Sleep quality of Shanghai residents: population-based cross-sectional study

Abstract

Objective
To estimate the prevalence of poor sleep and its risk factors for adults living in a suburban area of Shanghai with rapid urbanization.

Methods
A total of 37,545 residents who were aged 20 to 74 years and from the “Peak Program,” a community-based natural population cohort study, were included. Data on demographics, lifestyle, and physical health-related factors were collected using a face-to-face questionnaire interview. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep was defined as a PSQI score above 7.

Results
The overall mean of PSQI score was 3.69 ± 2.57 while the prevalence of poor sleep was 8.3%. The prevalence of poor sleep quality was higher in participants who were older than 40 years, had less education, smoked tobacco, had anxiety, and had a chronic disease (p < 0.05 for all comparisons). After adjustment for confounding, a logistic regression model indicated that poor sleep was associated with advanced age, smoking, anxiety, cardiovascular and cerebrovascular diseases, respiratory diseases, and other chronic diseases (p < 0.05 for all comparisons). In addition, compared to women who were premenopausal, the naturally postmenopausal women (OR 1.675, 95% CI 1.44–1.94) and induced menopausal women (OR 2.26, 95% CI 1.81–2.82) were more likely to report poor sleep.

Conclusion
The prevalence of poor sleep among individuals who lived in the Songjiang District of Shanghai and were aged 20 to 74 years was remarkably lower than in the general population of China. Poor sleep was generally more common in middle-aged and elderly residents and in those suffering from anxiety and chronic diseases. Regular exercise, anxiety relieving, and treatment improvement of different chronic diseases may help sleep better.

Full text

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Quality of Life Research (2020) 29:1055–1064
https://doi.org/10.1007/s11136-019-02371-x
Sleep quality ofShanghai residents: population‑based cross‑sectional
study
WenjunWu1· YonggenJiang2· NaWang1· MeiyingZhu2· XingLiu1· FengJiang1· GenmingZhao1· QiZhao1
Accepted: 19 November 2019 / Published online: 28 November 2019
© Springer Nature Switzerland AG 2019
Abstract
Objective To estimate the prevalence of poor sleep and its risk factors for adults living in a suburban area of Shanghai with
rapid urbanization.
Methods A total of 37,545 residents who were aged 20 to 74years and from the “Peak Program,” a community-based natural
population cohort study, were included. Data on demographics, lifestyle, and physical health-related factors were collected
using a face-to-face questionnaire interview. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI),
and poor sleep was defined as a PSQI score above 7.
Results The overall mean of PSQI score was 3.69 ± 2.57 while the prevalence of poor sleep was 8.3%. The prevalence of
poor sleep quality was higher in participants who were older than 40years, had less education, smoked tobacco, had anxi-
ety, and had a chronic disease (p < 0.05 for all comparisons). After adjustment for confounding, a logistic regression model
indicated that poor sleep was associated with advanced age, smoking, anxiety, cardiovascular and cerebrovascular diseases,
respiratory diseases, and other chronic diseases (p < 0.05 for all comparisons). In addition, compared to women who were
premenopausal, the naturally postmenopausal women (OR 1.675, 95% CI 1.44–1.94) and induced menopausal women (OR
2.26, 95% CI 1.81–2.82) were more likely to report poor sleep.
Conclusion The prevalence of poor sleep among individuals who lived in the Songjiang District of Shanghai and were aged
20 to 74years was remarkably lower than in the general population of China. Poor sleep was generally more common in
middle-aged and elderly residents and in those suffering from anxiety and chronic diseases. Regular exercise, anxiety reliev-
ing, and treatment improvement of different chronic diseases may help sleep better.
Keywords Sleep quality· The Pittsburgh sleep quality index· Cross-sectional study
Introduction
The symptoms of poor sleep include complaints of diffi-
culty initiating sleep, difficulty maintaining sleep, waking
up too early, or having chronic nonrestorative sleep or per-
sistently poor-quality sleep [1, 2]. Adequate sleep is impor-
tant for good health, and people with poor sleep are more
likely to experience physical and psychological problems,
such as headaches, cognitive impairment, workplace errors,
mood disorders, and even an increased risk of death [3–6].
However, existing epidemiological surveys indicate that
about 30 to 40% of adults in the general population chroni-
cally suffer from at least one sleep disorder symptom and
that about 9 to 15% who have chronic symptoms report day-
time consequences [7].
The prevalence of poor sleep varies according to the
assessment criteria and target population [2, 7–9]. In 1989,
Buysse etal. proposed the Pittsburgh Sleep Quality Index
(PSQI) to evaluate the sleep quality of adults and determined
the test–retest reliability and validity of this instrument [10].
Since then, there have been numerous studies using PSQI
to assess the quality of sleep in various populations (e.g.,
college students, the elderly, pregnant women, patients with
chronic diseases, and civil servants) [11–13]. However,
researchers used different standard PSQI scores for evaluat-
ing the quality of sleep. Buysse etal. considered a global
PSQI score greater than 5 yielded a diagnostic sensitivity of
* Qi Zhao
zhaoqi@shmu.edu.cn
1 Department ofEpidemiology, School ofPublic Health,
Fudan University, 130 DongAn Road, Shanghai, China
2 Songjiang District Center forDisease Control
andPrevention, Shanghai, China
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