Sleep problems are common in the American Indian population, with reported inadequate sleep, sleeping pill use, leg symptoms (cramps or jerks), and nocturia being more frequently reported among American Indians with CKD than those without CKD
Chart Explanation: Overall, American Indians with CKD reported more sleep problems than those without CKD, although sleep problems were common in both groups. Those with more severe CKD also had higher prevalence of daytime sleepiness, leg cramps, and apnea, compared to those with mild CKD. Inadequate sleep and sleeping pill use did not differ by severity of CKD.
The Strong Heart Study consisted of several components and three study exams (baseline, 1989-1992; second exam, 1993-1995; and third exam, 1998-1999), followed by morbidity and mortality surveillance of 4,500 tribal participants. Strong Heart enrolled men and women aged 45-74 at baseline from 13 American Indian tribes/communities in Arizona, Oklahoma, and the Dakotas. As part of the Sleep Heart Health Study (Quan et al., 1997), 2,896 Strong Heart participants with information on CKD status also self-reported on various aspects of sleep at the third exam, including sleep adequacy (“Do you get enough sleep?”), daytime sleepiness (“Do you feel excessively sleepy during the day?”), sleeping pill use (“Do you use sleeping pills or aids to fall asleep?”), leg symptoms (“Do you have leg cramps or jerks that wake you up?”), nocturia (“Does the need to use the bathroom wake you up?”), and apnea (“Do you stop breathing while sleeping?”).
| Field | Data |
|---|
|
| Description of Measure | Prevalence of sleep problems
|
|---|
| Data Source | Strong Heart Study
|
|---|
| Type of Data Source | Private
|
|---|
| Data Set | SHS
|
|---|
| Health Care System Data | No
|
|---|
| Regional or National? | National
|
|---|
| Demographic Group | American Indians aged 45-74 from 13 tribes/communities
|
|---|
| Numerator | Number of participants with reported sleep problems at exam 3
|
|---|
| Denominator | All participants with sleep information at exam 3
|
|---|
| Definition of CKD | No CKD, eGFR >90 ml/min/1.73 m2 & albumin:creatinine ratio <30 mg/g
Stage 1, eGFR >90 ml/min/1.73 m2 & albumin:creatinine ratio >30 mg/g
Stage 2, eGFR 60-89 ml/min/1.73 m2 & albumin:creatinine ratio >30 mg/g
Stages 3-5, eGFR <60 ml/min/1.73 m2
|
|---|
| Glomerular filtration rate | Calculated by MDRD-4 Study equation
|
|---|
| Proteinuria | Spot urine albumin:creatinine ratio
|
|---|
| Primary Data Source Indicator | Percentage of participants with self-reported sleep problems
|
|---|
| Primary Indicator Method of Measurement | Questionnaire
|
|---|
| Frequency of Measurement (Primary) | Once
|
|---|
| U.S. Region Covered by Primary Variable | Arizona, Oklahoma, and the Dakotas
|
|---|
| Period Currently Available | 1998–1999 |
|---|
| Pending Data | Possible continued passive follow-up only
|
|---|
| Additional Data Items of Interest | Age, gender, diabetes, hypertension
|
|---|
| Limitations of Indicator | Loss to follow-up may be differential by sleep quality
|
|---|
| Analytical Considerations | Analysis performed by SHS investigators; denominators for each study exam and indicator must be defined properly
|
|---|
