The relationship between poor sleep quality measured by the Pittsburgh Sleep Quality Index and smoking status according to sex and age: an analysis of the 2018 Korean Community Health Survey

Abstract

OBJECTIVES: Several reports have described that cigarette smokers are more likely to experience sleep disturbances. This study aimed to evaluate the differential associations between smoking and sleep quality according to sex and age group, which were not adequately characterized in previous studies. METHODS: Data analysis was conducted with a nationally representative sample of 224,986 Korean adults collected from the 2018 Community Health Survey. Sleep quality, as the dependent variable, was measured with the Pittsburgh Sleep Quality Index (PSQI), with the PSQI score dichotomized as good (≤4) or poor (>5). Multiple logistic regression analysis was performed considering socio-demographic factors, health behaviors, comorbidities, and psychological factors as covariates. RESULTS: The overall weighted prevalence of poor sleep quality was 39.4% (95% CI: 39.1~39.7%). In the multivariate model excluding psychological factors, poor sleep quality was positively correlated with smoking in both sexes and in all age groups except in males aged ≥ 65 years. However, in the full model including psychological factors, statistically significant odds ratios of poor sleep quality according to smoking level were observed only in women under 65 years of age, and the values were around 1.5. CONCLUSION: The relationship between poor sleep quality and cigarette smoking differs according to sex and age group. Smoking cessation interventions to improve sleep quality need to be preferentially applied to women, especially those under middle age, in addition to solutions for psychological problems.

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