Sleep-related disorders among a healthy population in South India

Introduction: Sleep-related disorders (SRDs) though frequent, are under-reported and their implications are often neglected. Objective: To estimate SRDs in an apparently healthy South Indian population. Materials and Methods: Data was collected by administering a questionnaire including Sleep Disorders Proforma, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index (PSQI) to 1050 apparently healthy attendants/relatives of patients attending a tertiary healthcare institution. Results: The mean age of the respondents was 35.18.7 years with even gender distribution (male: female; 29:21), work hours were 7.81.33 h and had regional representation from the southern Indian states. The majority of the respondents did not report any significant medical/psychiatric co-morbidities, hypertension was noted in 42.6, in one-fourth, the body mass index (BMI) was > 25, and in 7.7 the neck size was > 40 cm. Daily tea (70.3) and coffee (17.9) consumption was common and 22.2 used tobacco. Average time-to-fall-asleep was 22 min (range: 5-90 min), average duration-of-actual-sleep was 7 h (range: 3.5-9.1 h) with the majority (93.8) reporting good-quality sleep (global PSQI <= 5). The reported rates of SRDs varied between 20.0 and 34.2 depending on the instrument used in the questionnaire. Insomnia, sleep-related breathing disorders (SRBD), narcolepsy, and restless legs syndrome (RLS) were reported by 18.6, 18.4, 1.04 and 2.9, respectively. Obesity was not strongly associated with SRBD. in 51.8 of subjects with SRBD BMI was < 25 kg/m (2) . Of the respondents with insomnia, 18 had difficulty in initiating sleep, 18 in maintaining sleep and 7.9 had early morning awakening. Respondents attributed insomnia to depression (11.7) or anxiety (2.5). Insomnia was marginally high in females when compared to males (10.3 vs. 8.3) and depression was the major reason. RLS, which was maximal at night, was responsible for delayed sleep onset (74.2). Other SRDs included night terrors (0.6), nightmares (1.5), somnambulism (0.6), and sleep-talking (2.6). Family history of SRDs was present in 31.4 respondents. While, only 2.2 of the respondents self-reported and acknowledged having SRD, health-seeking was extremely low (0.3). Conclusion: SRDs are widely prevalent in India. Considering the health implications and poor awareness, there is a need to sensitize physicians and increase awareness among the public.