Abstract
ObjectiveTo investigate the prevalence and associated factors of poor sleep quality among community-dwelling elderly population in a rural area of Northern China.MethodsWe 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.ResultsThe 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).ConclusionsThe 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.
Highlights
In 2017, the number of people aged 60 years and above had reached nearly 241 million in China, accounting for 17.3% of the nation’s total population [1]
In this large-scale population-based study, we sought to investigate the prevalence of poor sleep quality and abnormal sleep patterns, and to further analyze a range of various factors related to poor sleep quality among older adults who were living in a rural area in western Shandong province, China
When using the forward stepwise multivariate analysis to fit the best model, the following factors showed significant associations with poor sleep quality: female sex (OR = 1.76, 95% CI 1.46–2.12), hypertension (OR = 1.28, 95% CI 1.06–1.54), coronary heart disease (CHD) (OR = 1.60, 95% CI 1.27–2.00), and chronic obstructive pulmonary disease (COPD) (OR = 1.82, 95% CI 1.34–2.49) (Table 3, model 3). In this large-scale population-based study, we showed that poor sleep quality affected nearly one-third of older adults who were living in the rural communities in China, which was slightly higher than that of those living in the urban areas [5, 6]
Summary
In 2017, the number of people aged 60 years and above had reached nearly 241 million in China, accounting for 17.3% of the nation’s total population [1]. Poor sleep quality or sleep disorders in old people are associated with highly prevalent chronic health conditions, such as hypertension [21], type 2 diabetes [22], cardiovascular disease [23], stroke [24], depression [25], and cognitive impairment [26] Most of these previous studies have been conducted in western societies. Identifying potentially modifiable factors that are related to poor sleep quality or sleep disorders may help develop effective interventions to improve sleep quality and, reduce the risk of chronic diseases in older adults associated with sleep disorders [27] In this large-scale population-based study, we sought to investigate the prevalence of poor sleep quality and abnormal sleep patterns, and to further analyze a range of various factors related to poor sleep quality among older adults who were living in a rural area in western Shandong province, China
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