Many women report sleep disturbance resulting from weakened breathing muscles, pain, or overweight.
Prevalence
A total of 265 (60 percent) of the 443 women who were enrolled in a year-long study of secondary conditions in women with physical disabilities reported that sleep disturbance had been a problem in the past three months. This prevalence is much greater than the approximate 33 percent found in the general population in this country.
Sleep disorders and disordered sleep are highly prevalent among the general U.S. population. Insomnia alone has been estimated to affect from 20 million. Although insomnia is the most common, other sleep disorders also described in the International Classification of Sleep Disorders (1979) such as narcolepsy and sleep apnea are less prevalent in the general population, but more common among people with disabilities.
Various research studies have reported sleep disturbance by:
- 34 percent of persons with spinal cord injury,
- 75 percent of those with rheumatic disease,
- 42 percent with sleep-disordered breathing in neuromuscular disorders, including post-polio syndrome, and
- 57 percent of a cross-disability group of women.
Risk Factors
Women with disabilities may experience sleep disturbances as a result of being disabled and female. First, sleep problems constitutes a common secondary condition among people with activity limitations. Moreover, sleep disturbance is more common among females compared to males in the United States.
Psychosocial factors, not organic disease per se, are believed to contribute significantly to sleep complaints in people with paraplegia due to spinal cord injury, musculoskeletal (rheumatic) disease, and other physical disabling conditions.
The cause of sleep disturbance associated with primary disabilities ranges from:
- Primary sleep disorders such as apnea or narcolepsy,
- Secondary to psychiatric conditions such as depression or anxiety, or
- Medical complications such as impaired breathing, medication side effects, or frequent urination.
Implications
Regardless of its cause, chronic sleep disturbance may exacerbate daytime functional limitations, produce excessive daytime sleepiness and fatigue, lead to secondary injury from traffic accidents and falls, increase chronic pain, and promote emotional distress.
Sleep disturbance in multiple sclerosis is associated with various factors such as leg spasms, pain, immobility, and medication. People with spinal cord injury also commonly have periodic leg movements and sleep apnea.
Research is needed to understand and ameliorate sleep disturbance and other secondary conditions among women with disabilities.
