Prevalence and associated factors of poor sleep quality among Chinese older adults living in a rural area: a population-based study

Abstract

Objective To investigate the prevalence and associated factors of poor sleep quality among community-dwelling elderly population in a rural area of Northern China. Methods We conducted a cross-sectional survey in August-December 2014 and recruited 2195 participants who were aged 65 years or older and living in Yanlou Town of Yanggu County in western Shandong Province, China. Data on demographics, health-related behaviors, and clinical conditions were collected through structured interviews. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality and patterns. Poor sleep quality was defined as a PSQI score > 7. We employed multiple logistic models to relate poor sleep quality to various factors. Results The overall prevalence rates of poor sleep quality were 33.8% in the total sample, 39.2% in women and 26.3% in men (P < 0.01). The most common abnormal sleep domains were prolonged sleep latency (39.7%), decreased sleep duration (31.0%), and reduced habitual sleep efficiency (28.8%). Multiple logistic regression analyses revealed that poor sleep quality was significantly associated with female sex (OR = 1.76, 95% CI 1.46-2.12) and clinical comorbidities such as hypertension (OR = 1.28, 95% CI 1.06-1.54), coronary heart disease (OR = 1.60, 95% CI 1.27-2.00), and chronic obstructive pulmonary disease (OR = 1.82, 95% CI 1.34-2.49). Conclusions The sleep disorders were highly prevalent among the elderly in rural China. Modifiable risk factors such as cardiometabolic risk factors and disorders were associated with poor sleep quality, which might be potential targets for interventions to improve sleep quality in elderly population.

The Relationship between the Number of Daily Health-Related Behavioral Risk Factors and Sleep Health of the Elderly in China

“…Substantial concrete evidence indicated that there was a significant negative effect on the individual's sleep health when people engaged in health-related risk behavior(s) [19,20,32,33]. This study concluded that with an increase in health-related risk behaviors, the negative effects on sleep health could be further increased, at least for both the increased prevalence of sleep problems and the deterioration of sleep quality.…”

“…Previous studies from developed countries or regions have confirmed the link between specific behaviors and sleep health. Health-related behavioral risk factors, including tobacco use, alcohol drinking, unhealthy dietary behaviors, as well as insufficient time for leisure activities and physical inactivity, have been shown to be associated with sleep health [17,19,20,32,33]. The results of these studies provide the theoretical basis for developing interventions that specifically target a particular health-related risk behavior.…”

“…Existing studies provide several socio-ecological explanations of sleep, which generally believe that sleep can be influenced by psychological and physiological factors, environment, financial status, and other social factors [16][17][18][19][20]. Anxiety could directly lead to poor sleep quality, and there is a strong association between depression symptoms and sleep disturbances [21].…”

“…Anxiety could directly lead to poor sleep quality, and there is a strong association between depression symptoms and sleep disturbances [21]. In addition, physiological factors, such as age, gender, and diseases can affect sleep status [17,19,20]. A previous study revealed that the risk of sleep disorders was higher among females, and their sleep qualities were also reported to be worse [22].…”

“…Elderly people are considered to be a vulnerable population. Their risks of sleep disturbances are significantly higher than that of other age groups [19,28]. It has been reported that sleep quality becomes worse with an increase of age, due to a decline in physiological functioning and a change of the endocrine system [3,6,[9][10][11].…”