Insomnia and the inability to sleep affect people’s health and well-being. However, its systematic estimates of prevalence and distribution in the general population in China are still lacking. A population-based cluster sampling survey was conducted in the rural and urban areas of Hunan, China. Subjects (n = 26,851) were sampled from the general population, with a follow-up using the Pittsburgh Sleep Quality Index (PSQI) for interview to assess quality of sleep and Insomnia (PSQI score >5). While the overall prevalence of insomnia was 26.6%, and little difference was found between males (26.3%) and females (27.0%); the mean PSQI score was 4.26 (±2.67), and significant higher in females (4.32 ± 2.70) than males (4.21 ± 2.64, p = 0.003). Individuals in the rural areas tended to report a higher PSQI score (4.45 ± 2.81) than urban residents did (4.18 ± 2.60) (p < 0.001) and the estimates of prevalence of insomnia was 29.4% in the rural areas, significant higher than 25.5% in the urban areas (p < 0.001). Multiple logistic regression analysis showed that female gender, older age, higher level of education, being unmarried, living in the rural area, cigarette smoking and alcohol drinking were associated with insomnia. Our study may provide important information for general and mental health research.

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Background Sleep problems are common in the general population. Cigarette smoking is common in the general population of China. Examinations of the prevalence of poor sleep quality among Chinese smokers and nonsmokers are still lacking. This study was designed to examine sleep quality and sleep disturbances among cigarette smokers and nonsmokers in the general population in central China. Methods In this population-based sampling project, we used a multi-stage sampling method to recruit survey participants from September 2012 to October 2012 in rural and urban areas of Hunan province, China. A total of 27,300 subjects were sampled from the general population and 26,282 completed the self-report of cigarette smoking characteristics. Cigarette smoker was defined as having smoked ≥100 cigarette in a lifetime and smoked during the last 28 days. Cigarette smoking characteristics were obtained from smokers, including cigarettes per day, years of smoking, quit attempts, and smoking cravings. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess quality of sleep and sleep disturbances (PSQI score > 5). Results Significantly more smokers than nonsmokers demonstrated poor sleep quality and sleep disturbances. Among smokers, linear regression analyses showed that poor sleep was inversely associated with cigarettes per day, and positively associated with years of smoking, quit attempts, and smoking craving. Logistic regression analysis showed that quit attempts and smoking cravings were associated with higher odds of sleep disturbances. Conclusions Sleep disturbances were more prevalent among cigarette smokers than nonsmokers. Smokers also varied in sleep problems on the basis of the characteristics of their smoking. Smokers should be informed about the link between cigarette smoking and poor sleep quality, and should be advised that one of several important health benefits from smoking cessation could be the improvement of sleep quality. Sleep therapy should be recommended as an adjunctive treatment for smoking cessation.

Aim To evaluate the prevalence of mild cognitive impairment (MCI) within the empty‐nest older adults population in poor rural areas of the Hunan province of China, and to explore the effects of resilience and affective balance on cognitive functioning within this specific population. Methods A cross‐sectional, multistage, random cluster survey was administered to participants from March 2013 to December 2014 in the Hunan province. There were a total of 1164 participants. These participants were empty‐nest older adults who were residing in poor rural areas of the Hunan province. The data was collected in two stages. In stage 1, the participants were administered the Montreal Cognitive Assessment for screening cognitive impairment. In stage 2, the participants were screened for any potential cognitive impairment, were administered a series of neuropsychological tests and received a definitive diagnosis for MCI, if the criteria were met. Resilience and affect balance were assessed by the Chinese modified version of the Stress Resilience Quotient and the Affect Balance Scale. Results The prevalence of MCI was 38.40% within this empty‐nest older adult population. Significant differences were found between MCI and non‐MCI empty‐nest older adults specific to resilience and affect balance. Path analysis showed that resilience mediated the relationship between MCI and affect balance. Conclusions Resilience and affect balance were less prominent within the MCI empty‐nest older adults than those in the non‐MCI group. The results suggest that resilience is a mediating variable between MCI and affect balance. Geriatr Gerontol Int 2019; 19: 222–227.