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.