Association between Nephropathia Epidemica and Poor Sleep Quality as a Long-Term Outcome
Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Background: Nephropathia epidemica (NE) is a common viral disease in northern Sweden. While the clinical aspects of NE have been widely described, the long-term outcomes following the recovery phase of the disease are not well known. Research on other infectious diseases shows that long-term consequences, such as chronic fatigue, poor general health, and poor sleep quality, may persist after the recovery phase of an infectious disease. The aim of this study was to investigate if there is an association between nephropathia epidemica and poor sleep quality as a long-term consequence.
Methods: Secondary data from a survey "Patient reported long-term outcomes of Puumala virus infection in northern Sweden" was used for this study. 1132 former NE patients and 915 non-exposed subjects responded to the survey. The age range was 18-93 years. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). As a dependent variable sleep quality was evaluated as both continuous variable (PSQI total score) and a binary variable (poor sleep quality). An association between NE exposure and sleep quality was evaluated by simple and multiple linear and logistic regression models. The analyses were stratified by sex. Results with p values less than 0.05 and confidence intervals of 95% were considered statistically significant.
Results: Former NE patients reported higher PSQI total scores than the subjects in the comparison group, indicating that exposure to NE is associated with poor sleep quality (results statistically significant). Female patients had higher PSQI total scores than male patients (result statistically significant). The linear and logistic regression analyses of NE exposure and sleep quality showed similar results. After adjusting for the other variables in the study (age, current disease, smoking, obesity and exercise) sleep quality remained significantly associated with NE exposure. In men, sleep quality showed statistically significant association with time since exposure to NE only in the "≥4 years ago" category while the other categories (2-3 years ago, 1 year ago, 6-12 months ago and 3-6 months ago) did not show statistically significant results. In women, association between time since exposure to NE and sleep quality was statistically significant for "≥4 years ago", "2-3 years ago", and "1 year ago" and not statistically significant for "6-12 months ago" and "3-6 months ago".
Conclusion: Poor sleep quality may be a long-term outcome of nephropathia epidemica. Former NE patients have higher PSQI component scores and a higher PSQI total score, which is indicative of poor sleep quality. Sleep quality is worse in female patients than in male patients. Time since exposure to NE does not have a significant impact on sleep quality. Further research is needed to better asses sleep disturbances after exposure to nephropathia epidemica.
Place, publisher, year, edition, pages
2016. , 25 p.
Centre for Public Health Report Series, ISSN 1651-341x ; 2016:20
Nephropathia Epidemica, Poor Sleep Quality, northern Sweden
Public Health, Global Health, Social Medicine and Epidemiology
IdentifiersURN: urn:nbn:se:umu:diva-131553OAI: oai:DiVA.org:umu-131553DiVA: diva2:1074883
Västerbottens läns landsting - Maria Furberg
Master's Programme in Public Health
2016-05-23, Umeå Universitet, Umeå, 13:19 (English)
Schumann, Barbara, ResearcherFurberg, Maria, Physician
Lindholm, Lars, Professor