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Poor sleep quality and influencing factors among rural adults in Deqing, China

  • Epidemiology • Original Article
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Abstract

Background

Poor sleep quality is prevalent and is associated with cognitive decline, impaired health, and reduced quality of life. There is a lack of studies about sleep quality and its potential risk factors among rural adults aged 45 years or above under rapid urbanization in China.

Methods

In a cross-sectional survey conducted in Deqing County, China in 2015, we included 1584 adults 45+ years of age. Sleep quality was measured by using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleep quality was defined by a CPSQI global score > 5. Other data collected included sociodemographic and lifestyle factors as well as physical health. Logistic regression model was applied to assess factors influencing sleep quality by calculating crude odds ratio (cOR), adjusted OR (aOR), and their 95% confident intervals (CI).

Results

Of 1584 subjects, more than half were female with an average age of 58.9 ± 8.1 years. Their night sleep duration was 7.7 ± 1.2 h, sleep latency was 31.9 ± 32.0 min, and 17% of them could not fall asleep within half hour, averagely. The mean score of CPSQI was 4.4 ± 2.7. The prevalence of poor sleep quality was 27.7% (95% CI = 25.4–29.7%) overall, and there existed a significant sex difference—30.6% (95% CI = 27.7–33.7%) for women and 24.0% (95% CI = 20.9–27.2%) for men. Five domains of the CPSQI except for sleep efficiency and use of sleeping medication also showed a sex difference (p < 0.05). Logistic regression analysis indicated that unmarried status (aOR = 1.51, 95% CI = 1.03–2.22), lower monthly individual income (aOR = 2.09, 95% CI = 1.49–2.94), and chronic diseases (aOR = 1.95, 95% CI = 1.51–2.51) were significantly related to poor sleep quality.

Conclusions

Sleep problems were prevalent among the rural Chinese adults aged 45+ years. People who were unmarried or had low personal income or any chronic diseases were more likely to have poor sleep quality.

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References

  1. Wong WS, Fielding R (2011) Prevalence of insomnia among Chinese adults in Hong Kong: a population-based study. J Sleep Res 20(1 Pt 1):117–126

    Article  Google Scholar 

  2. Bawden FC, Oliveira CA, Caramelli P (2011) Impact of obstructive sleep apnea on cognitive performance. Arq Neuropsiquiatr 69(4):585–589

    Article  Google Scholar 

  3. Li J, Yao YS, Dong Q, Dong YH, Liu JJ, Yang LS, Huang F (2013) Characterization and factors associated with sleep quality among rural elderly in China. Arch Gerontol Geriatr 56(1):237–243

    Article  Google Scholar 

  4. Luo J, Zhu G, Zhao Q, Guo Q, Meng H, Hong Z, Ding D (2013a) Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the shanghai aging study. PLoS One 8(11):e81261

    Article  Google Scholar 

  5. Manjavong M, Limpawattana P, Mairiang P, Anutrakulchai S (2016) Prevalence of insomnia and related impact[J]. Int J Psychiatry Med 51(6):544–553

    Article  Google Scholar 

  6. Miao J, Wu X (2016) Urbanization socioeconomic status and health disparity in China. Health Place 42:87–95

    Article  Google Scholar 

  7. Statistical Communiqué of China on 2015 National Economic and Social Development [EB/OL]. [2018/4/22]. http://www.stats.gov.cn/tjsj/zxfb/201602/t20160229_1323991.html

  8. Yang XJ (2013) China’s rapid urbanization. Science 342(6156):310

    Article  CAS  Google Scholar 

  9. Yu J, Li J, Cuijpers P, Wu S, Wu Z (2012) Prevalence and correlates of depressive symptoms in Chinese older adults: a population-based study. Int J Geriatr Psychiatry 27(3):305–312

    Article  Google Scholar 

  10. Luo C, Zhang J, Pan J (2013b) One-year course and effects of insomnia in rural Chinese adolescents. Sleep 36(3):377–384

    Article  Google Scholar 

  11. Buysse DJ, Reynolds CR, Monk TH et al (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  Google Scholar 

  12. Haseli-Mashhadi N, Pan A, Ye X et al (2009) Self-rated health in middle-aged and elderly Chinese: distribution, determinants and associations with cardio-metabolic risk factors. BMC Public Health 9:368

    Article  Google Scholar 

  13. Zhang HS, Li Y, Mo HY, Qiu DX, Zhao J, Luo JL, Lin WQ, Wang JJ, Wang PX (2017) A community-based cross-sectional study of sleep quality in middle-aged and older adults. Qual Life Res 26(4):923–933

    Article  Google Scholar 

  14. Poland RE, Rao U, Lutchmansingh P, McCracken JT, Lesser IM, Edwards C, Ott GE, Lin KM (1999) REM sleep in depression is influenced by ethnicity. Psychiatry Res 88(2):95–105

    Article  CAS  Google Scholar 

  15. Jean-Louis G, Magai CM, Cohen CI, Zizi F, von Gizycki H, DiPalma J, Casimir GJ (2001) Ethnic differences in self-reported sleep problems in older adults. Sleep 24(8):926–933

    Article  CAS  Google Scholar 

  16. Hale L, Do DP (2007) Racial differences in self-reports of sleep duration in a population-based study. Sleep 30(9):1096–1103

    Article  Google Scholar 

  17. Report on the work of the Deqing Government [EB/OL]. [2018/4/23]. http://www.deqing.gov.cn/art/2017/2/23/art_9378_289833.html

  18. Fu CW, Chen Y, Wang F, Jiang QW (2012) Chronic diseases in adults living in rural communities of China: World Congress on Public Health World Health Organization

  19. Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, Fang SC (2005) Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res 14(8):1943–1952

    Article  CAS  Google Scholar 

  20. WHO|Physical activity [EB/OL]. [2018/4/26].http://www.who.int/topics/physical_activity/en/

  21. (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:1–253

  22. Su TP, Huang SR, Chou P (2004) Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: a Taiwanese urban area survey. Aust N Z J Psychiatry 38(9):706–713

    Article  Google Scholar 

  23. Liu X, Liu L (2005) Sleep habits and insomnia in a sample of elderly persons in China. Sleep 28(12):1579–1587

    PubMed  Google Scholar 

  24. Xiang YT, Ma X, Cai ZJ, Li SR, Xiang YQ, Guo HL, Hou YZ, Li ZB, Li ZJ, Tao YF, Dang WM, Wu XM, Deng J, Lai KYC, Ungvari GS (2008) The prevalence of insomnia, its sociodemographic and clinical correlates, and treatment in rural and urban regions of Beijing, China: a general population-based survey. Sleep 31(12):1655–1662

    Article  Google Scholar 

  25. Roth T, Ancoli-Israel S (1999) Daytime consequences and correlates of insomnia in the United States: results of the 1991 National Sleep Foundation survey. II. Sleep 22(Suppl 2):S354–S358

    PubMed  Google Scholar 

  26. Shochat T, Ancoli-Israel S (2017) Chapter 153—insomnia in older adults. In: Kryger A, Meir M, Roth T, Dement WC (eds) Principles and practice of sleep medicine, sixth edn. Elsevier, pp 1503–1509

  27. Murphy F (2006) Loneliness: a challenge for nurses caring for older people. Nurs Older People 18(5):22–25

    Article  Google Scholar 

  28. Breslau N, Roth T, Rosenthal L, Andreski P (1996) Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 39(6):411–418

    Article  CAS  Google Scholar 

  29. Yeo BK, Perera IS, Kok LP, Tsoi WF (1996) Insomnia in the community. Singap Med J 37(3):282–284

    CAS  Google Scholar 

  30. Zhang B, Wing YK (2006) Sex differences in insomnia: a meta-analysis. Sleep 29(1):85–93

    Article  Google Scholar 

  31. Lu CH, Wang PX, Lei YX, Luo ZC (2014) Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers. Health Qual Life Outcomes 12:121

    Article  Google Scholar 

  32. Ohayon M (1996) Epidemiological study on insomnia in the general population. Sleep 19(3 Suppl):S7–S15

    Article  CAS  Google Scholar 

  33. Tseng HC, Wang CJ, Cheng SH, Sun ZJ, Chen PS, Lee CT, Lin SH, Yang YK, Yang YC (2014) Tea-drinking habit among new university students: associated factors. Kaohsiung J Med Sci 30(2):98–103

    Article  Google Scholar 

  34. Garaulet M, Ortega FB, Ruiz JR, Rey-López JP, Béghin L, Manios Y, Cuenca-García M, Plada M, Diethelm K, Kafatos A, Molnár D, al-Tahan J, Moreno LA (2011) Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes 35(10):1308–1317

    Article  CAS  Google Scholar 

  35. Zhejiang Statistical Yearbook 2014[R]. Beijing: Zhejiang Provincial Bureau of Statistics, 2014

Download references

Funding

National Natural Science Foundation of China and Shanghai Government provided financial support in the form of the National Natural Science Foundation of China (81473038), Shanghai 3-Year Public Health Action Plan (GWTD2015S04), and Shanghai Leading Academic Discipline Project of Public Health (15GWZK80101). The sponsor had no role in the design or conduct of this research.

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Author notes

  1. Xiaolian Dong and Yuzhuo Wang contributed equally to this work.

Authors and Affiliations

  1. Deqing County Center of Disease Prevention and Control, Deqing, Zhejiang Province, China

    Xiaolian Dong, Xuecai Wang & Jianfu Zhu

  2. School of Public Health, Key Laboratory of Public Health Safety, Pudong Institute of Prevention Medicine, Fudan University, Shanghai, 200032, China

    Yuzhuo Wang, Na Wang, Qingwu Jiang & Chaowei Fu

  3. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada

    Yue Chen

Authors
  1. Xiaolian Dong
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  2. Yuzhuo Wang
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  4. Xuecai Wang
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  5. Jianfu Zhu
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Correspondence to Chaowei Fu.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of the Fudan University School of Public Health and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Appendix

Appendix

Table 5 Univariate and multiple logistic regression models of chronic diseases associated with poor sleep quality
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Dong, X., Wang, Y., Chen, Y. et al. Poor sleep quality and influencing factors among rural adults in Deqing, China. Sleep Breath 22, 1213–1220 (2018). https://doi.org/10.1007/s11325-018-1685-8

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  • DOI: https://doi.org/10.1007/s11325-018-1685-8

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