Abstract
BackgroundThe combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas. This study aimed to explore the independent and combined effects of sleep quality and night sleep duration on HRQoL.MethodsA total of 21,926 eligible participants from the Henan rural cohort study were selected. The Pittsburgh Sleep Quality Index was utilized to evaluate sleep quality and night sleep duration. The Tobit regression model, generalized linear model (GLM), and logistic regression model were performed to assess the associations of sleep quality and night sleep duration with HRQoL. The restricted cubic spline was applied to identify the dose–response relationships of sleep quality and night sleep duration with HRQoL.ResultsAfter multivariable adjustment, the Tobit regression and GLM indicated that the regression coefficients [95% confidence interval (CI)] for poor sleep quality were − 0.124 (− 0.133, − 0.114) and − 6.25 (− 6.71, − 5.78) on utility index and VAS score, respectively. Compared with the reference group (7 h-), participants with short sleep duration (< 6 h) or long sleep duration (≥10 h) reported a lower HRQoL. A U-shape relationship between night sleep duration and HRQoL was observed, along with a J-shape relationship between sleep quality and HRQoL (P for non-linear < 0.001). Furthermore, individuals with longer night sleep duration (≥10 h) and poorer sleep quality were strongly associated with lower HRQoL (utility index [odds ratio (OR) (95% CI)]: 6.626 (3.548, 8.920), VAS score [OR (95% CI)]: 2.962 (1.916, 4.578)).ConclusionPoor sleep quality and extreme night sleep duration were independently and combinedly associated with low HRQoL, suggesting that maintaining good sleep quality and appropriate night sleep duration was important.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.
Highlights
The combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas
T-test was performed to compare the differences in continuous variables; Chi-square test was used to compare the differences in the categorical variables SD, standard deviation; RMB, Renminbi; BMI, Body mass index
The results indicated that poor sleep quality and extreme night sleep duration were independently associated with low HRQoL
Summary
The combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas. Sleep disturbance mainly includes insomnia, narcolepsy, obstructive sleep apnea, and restless legs syndrome, which have adverse effects on health status [1,2,3,4]. These sleep disturbances are usually characterized by poor sleep quality and abnormal sleep duration. Previous studies have reported that poor sleep quality and extreme sleep duration (both short and long) are associated with a broad spectrum of health outcomes, such as cognitive impairment, depressive symptoms, anxiety, coronary heart diseases (CHD), hypertension, and all-cause mortality [5,6,7,8,9,10]. Limited evidence is available on the associations of sleep quality or sleep duration with HRQoL
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