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Open Access 01-12-2019 | Insomnia | Research article

Over-indebtedness and its association with sleep and sleep medication use

Authors: Jacqueline Warth, Marie-Therese Puth, Judith Tillmann, Johannes Porz, Ulrike Zier, Klaus Weckbecker, Eva Münster

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Over-indebtedness is currently rising in high-income countries. Millions of citizens are confronted with the persistent situation when household income and assets are insufficient to cover payment obligations and living expenses. Previous research shows that over-indebtedness increases the risk of various adverse health effects. However, its association with sleep problems has not yet been examined. The objective of this study was to investigate the association between over-indebtedness and sleep problems and sleep medication use.

Methods

A cross-sectional study on over-indebtedness (OID survey) was conducted in 70 debt advisory centres in Germany in 2017 that included 699 over-indebted respondents. The survey data were combined with the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). We limited analyses to participants with complete data on all sleep variables (OID: n = 538, DEGS1: n = 7447). Descriptive analyses and logistic regression analyses were used to examine the association between over-indebtedness and difficulty initiating and maintaining sleep, and sleep medication use.

Results

A higher prevalence of sleep problems and sleep medication use was observed among over-indebted individuals compared to the general population. After adjustment for socio-economic and health factors (age, sex, education, marital status, employment status, subjective health status and mental illness), over-indebtedness significantly increased the risk of difficulties with sleep onset (adjusted odds ratio (aOR) 1.79, 95%-confidence interval (CI) 1.45–2.21), sleep maintenance (aOR 1.45, 95%-CI 1.17–1.80) and sleep medication use (aOR 3.94, 95%-CI 2.96–5.24).

Conclusions

Evidence suggests a strong association between over-indebtedness and poor sleep and sleep medication use independent of conventional socioeconomic measures. Considering over-indebtedness in both research and health care practice will help to advance the understanding of sleep disparities, and facilitate interventions for those at risk.

Trial registration

German Clinical Trials Register: DRKS00013100 (OID survey, ArSemü); Date of registration: 23.10.2017; Date of enrolment of the first participant: 18.07.2017, retrospectively registered.

Available only for authorised users

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Title: Over-indebtedness and its association with sleep and sleep medication use
Authors: Jacqueline Warth
Marie-Therese Puth
Judith Tillmann
Johannes Porz
Ulrike Zier
Klaus Weckbecker
Eva Münster
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Insomnia
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7231-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Over-indebtedness and its association with sleep and sleep medication use

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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