In our study, according to the results of the Pittsburgh Sleep
Quality Scale, sleep quality was significantly better in men compared to
the demographic characteristics of sleep quality, non-chronically ill
and those who smoked. According to the Insomnia Violence Index, it was
determined that the frequency of insomnia was higher among the elderly,
the males, the students with the higher education level and those with
chronic diseases and those using
alcohol.
In the literature search, it has been observed that studies related to
sleep quality and sleeplessness in our country are generally performed
in individuals with chronic diseases, occupation in occupation and
students. In most of these studies, sleep quality decreases with age
increase; it was stated that this situation is due to reasons such as
difficulty in falling asleep and sustaining with age. In our study, it
was found that sleep quality did not change with age but insomnia status
increased with age. A study in Spain found that sleep quality worsened
with age [11], in accordance with our study no correlation was found
between age and sleep quality in two studies [7,13]. Ohayon et al.
,Aslan et al and Farazdaq et al was concluded that insomnia increases
with age and that was support our study [14-16]. In studies
conducted on healthy adults, sleep quality is generally not changed
according to gender, but in some studies it is stated that women sleep
quality is worse. In our study, we found that men ’s sleep quality was
better, but they were more likely to have insomnia. In the study of Hinz
et al. and Madrid-Valero, it was concluded that the sleep quality of
women was worse in parallel with our study [7,12]. In a study
conducted in primary care and insomnia severity index, no difference was
found between sexes in terms of insomnia [17]. In international
studies, it was concluded that insomnia affects female gender more
[14,15]. In the study made by Aslan et al., it was concluded that
insomnia is seen more in female gender [16]. In a prospective cohort
study no difference was found between the genders [13]. It is known
that sleepers suffer from sleep problems and sleep quality is worse. In
our study, it was found that sleep quality of the patients who had
smoked but who had previously smoked before, had better sleep quality
and generally had less insomnia compared to those who did not use
non-smokers. Aslan et al. also found smoking as a risk factor for
insomnia [16]. In a study conducted in the family medicine clinic of
a university in Malaysia, it was found that insomnia was associated with
smoking [14].
The effect of alcohol on sleep quality is the suppression of the central
nervous system and easing the transition to sleep, but it is known that
sleep quality disrupts the activity of REM sleep. In our study, the
effect of alcohol use on sleep quality was not found to be statistically
significant. The relationship between sleep and chronic disease is
mutual; impaired sleep quality increases the risk of cardiovascular,
metabolic (diabetes, obesity, thyroid diseases), rheumatic diseases, or
the frequency of current symptoms. Similarly, having chronic illness
affects both the quality of the sleep and the duration of sleep due to
both the disease and the drugs used. In our study, it was determined
that people with chronic diseases had higher incidence of insomnia in
accordance in a study Aslan et al [16]. In addition, according to
the Pittsburgh Sleep Quality Scale, we found that people with good sleep
quality had less insomnia than the Insomnia Severity Index.
When the demographic characteristics were compared according to the
results of the Berlin sleep questionnaire, the risk of OSAS was found to
be high in the elderly, in singles, in primary school graduates, in
winners above the minimum wage, in those with chronic diseases and in
alcohol users.
In addition, according to the Pittsburgh Sleep Quality Scale, it was
determined that those with good sleep quality and those with less
insomnia to the Insomnia Severity Index had a lower OSAS risk than the
Berlin sleep questionnaire. In studies, age, gender, obesity, neck
circumference, upper airway resistance, smoking and alcohol are the main
factors affecting obstructive sleep symptoms. In our study, findings
consistent with literature data were found.
When the contribution of our study to the literature was evaluated as
patient profile, the study of the patients of the family physicians who
have the richest patient group and the fact that the patients coming to
the family health center constitute the most appropriate group in terms
of generalizability, increase the interpretability of the results over
the general population when evaluating the results of the study. In our
study, it was thought that 2/3 of the patients had poor sleep quality
and that half of them had insomnia.
In this context, it will be very effective in terms of the quality of
life of patients in order to determine the conditions that disrupt sleep
hygiene and to perform the necessary interventions in the interventions
which can be intervened in the primary health care institutions and the
other patients to be delivered to the related upper levels. The fact
that sleep disorders are not taken seriously and the hospital is not
applied to this reason causes the frequency of these diseases to
continue to increase. In this context, family physicians play a vital
role in recognizing OSAS and sleep disorders and increasing the
awareness of patients on this issue.