Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 21:14:26335565241228549.
doi: 10.1177/26335565241228549. eCollection 2024 Jan-Dec.

Impaired sleep, multimorbidity, and self-rated health among Canadians: Findings from a nationally representative survey

Shirmin Bintay Kader  1   2 , Nahin Shakurun  2 , Bonnie Janzen  2 , Punam Pahwa  2   3
Affiliations

Impaired sleep, multimorbidity, and self-rated health among Canadians: Findings from a nationally representative survey

Shirmin Bintay Kader et al. J Multimorb Comorb. .

Abstract

Background: Self-rated health (SRH) is a globally recognized measure of health status. Both impaired sleep (IS) and the presence of multimorbidity are related to poorer SRH, but the precise nature of these associations remains unclear. This study explored the association between IS, multimorbidity, and SRH among Canadian adults.

Method: We used 2017-18 Canadian Community Health Survey (CCHS) data for this study. The main variable of interest, self-rated health (SRH), measured participants' health on a 5-point Likert scale, later categorized as "good or better" vs. "fair or poor". The primary predictor, IS, was derived from two variables and categorized into four groups: no sleep issues; fewer sleeping hours (<7 hours) only; trouble sleeping only; and fewer hours & trouble sleeping. Multimorbidity was present (yes/no) if a participant indicated being diagnosed with two or more chronic conditions.

Results: Just over one in ten Canadians reported fair/poor SRH and approximately one-quarter had multimorbidity or experienced few sleep hours in combination with trouble sleeping. The adjusted model indicated greater odds of fair/poor SRH associated with the 40-64 years age group, male sex, and lower socio-economic status. It also suggested the presence of multimorbidity (AOR= 4.63, 95% CI: 4.06-5.28) and a combination of fewer sleep hours and troubled sleep (AOR= 4.05, 95% CI: 2.86-5.74) is responsible for poor SRH. Forty-four percent of the total effect of IS on SRH was mediated by multimorbidity.

Conclusion: This unique finding highlights the mediating role of multimorbidity, emphasizing the importance of addressing it alongside sleep issues for optimal health outcomes.

Keywords: Self-rated health; chronic diseases; impaired sleep; multimorbidity; noncommunicable diseases.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Theoretical framework for this study.
Figure 2.
Figure 2.
Interaction between impaired sleep and age based on logistic regression of the prevalence plots for impaired sleep and age groups showing the predicted probability of fair or poor SRH.
Figure 3.
Figure 3.
Mediation model of the relationship among impaired sleep, multimorbidity and SRH.
See this image and copyright information in PMC

References

    1. Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X, et al. The relationship between self-rated health and objective health status: a population-based study. BMC Public Health [Internet]. 2013. [cited 2023 Feb 7];13(1). Available from: https://pubmed.ncbi.nlm.nih.gov/23570559/ - PMC - PubMed
    1. Idler EL, Angel RJ. Self-rated health and mortality in the NHANES-I epidemiologic follow-up study. Am J Public Health [Internet]. 1990. [cited 2023 Feb 7];80(4):446–52. Available from: https://pubmed.ncbi.nlm.nih.gov/2316767/ - PMC - PubMed
    1. Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health [Internet]. 1982. [cited 2023 Feb 7];72(8):800–8. Available from: https://pubmed.ncbi.nlm.nih.gov/7091475/ - PMC - PubMed
    1. Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav. 1997; 38(1): 21–37. http://www.ncbi.nlm.nih.gov/pubmed/9097506 - PubMed
    1. Haddock CK, Poston WSC, Pyle SA, Klesges RC, Vander Weg MW, Peterson A, et al. The validity of self-rated health as a measure of health status among young military personnel: evidence from a cross-sectional survey. Health Qual Life Outcomes [Internet]. 2006. Aug 29 [cited 2023 Feb 7];4:57. Available from: https://pubmed.ncbi.nlm.nih.gov/16939653/ - PMC - PubMed