دانلود رایگان مقاله انگلیسی تاثیر عوامل استرس زای روانی-اجتماعی در نوجوانان مبتلا به آسم - الزویر 2018

abstract

Objective: Insufficient sleep is common among caregivers and is associated with worse health outcomes; however, the contributors to poor sleep among caregivers are unknown. We investigated the crosssectional association between socioeconomic status (SES), psychosocial stressors, and sleep among caregivers. Methods: Caregivers (n = 98) of teenagers with asthma self-reported sleep duration (hours), sleep quality (very good to very bad), education (bhigh school to college graduate), income ($15,000 to $50,000), and psychosocial stressors (stress, worry, social support, depressive symptoms, nightly awakenings due to caregiving). Logistic and linear regression models were performed to study the association of between SES, psychosocial stressors, and sleep, adjusting for possible confounders. Results: Caregivers on average were 45.5 years, female (89%), and African American (90%). Average sleep duration was 5.9 hours (standard deviation: 1.5), 72% reported short sleep (b7 hours), and 65% reported “fairly bad or very bad” sleep quality. After adjustment for covariates, caregivers with greater social support had a 44% (95% confidence interval: 0.32, 0.98) lower odds of short sleep duration and slept 20.0 minutes (3.09, 37) longer on average. Greater depressive symptoms were associated with a 26% (1.11, 1.44) higher odds of short sleep and sleeping on average 6.08 minutes (−8.67, −3.49) less at night. SES and other psychosocial stressors were not associated with sleep. Conclusions: Caregivers had a high prevalence of short and poor quality sleep. Depressive symptoms were associated with shorter sleep, whereas social support was associated with longer sleep. Identifying factors that mitigate the effect of psychosocial stressors on sleep is warranted.

Discussion

In this study, we examined self-reported sleep of caregivers of teenagers with predominantly poorly controlled asthma and examined the associations between SES, social support, and psychosocial stressors with sleep duration and sleep quality in a predominately African American study group. We found that a high proportion (72%) of the caregivers slept less than 7 hours at night and a majority reported poor sleep quality. In general, SES did not contribute to variations in sleep duration or sleep quality, possibly reflecting the limited variation in income and education in this sample. Greater social support was associated with longer sleep duration (approximately 20 minutes more on average) and lower odds of short sleep duration. Although higher reports of depressive symptoms were associated with shorter sleep duration, associations were not as large as what was observed for social support. Our findings highlight the high prevalence of short sleep and poor quality of sleep in African American caregivers of children with asthma, and identify factors such as depressive symptoms and social support that may be important to sleep health.