Sleep Efficiency and Sleep Onset Latency in One Saskatchewan First Nation.

BACKGROUND: Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. METHODS: A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. RESULTS: More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. CONCLUSIONS: Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation.

Obesity, Sex, Snoring and Severity of OSA in a First Nation Community in Saskatchewan, Canada.

Sleep disorders have been related to body weight, social conditions, and a number of comorbidities. These include high blood pressure and type 2 diabetes, both of which are prevalent in the First Nations communities. We explored relationships between obstructive sleep apnea (OSA) and risk factors including social, environmental, and individual circumstances. An interviewer-administered survey was conducted with adult participants in 2018−2019 in a First Nations community in Saskatchewan, Canada. The survey collected information on demographic variables, individual and contextual determinants of sleep health, and objective clinical measurements. The presence of OSA was defined as an apnea−hypopnea index (AHI) ≥5. Multiple ordinal logistic regression analysis was conducted to examine relationships between the severity of OSA and potential risk factors. In addition to the survey, 233 men and women participated in a Level 3 one-night home sleep test. Of those, 105 (45.1%) participants were reported to have obstructive sleep apnea (AHI ≥ 5). Mild and moderately severe OSA (AHI ≥ 5 to <30) was present in 39.9% and severe OSA (AHI ≥ 30) was identified in 5.2% of participants. Being male, being obese, and snoring loudly were significantly associated with severity of OSA. The severity of OSA in one First Nation appears relatively common and may be related to mainly individual factors such as loud snoring, obesity, and sex.

Duration and quality of sleep in 2 rural Cree First Nation communities in Saskatchewan, Canada.

STUDY OBJECTIVES: Estimates of sleep duration and quality are lacking for Canadian First Nations peoples. This study examines the prevalence of and risk factors for short/normal/long sleep duration and sleep quality. METHODS: Five hundred eighty-eight adults participated in the baseline survey of the First Nations Sleep Health Project conducted in 2018-2019 in Saskatchewan, Canada. Sleep duration and quality were self-reported. RESULTS: Mean sleep duration was 8.18 hours per night. About 45.5% slept the recommended 7 hours per night. However, short sleep duration and poor sleep quality were relatively common: about one-quarter of the participants slept fewer hours than recommended. Sleep duration was significantly less for men than women. Women were significantly more likely to report poor sleep quality than males. Multiple regression models revealed that age was significantly related with shorter sleep duration; sex and employment status were significantly related with sleep duration; and sex and income indicators were significantly associated with sleep quality. Nearly half of participants reported having had the recommended hours of sleep, but nearly two-thirds reported poor sleep quality. CONCLUSIONS: Information about the proportion of First Nations adults who sleep the recommended duration and the quality of sleep is important in informing health care and health policy.

STOP-Bang Score and Prediction of Severity of Obstructive Sleep Apnea in a First Nation Community in Saskatchewan, Canada.

The STOP-Bang questionnaire is an easy-to-administer scoring model to screen and identify patients at high risk of obstructive sleep apnea (OSA). However, its diagnostic utility has never been tested with First Nation peoples. The objective was to determine the predictive parameters and the utility of the STOP-Bang questionnaire as an OSA screening tool in a First Nation community in Saskatchewan. The baseline survey of the First Nations Sleep Health Project (FNSHP) was completed between 2018 and 2019. Of the available 233 sleep apnea tests, 215 participants completed the STOP-Bang score questionnaire. A proportional odds ordinal logistic regression analysis was conducted using the total score of the STOP-Bang as the independent variable with equal weight given to each response. Predicted probabilities for each score at cut-off points of the Apnea Hypopnea Index (AHI) were calculated and plotted. To assess the performance of the STOP-Bang questionnaire, sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs), and area under the curve (AUC) were calculated. These data suggest that a STOP-Bang score ≥ 5 will allow healthcare professionals to identify individuals with an increased probability of moderate-to-severe OSA, with high specificity (93.7%) and NPV (91.8%). For the STOP-Bang score cut-off ≥ 3, the sensitivity was 53.1% for all OSA and 72.0% for moderate-to-severe OSA. For the STOP-Bang score cut-off ≥ 3, the specificity was 68.4% for all OSA and 62.6% for moderate-to-severe OSA. The STOP-Bang score was modestly superior to the symptom of loud snoring, or loud snoring plus obesity in this population. Analysis by sex suggested that a STOP-Bang score ≥ 5 was able to identify individuals with increased probability of moderate-to-severe OSA, for males with acceptable diagnostic test accuracy for detecting participants with OSA, but there was no diagnostic test accuracy for females.

Sleep deprivation in two Saskatchewan First Nation communities: a public health consideration.

OBJECTIVES: Sleep deprivation is a common problem in Canada and is associated with many health problems. More than a quarter of Canadians get fewer than the recommended sleep hours (<7 h). This paper examines the prevalence and risk factors for sleep deprivation in two First Nation communities in Saskatchewan, Canada. METHODS: The baseline cross-sectional survey was completed between 2018 and 2019 in collaboration with the two Cree First Nation communities in Saskatchewan, Canada. There were five hundred and eighty-eight participants participated in the survey from two communities. A Multivariate logistic regression model was used for analysis. RESULTS: The prevalence of sleep deprivation (<7 h of sleep) was 25.4%. The multivariate logistics regression revealed that middle and older age groups, visible mold in the house, and being male with nighttime insomnia symptoms were significantly associated with a higher risk of sleep deprivation among study participants in the study. CONCLUSIONS: In these two First Nation communities, a higher proportion of the participants reported having sleep deprivation. This was a unique study, which evolved from ongoing research collaboration with two First Nation communities in Saskatchewan, Canada. Findings will be helpful in the management of patients with sleep deprivation in these communities; as well as for co-creating policy with the communities and future research priorities.

Seasonal Changes in Sleep Patterns in Two Saskatchewan First Nation Communities.

Sleep is crucial for maintaining the recovery and restoration of the body and brain. Less sleep is associated with poor mental and physical performance. Seasonal changes in sleep patterns can be observed. This paper examines seasonal effects on sleep timing, duration, and problems in two Cree First Nation communities in Saskatchewan, Canada. Data were available from a community survey of 588 adults aged 18 years and older (range: 18-78 years) with 44.2% males and 55.8% females. Results are presented using descriptive statistics and a binary logistic-regression model to identify the association between seasonal changes in sleep patterns, and demographic, social, and environmental factors. The participants reported sleeping the least during the spring and summer months and sleeping the most during the fall and winter months. This was further confirmed by sleep hours and the lower proportion of recommended hours of sleep during the spring and summer, and a higher proportion of longer sleep duration during the fall and winter months. There was no significant variation in sleeping onset and wake-up times by season. Overall, there were no significant differences in the prevalence of sleep deprivation, insomnia, and excessive daytime sleepiness by season. When stratified by age group and sex, some differences existed in the prevalence of sleep problems by season. More than two-thirds (68.6%) of the participants reported that there was a change in sleep patterns across seasons, and about 26.0% reported a very or extremely marked change in sleep patterns across seasons. Changes in sleep patterns by season were related to money left at the end of the month and damage caused by dampness in the house.

Prevalence of Insomnia in Two Saskatchewan First Nation Communities.

Insomnia is a common problem in Canada and has been associated with increased use of health care services and economic burden. This paper examines the prevalence and risk factors for insomnia in two Cree First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eight adults participated in a baseline survey conducted as part of the First Nations Sleep Health Collaborative Project. The prevalence of insomnia was 19.2% among participants with an Insomnia Severity Index score of ≥15. Following the definition of nighttime insomnia symptoms, however, the prevalence of insomnia was much higher, at 32.6%. Multivariate logistic regression modeling revealed that age, physical health, depression diagnosis, chronic pain, prescription medication use for any health condition, and waking up during the night due to terrifying dreams, nightmares, or flashbacks related to traumatic events were risk factors for insomnia among participants from two Saskatchewan Cree First Nation communities.