Association of sleep duration and sleep quality with the physical, social, and emotional functioning among Australian adults.

OBJECTIVES: We aimed to evaluate the interaction of two key determinants of sleep health, quantity and quality, with physical, emotional, and social functioning, in the general population.

DESIGN: Nationally-representative Australian cross-sectional study.

SETTING: General population.

PARTICIPANTS: 14,571 people aged 15 or older in Household, Income and Labor Dynamics in Australia (HILDA) in 2013.

MEASUREMENTS: The associations of sleep quality (good/poor) in combination with mid-range (6-8 hours), short (<6) or long (>8) sleep duration with functioning, determined from the SF-36, were evaluated using logistic regression adjusting for sociodemographic, relationships, health behaviors, obesity, pain, and mental and physical illness confounders.

RESULTS: After adjusting for gender, and age, poor sleep quality in combination with short, mid-range and long sleep was associated with worse physical, emotional and social functioning. Pain and comorbid illness explained much of these associations, while attenuation from other covariates was minor. The associations of poor sleep quality with worse functioning remained after full adjustment regardless of sleep duration, while among people with good quality sleep, only those with long sleep duration reported poorer functioning.

CONCLUSIONS: Poor sleep quality has robust associations with worse functioning regardless of total duration in the general population. There appears to be a substantial number of functional short sleepers with good quality sleep.