Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 6;18(23):12835.
doi: 10.3390/ijerph182312835.

Association of Subjective Quality and Quantity of Sleep with Quality of Life among a General Population

Kentaro Matsui  1   2   3 , Takuya Yoshiike  2 , Kentaro Nagao  2 , Tomohiro Utsumi  2   4 , Ayumi Tsuru  1   2 , Rei Otsuki  1   2   5 , Naoko Ayabe  2   6 , Megumi Hazumi  2 , Masahiro Suzuki  5 , Kaori Saitoh  5 , Sayaka Aritake-Okada  7 , Yuichi Inoue  3   8 , Kenichi Kuriyama  2
Affiliations

Association of Subjective Quality and Quantity of Sleep with Quality of Life among a General Population

Kentaro Matsui et al. Int J Environ Res Public Health. .

Abstract

This study aimed to determine whether both subjective sleep quality and sleep duration are directly associated with quality of life (QOL), as well as indirectly associated with QOL through insomnia symptoms. Individuals aged 20-69 years without mental illness (n = 9305) were enrolled in this web-based cross-sectional survey. The Short Form-8 was used to assess physical and mental QOL. We used the Pittsburgh Sleep Quality Index (PSQI) and extracted items related to subjective sleep quality and sleep duration. Insomnia symptoms were also extracted from the PSQI. The hypothesized models were tested using structural equation modeling. Worse sleep quality, but not shorter sleep duration, was related to worse physical QOL. Both worse sleep quality and shorter sleep duration were related to worse mental QOL. Insomnia symptoms mediated these relationships. Subgroup analyses revealed a U-shaped relationship between sleep duration and physical/mental QOL. However, the relationship between sleep quality and physical/mental QOL was consistent regardless of sleep duration. The results suggest that subjective sleep quality has a more coherent association with QOL than subjective sleep duration. Because of its high feasibility, a questionnaire on overall sleep quality could be a useful indicator in future epidemiological studies of strategies for improving QOL.

Keywords: insomnia; quality of life; sleep duration; sleep quality.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Hypothesized mediation model. Dashed lines are used to represent indirect effects, and solid lines are used to represent direct effects. QOL, quality of life.
Figure 2
Figure 2
The hypothesized multiple mediator models examining the relationship of sleep quality and sleep duration to physical QOL (A) and mental QOL (B) for the entire sample (n = 9305). Standardized regression weights for each path are presented. Numbers in brackets represent 95% confidence intervals. Dashed lines are used to represent indirect effects, and solid lines are used to represent direct effects. The covariates (age, categorized body mass index, and existence of currently treated diseases for both PCS and MCS, and sex for MCS) were controlled in the equation, but they are not shown in the figure for the sake of brevity. * p < 0.001. QOL, quality of life. R2, R squared value.
Figure 3
Figure 3
The hypothesized multiple mediator models examining the relationship of sleep quality and sleep duration to physical QOL and mental QOL for the short sleep group (A-SS and B-SS, respectively, n = 2394) and long sleep group (A-LS and B-LS, respectively, n = 806). The analyses performed were the same as those shown in Figure 2. * p < 0.001. QOL, quality of life. R2, R squared value.
See this image and copyright information in PMC

References

    1. The WHOQOL Group The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Soc. Sci. Med. 1995;41:1403–1409. doi: 10.1016/0277-9536(95)00112-K. - DOI - PubMed
    1. Fayers P.M., Machin D. Quality of Life: The Assessment, Analysis and Reporting of Patient-Reported Outcomes. John Wiley & Sons; Hoboken, NJ, USA: 2015.
    1. Verster J.C., Pandi-Perumal S.R., Streiner D.L. Sleep and Quality of Life in Clinical Medicine. Springer; Berlin/Heidelberg, Germany: 2008.
    1. Stranges S., Dorn J.M., Shipley M.J., Kandala N.B., Trevisan M., Miller M.A., Donahue R.P., Hovey K.M., Ferrie J.E., Marmot M.G., et al. Correlates of short and long sleep duration: A cross-cultural comparison between the United Kingdom and the United States: The Whitehall II Study and the Western New York Health Study. Am. J. Epidemiol. 2008;168:1353–1364. doi: 10.1093/aje/kwn337. - DOI - PMC - PubMed
    1. Magee C.A., Caputi P., Iverson D.C. Relationships between self-rated health, quality of life and sleep duration in middle aged and elderly Australians. Sleep Med. 2011;12:346–350. doi: 10.1016/j.sleep.2010.09.013. - DOI - PubMed

Publication types

LinkOut - more resources