ASSESSMENT OF HEALTH-RELATED QUALITY OF LIFE AND SLEEP QUALITY AMONG PATIENTS OF INSOMNIA IN PAKISTAN

: Insomnia is the most frequent sleep related complaint and labeled as a 24 hour disorder. Sleep insufficiency both in terms of sleep quantity and quality have significant direct and indirect effects on health related quality of life. Objective: The aim of the present study was to assess health related quality of life and quality of sleep among patients of insomnia in twin cities of Pakistan. Methodology: A descriptive cross-sectional study design was used. Health related quality of life among insomniacs was measured by SF-36 and sleep quality was assessed by PSQI. Both questionnaires were distributed to a sample 0f 382 insomniacs selected through convenience sampling technique. After data collection, data was cleaned, coded and analyzed statistically by using Mann-Whitney and Kruskal Wallis (p ≥ 0.05) tests. Results: Lower mean scores of HRQoL were observed in the domain of role physical (35.32± 11.04) followed by role emotional (45.54 ±10.59) and social functioning (49.64± 10.34), whereas highest mean scores were observed in the domain of mental health (69.36, ±12.96). Analyzing the scores of the respondents with different age groups reported a significantly higher (p=0.005) physical health component score (PCS) among insomnia patients of age group between 18-30 years. A significant difference (p=0.001) in physical health component score (PCS) of unmarried respondents was observed, on the other hand married respondents with (p=0.023) reported better mental health component score (MCS). The results also highlighted that among domains of Pittsburgh Sleep Quality index respondents have most effected sleep quality among domain of Sleep disturbances (10.75, ± 4.25) followed by sleep latency (4.39, ± 1.49) and Day time dysfunction(4.29, ±1.75). Conclusion: The current study concluded that insomnia had an influence on all domains of HRQoL with greatest impact reported in role physical, role emotional and social functioning due to compromised physical health. The general health was below good among insomniacs with significantly lower sleep quality as a result of sleep disturbances and sleep latency also causing great impact as daytime dysfunction. The results showed that among sleep quality domains, highest scores were observed in latency of sleep as how long (in minutes) the respondent had taken to fall asleep, in group of 31-60min (n=136 ,35.6%) and 16-30 min (n=115,30.1%). The response to actual sleep hours was greater in <5hr group (n=132, 34.6%) and 6-7 hr group (n=120,31.4%). The response of insomniacs about not being able to sleep with in 30 min (n=277,72.5%),waking up in middle of night or too early (n=207,54.2),having bad dreams(n=109,28.5%), having pain (n=173,45.3%),taking insomnia medication (n=256,67.0%),problem in enthusiasm for getting work done(n=155,40.6%),difficulty in staying awake during daily activities (n=197,51.6%) was three or more times per week. The patient’s response in having disturbed sleep due to breathing difficulty (n=227,59.4%), cough or snoring (n=198,51.8%), feeling too cold (n=260,68.1%), feeling too hot (n=281,73.6%) was not during last month. The highest score of patient's perceptions of their sleep quality was very bad (n=191,51.6%). A detailed description is given in (Table 4).