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. 2025 May 8;29(2):179.
doi: 10.1007/s11325-025-03346-8.

The relationship between multiple chronic diseases and sleep quality among the older people ≥ 60 years in China

Zhiwei Zhang  1 , Qianwen Yang  1 , Panpan He  1 , Xueyi Jin  1 , Xueqian Mao  1 , Ying Hu  1 , Lipeng Jing  2
Affiliations

The relationship between multiple chronic diseases and sleep quality among the older people ≥ 60 years in China

Zhiwei Zhang et al. Sleep Breath. .

Abstract

Background: High-quality sleep is essential for both physical well-being and mental health, particularly in promoting the health and longevity of older adults. However, limited evidence exists regarding the relationship between chronic diseases and sleep quality in this population.

Methods: The study investigated 35 common chronic diseases among 1186 older individuals aged 60 and above from six rural communities in northwest China. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multiple logistic regression and interaction analyses were employed to explore the relationship between multiple chronic diseases and sleep quality.

Results: Compared with the first quartile (≤ 1) of the number of chronic diseases, the second (2), third (3-4), and fourth (≥ 5) quartile ORs were 1.771 (95% CI: 1.191-2.631, p = 0.005), 2.434 (95% CI: 1.660-3.567, p < 0.001), and 3.180 (95% CI: 2.039-4.959, p < 0.001), respectively. For the duration of chronic diseases, compared with the first quartile (≤ 4.32 years) of duration of chronic diseases, the second (4.33-7.49 years), third (7.50-11.32 years) and fourth (≥ 11.33 years) quartile ORs were 1.350 (95% CI: 0.931-1.957, p = 0.113), 1.381 (95% CI: 0.953-2.000, p = 0.088), and 1.629 (95% CI: 1.122-2.365, p = 0.010), respectively. Older adults with multimorbidity and a longer duration of chronic diseases (≥ 7.5 years) had poorer sleep quality than those without multimorbidity and shorter duration of chronic diseases.

Conclusion: The higher number and longer duration of chronic diseases are associated with poorer sleep quality among older adults, with a stronger correlation observed in females compared to males.

Keywords: Community-dwelling population; Multiple chronic diseases; Older adults; Pittsburgh sleep quality index; Quality of sleep.

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Conflict of interest statement

Declarations. Ethical approval: All participants have signed the written informed consent form, and the study was approved by Lanzhou University’s Ethics Committee (IRB21010301). Conflict of interest: The authors declare no conflict of interest.

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