Gender-specific prevalence of poor sleep quality and related factors in a Chinese rural population: the Henan Rural Cohort Study

Abstract

Objective: To estimate the prevalence of poor sleep quality and identify related factors by gender in the Chinese rural population.

Methods: Overall, 27424 subjects (10881 males and 16543 females) aged 18-79 years were enrolled from the Henan Rural Cohort Study. Sleep quality was evaluated by the standard Pittsburgh Sleep Quality Index (PSQI) and global score>5 was classified as poor sleep quality. Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). A meta-analysis including 14 studies was used to validate the result of the cross-sectional study.

Results: The average PSQI score was 3.78 ± 2.72 in total, and the score of females (4.10 ± 2.90) was significantly higher than males (3.29 ± 2.33). The crude and age-standardized prevalences of poor sleep quality were 21.62% and 15.80%, respectively. The crude prevalence in females (25.73%) was significantly higher than males (15.38%). The results of meta-analysis showed that the pooled prevalence of poor sleep quality was 25.0% (18.8%-31.2%) in total sample, 31.7% (24.9%-38.5%) in male, and 38.2% (29.7%-46.7%) in females. Multivariate logistic regression identified that older age, being female, unmarried/divorced/widowed, low education level, low income, drinking, depression and dyslipidemia could increase the odds of poor sleep quality.

Conclusions: More than one fifth of the participants in a rural area of China slept poorly and the prevalence in females was significantly higher than males. Effective interventions are urgently needed to improve the sleep quality in resource limited areas.

Clinical trial registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375.

Keywords: Pittsburgh sleep quality index (PSQI); Related factor; Rural population; Sleep quality.