The effect of chronic diseases on sleep quality: a family medicine perspective

INTRODUCTION: Chronic diseases are leading causes of morbidity and mortality, significantly impacting quality of life and constituting a major part of primary healthcare visits. They adversely affect physical, psychological, and social well-being. Sleep is essential for restoration, and its quality is a crucial health indicator. A bidirectional relationship exists between chronic diseases and sleep disorders; disease symptoms disrupt sleep, while poor sleep worsens chronic conditions by increasing inflammation and disrupting metabolic balance. Family physicians are ideally positioned to manage these issues. This study aims to assess sleep quality in patients with chronic diseases and its relationship to specific conditions and comorbidities.
METHODS: This cross-sectional study was conducted at a Family Health Center (June-August 2024) with 268 adult patients having at least one chronic disease. Data were collected using a sociodemographic form and the Pittsburgh Sleep Quality Index (PSQI). Analysis employed descriptive statistics, Mann-Whitney U, Kruskal-Wallis, and Spearman's correlation tests.

RESULTS: The mean participant age was 54.29±17.1 years, and 52.6% were female. The average number of chronic diseases was 2.62. The most prevalent conditions were hypertension (36.57%), diabetes mellitus (22.01%), and vitamin D deficiency (17.91%). Poor sleep quality (PSQI ≥5) was found in 59.3% of participants. A higher number of diseases correlated with significantly worse PSQI scores (r=0.227, p<0.001). Significantly poorer sleep was associated with psychiatric diseases, COPD, migraine, and skin diseases. Metabolic comorbidities (e.g., hypertension with diabetes) had a stronger negative impact than single diseases.
DISCUSSION AND CONCLUSION: Sleep quality is seriously impaired in individuals with chronic diseases, particularly psychiatric, respiratory, neurological, and metabolic conditions. Multimorbidity is an independent risk factor for sleep disorders. Family physicians should routinely screen for sleep problems in this population and plan personalized interventions.