Sleep disturbance and fatigue among women with chronic obstructive pulmonary disease: socioeconomic and multi-morbidity influences in a nationally representative sample Sleep and Fatigue in Women with COPD
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Abstract
Background: This study examines the prevalence and social patterning of sleep disturbance and fatigue as item-level depressive symptoms among women with chronic obstructive pulmonary disease (COPD).
Methods: Data was drawn from 564 women aged 40-79 years (mean age = 62) with spirometry defined COPD in the 2007–2012 U.S. National Health and Nutrition Examination Survey. Logistic regression evaluated associations between age, race/ethnicity, socioeconomic position, smoking, lung function, multi-morbidity, and symptom outcomes. The adjusted regression analyses included 486 participants with complete data.
Results: Sleep disturbance was associated with younger age relative to the sample range (40–79 years) (OR = 0.98, 95% CI [0.96, 0.99]) and lower socioeconomic position (aOR = 2.04, 95% CI [1.25, 3.31]), p = .004). Fatigue was associated with younger age (OR = 0.96, 95% CI [0.95, 0.98]), p < .001), lower socioeconomic position (aOR = 2.31, 95% CI [1.40, 3.81], p = .001), and multi-morbidity (≥2 chronic conditions versus 0-1; aOR = 2.16, 95% CI [1.31, 3.58], p = .003). Race/ethnicity, smoking, and lung function were not independently associated with either outcome.
Conclusion: Findings suggest that socioeconomic disadvantage and multimorbidity may be important considerations when assessing fatigue and sleep disturbance among women with COPD, supporting a more intersectional approach to symptom assessment and pulmonary rehabilitation.
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