Self rated health SRH is a
Self-rated health (SRH) is a subjective perception and has become an increasingly common measure for public health monitoring. SRH is a strong independent predictor of mortality after accounting for objective health status, behavioral risk factors and socio-demographic characteristics, and it also provides a suitable and inexpensive method of assessing an individual׳s health . Various socio-demographic, health and lifestyle determinants of SRH have been identified in different populations. Epidemiological studies from different tranylcypromine Supplier and cultures have shown that SRH is a valid and consistent predictor of cardiovascular disease and overall mortality . The incidences of chronic diseases such as obesity, hypertension, diabetes and dyslipidemia rise significantly as SRH decreases . Variations in general SRH status are observed as a result of changes in sleep duration on morbidity and mortality .
Although 3 meta-analyses have concluded that both short and long sleep duration were associated with an increased risk of mortality and also showed greater effects on long sleepers [6,8,16], sleep duration seems to reflect comorbidity and health status. Few studies have considered the relationship between sleep duration and self-rated health in detail. Therefore, the purpose of this study was to review the association between sleep duration and self-rated health.
Results We found 22 articles in English. Fig. 1 depicts the steps used to reach the final result. The associations of SD on SRH are shown in Table 1. In all 5 articles, the extremes of SD exhibited an interaction with poor or worse SRH, and all articles utilized self-administered questionnaires.
Discussion This review shows that SD is associated with poor or worse SRH. Short and long SD are associated with important health endpoints such as general mortality . A retrospective observational study assessed the relationship between SD and SRH in young adults in 24 countries  and indicated a dose–response relationship, as those who slept less than 7h were more likely to be in the poor health category. The association between short sleep (6–7h in this study) and poorer SRH is intriguing. Despite the fact that short sleep might be due to cultural and social reasons, genetic aspects may also interfere with short SD. For example, objective short sleep duration may be a biological marker for a genetic predisposition to chronic insomnia . As most of the studies include a heterogeneous group, nonvascular plants is possible to have individuals who are not sleeping enough with a wide range of sleep insufficiency and its consequences [19,20], as well as individuals with a lower physiological need for sleep . Therefore, it seems beneficial to distinguish between short sleepers and insufficient sleepers, who are often deprived of and/or restricted from sleep. Additionally, the direction of causality cannot be established: does shorter SD lead to poor SRH or does poor SRH cause shorter sleep? In the aforementioned Steptoe et al. study , it seems less likely that poor health causes shorter SD, as the investigation was performed using health subjects, suggesting the existence of underlying factors that possibly cause shorter SD and poorer SRH. Additionally, both possibilities can be associated with socioeconomic background, physical activity, body weight , health habits, mental health condition , mood changes, sleep disturbances  and genetic factors [20,24], as these analyses were controlled/adjusted for some of these factors. In a study of more than 377,000 participants aged 18 years or older, Geiger et al.  used logistic regression models to calculate the odds ratio of the SRH associated with increasing categories of insufficient rest/sleep. They found a positive association between increasing categories of insufficient sleep and poor SRH, independent of relevant covariates. The presence of a positive dose–response trend and the persistence of the association in stratified analyses by subgroups from potential confounders, such as gender, age, BMI, and race-ethnicity, suggest that these findings are not due to chance. These results suggest that poor SRH may be an indirect mediator of the association between insufficient sleep, cardiovascular disease and mortality, and self-reported insufficient rest/sleep appears to be a strong predictor of SRH. Kim et al.  found an association between short and long SD and poor SRH in the adjusted analyses in a large representative sample of the Korean adult population.