grateful to all sickle cell disease warriors who participated in this study.

Ethics approval

The study received ethical approval from the Mona Campus Research and Ethics Committee (ECP 184, 18/19). The study was conducted in accordance with the code of conduct stated by the Declaration of Helsinki. No identifying information is presented in this manuscript.

Authors’ Contributions

Both authors designed the study. NC conducted all data collection. Both authors conducted data analysis, wrote the manuscript together and have approved the final version for submission for publication.

Disclosure statement

The authors declare no conflicts of interest.

Consent to participate

All participants provided written informed consent before any testing was begun.

Availability of data and material

The authors can make the relevant data presented in this paper available on reasonable request.

Additional information

Funding

The study was conducted using departmental resources. No external sources of funding were used.