Sociodemographic and Health Correlates of Sleep Quality and Duration among Very Old Chinese

Abstract

Study Objectives: To examine factors associated with self-reported sleep quality and duration among very old adults in China. Design: Cross-sectional analysis of the 2005 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Setting: In-home interview with older adults in 22 provinces in mainland China. Participants: A total of 15,638 individuals aged 65 and older (5,047 aged 65-79, 3,870 aged 80-89, 3,927 aged 90-99, and 2,794 aged 100 and older, including 6,688 men and 8,950 women). Interventions: N/A Measurements and Results: Two self-reported sleep questions together with numerous sociodemographic and health status measures were used in this study. Sixty-five per cent of Chinese elders reported good quality of sleep. The average number of self-reported hours of sleep was 7.5 (SD 1.9), with 13.1%, 16.2%, 18.0%, 28.0%, 9.2%, and 15.5% reporting ≤ 5, 6, 7, 8, 9, and ≥ 10 hours, respectively (weighted). Multivariate analyses showed that male gender, rural residence, Han ethnicity, higher socioeconomic status, and good health conditions were positively associated with good quality of sleep. All other factors being equal, octogenarians, nonagenarians, and centenarians were more likely to have good sleep quality than the young elders aged 65-79. Elders with poorer health status or older age were more likely to have either relatively shorter (≤ 6 h) or longer (≥ 10 h) sleep duration. Married elders were more likely to have an average duration between these two values. Except for some geographic variations, associations between all other factors and sleep duration were weak compared to the effects of health. Conclusions: Age and health conditions are the two most important factors associated with self-reported sleep quality and duration. Good quality of sleep among long-lived old adults may have some implications for achieving healthy longevity. A commentary on this article appears in this issue on page 575.

Sociodemographic and health correlates of sleep problems and duration in older adults in South Africa

“…This duration seemed longer than that found in other studies, with a mean of 7 -7.5 h and a larger group (≥30%) with short sleep duration. 6,19 Consistent with other studies, 3,17 depression, cognitive impairment, lack of social cohesion and moderate or severe activity limitations were associated with a current sleeping problem. Depression has been found in several studies to be a risk factor for sleep disturbances.…”

“…Depression has been found in several studies to be a risk factor for sleep disturbances. 33,34 Unlike in certain other studies, 3,6,7,[9][10][11][12]14 gender, age, socioeconomic status, population group, urban residence, health behaviour (tobacco use, alcohol use and physical activity) and chronic conditions were not found to be associated with sleeping problems.…”

“…20 The category of 7 -8 h/day was used as reference to allow for comparison with earlier studies on older adults. 6,20 This reference category was chosen because some studies reported that those who slept 7 -8 h usually had the lowest mortality risk.…”

Association of sleep quality and dementia among long-lived Chinese older adults

“…However, this conclusion is not in agreement with other studies. Gu et al (2010) found that quality of sleep of the very elderly did not differ substantially from that of the young elders. Tafaro et al (2007) also reported that long-lived individuals showed better self-rated sleep quality.…”

“…Tafaro et al (2007) also reported that long-lived individuals showed better self-rated sleep quality. This disagreement could be explained by the following factors: (1) these two studies (Gu et al 2010;Tafaro et al 2007) used self-rated quality of sleep, which is a subjective measurement; (2) the participants included in these two studies were healthier than those included in our study; and (3) the healthy long-lived participants might have their own perception of what is "acceptable" sleep and, therefore, did not report poor sleep quality even if objective quality of sleep does in fact change with advancing age.…”