Skip to main content
Top
Published in: BMC Public Health 1/2021

Open Access 01-12-2021 | Affective Disorder | Research article

Subjective sleep quality and association with depression syndrome, chronic diseases and health-related physical fitness in the middle-aged and elderly

Authors: Min-Fang Hsu, Kang-Yun Lee, Tsung-Ching Lin, Wen-Te Liu, Shu-Chuan Ho

Published in: BMC Public Health | Issue 1/2021

Login to get access

Abstract

Background

As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.

Methods

We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.

Results

Overall, 27.9% of participants in this study demonstrated bad sleepers (with a PSQI score of > 5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.

Conclusions

Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.
Literature
1.
go back to reference Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213 Epub 1989/05/01.CrossRef Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213 Epub 1989/05/01.CrossRef
2.
go back to reference Landry GJ, Best JR, Liu-Ambrose T. Measuring sleep quality in older adults: a comparison using subjective and objective methods. Front Aging Neurosci. 2015;7:166 Epub 2015/10/07.PubMedPubMedCentral Landry GJ, Best JR, Liu-Ambrose T. Measuring sleep quality in older adults: a comparison using subjective and objective methods. Front Aging Neurosci. 2015;7:166 Epub 2015/10/07.PubMedPubMedCentral
3.
go back to reference Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28(4):499–521 Epub 2005/09/21.CrossRef Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28(4):499–521 Epub 2005/09/21.CrossRef
4.
go back to reference Moul DE, Nofzinger EA, Pilkonis PA, Houck PR, Miewald JM, Buysse DJ. Symptom reports in severe chronic insomnia. Sleep. 2002;25(5):553–63 Epub 2002/08/02.CrossRef Moul DE, Nofzinger EA, Pilkonis PA, Houck PR, Miewald JM, Buysse DJ. Symptom reports in severe chronic insomnia. Sleep. 2002;25(5):553–63 Epub 2002/08/02.CrossRef
5.
go back to reference Takamatsu S, Sekine M, Tatsuse T, Kagamimori S. Alcohol drinking patterns and sleep quality of Japanese civil servants. Sangyo eiseigaku zasshi. 2010;52(1):1–11 Epub 2009/11/28.CrossRef Takamatsu S, Sekine M, Tatsuse T, Kagamimori S. Alcohol drinking patterns and sleep quality of Japanese civil servants. Sangyo eiseigaku zasshi. 2010;52(1):1–11 Epub 2009/11/28.CrossRef
6.
go back to reference Wu CY, Su TP, Fang CL, Yeh CM. Sleep quality among community-dwelling elderly people and its demographic, mental, and physical correlates. J Chin Med Assoc. 2012;75(2):75–80 Epub 2012/02/22.CrossRef Wu CY, Su TP, Fang CL, Yeh CM. Sleep quality among community-dwelling elderly people and its demographic, mental, and physical correlates. J Chin Med Assoc. 2012;75(2):75–80 Epub 2012/02/22.CrossRef
7.
go back to reference Sariyildiz MA, Batmaz I, Bozkurt M, Bez Y, Cetincakmak MG, Yazmalar L, et al. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. J Clin Med Res. 2014;6(1):44–52 Epub 2014/01/09.PubMed Sariyildiz MA, Batmaz I, Bozkurt M, Bez Y, Cetincakmak MG, Yazmalar L, et al. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. J Clin Med Res. 2014;6(1):44–52 Epub 2014/01/09.PubMed
8.
go back to reference Sherrill DL, Kotchou K, Quan SF. Association of physical activity and human sleep disorders. Arch Intern Med. 1998;158(17):1894–8 Epub 1998/10/06.CrossRef Sherrill DL, Kotchou K, Quan SF. Association of physical activity and human sleep disorders. Arch Intern Med. 1998;158(17):1894–8 Epub 1998/10/06.CrossRef
9.
go back to reference Park YH. Physical activity and sleep patterns in elderly who visited a community senior center. Taehan Kanho Hakhoe chi. 2007;37(1):5–13 Epub 2007/03/07.PubMed Park YH. Physical activity and sleep patterns in elderly who visited a community senior center. Taehan Kanho Hakhoe chi. 2007;37(1):5–13 Epub 2007/03/07.PubMed
10.
go back to reference Zavecz Z, Nagy T, Galko A, Nemeth D, Janacsek K. The relationship between subjective sleep quality and cognitive performance in healthy young adults: evidence from three empirical studies. Sci Rep. 2020;10(1):4855 Epub 2020/03/19.CrossRef Zavecz Z, Nagy T, Galko A, Nemeth D, Janacsek K. The relationship between subjective sleep quality and cognitive performance in healthy young adults: evidence from three empirical studies. Sci Rep. 2020;10(1):4855 Epub 2020/03/19.CrossRef
11.
go back to reference Haseli-Mashhadi N, Dadd T, Pan A, Yu Z, Lin X, Franco OH. Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors. BMC Public Health. 2009;9:130 Epub 2009/05/12.CrossRef Haseli-Mashhadi N, Dadd T, Pan A, Yu Z, Lin X, Franco OH. Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors. BMC Public Health. 2009;9:130 Epub 2009/05/12.CrossRef
12.
go back to reference Hoffman S. Sleep in the older adult: implications for nurses (CE). Geriatr Nurs. 2003;24(4):210–4 quiz 5-6. Epub 2003/10/16.CrossRef Hoffman S. Sleep in the older adult: implications for nurses (CE). Geriatr Nurs. 2003;24(4):210–4 quiz 5-6. Epub 2003/10/16.CrossRef
13.
go back to reference Spencer RM, Gouw AM, Ivry RB. Age-related decline of sleep-dependent consolidation. Learn Mem. 2007;14(7):480–4 Epub 2007/07/12.CrossRef Spencer RM, Gouw AM, Ivry RB. Age-related decline of sleep-dependent consolidation. Learn Mem. 2007;14(7):480–4 Epub 2007/07/12.CrossRef
14.
go back to reference Yang CY, Chiou AF. Predictors of sleep quality in community-dwelling older adults in northern Taiwan. J Nurs Res. 2012;20(4):249–60 Epub 2012/11/17.CrossRef Yang CY, Chiou AF. Predictors of sleep quality in community-dwelling older adults in northern Taiwan. J Nurs Res. 2012;20(4):249–60 Epub 2012/11/17.CrossRef
15.
go back to reference Moreno-Vecino B, Arija-Blazquez A, Pedrero-Chamizo R, Gomez-Cabello A, Alegre LM, Perez-Lopez FR, et al. Sleep disturbance, obesity, physical fitness and quality of life in older women: EXERNET study group. Climacteric. 2017;20(1):72–9 Epub 2017/01/04.CrossRef Moreno-Vecino B, Arija-Blazquez A, Pedrero-Chamizo R, Gomez-Cabello A, Alegre LM, Perez-Lopez FR, et al. Sleep disturbance, obesity, physical fitness and quality of life in older women: EXERNET study group. Climacteric. 2017;20(1):72–9 Epub 2017/01/04.CrossRef
16.
go back to reference Lee AJ, Lin WH. Association between sleep quality and physical fitness in female young adults. J Sports Med Phys Fitness. 2007;47(4):462–7 Epub 2007/12/20.PubMed Lee AJ, Lin WH. Association between sleep quality and physical fitness in female young adults. J Sports Med Phys Fitness. 2007;47(4):462–7 Epub 2007/12/20.PubMed
17.
go back to reference Kline CE. The bidirectional relationship between exercise and sleep: implications for exercise adherence and sleep improvement. Am J Lifestyle Med. 2014;8(6):375–9 Epub 2015/03/03.CrossRef Kline CE. The bidirectional relationship between exercise and sleep: implications for exercise adherence and sleep improvement. Am J Lifestyle Med. 2014;8(6):375–9 Epub 2015/03/03.CrossRef
18.
go back to reference Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh sleep quality index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14(8):1943–52 Epub 2005/09/13.CrossRef Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh sleep quality index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14(8):1943–52 Epub 2005/09/13.CrossRef
19.
go back to reference Liou YM, Jwo CJ, Yao KG, Chiang LC, Huang LH. Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ. J Nurs Res. 2008;16(4):252–63 Epub 2008/12/09.CrossRef Liou YM, Jwo CJ, Yao KG, Chiang LC, Huang LH. Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ. J Nurs Res. 2008;16(4):252–63 Epub 2008/12/09.CrossRef
20.
go back to reference Lin PS, Hsieh CC, Cheng HS, Tseng TJ, Su SC. Association between physical fitness and successful aging in Taiwanese older adults. PLoS One. 2016;11(3):e0150389 Epub 2016/03/11.CrossRef Lin PS, Hsieh CC, Cheng HS, Tseng TJ, Su SC. Association between physical fitness and successful aging in Taiwanese older adults. PLoS One. 2016;11(3):e0150389 Epub 2016/03/11.CrossRef
21.
go back to reference Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84 Epub 1994/03/01.CrossRef Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84 Epub 1994/03/01.CrossRef
22.
go back to reference Gerber M, Brand S, Holsboer-Trachsler E, Puhse U. Fitness and exercise as correlates of sleep complaints: is it all in our minds? Med Sci Sports Exerc. 2010;42(5):893–901 Epub 2009/12/10.CrossRef Gerber M, Brand S, Holsboer-Trachsler E, Puhse U. Fitness and exercise as correlates of sleep complaints: is it all in our minds? Med Sci Sports Exerc. 2010;42(5):893–901 Epub 2009/12/10.CrossRef
23.
go back to reference Taylor-Gjevre RM, Gjevre JA, Nair B, Skomro R, Lim HJ. Components of sleep quality and sleep fragmentation in rheumatoid arthritis and osteoarthritis. Musculoskelet Care. 2011;9(3):152–9 Epub 2011/06/08.CrossRef Taylor-Gjevre RM, Gjevre JA, Nair B, Skomro R, Lim HJ. Components of sleep quality and sleep fragmentation in rheumatoid arthritis and osteoarthritis. Musculoskelet Care. 2011;9(3):152–9 Epub 2011/06/08.CrossRef
24.
go back to reference Goes ACJ, Reis LAB, Silva MBG, Kahlow BS, Skare TL. Rheumatoid arthritis and sleep quality. Rev Bras Reumatol. 2017;57(4):294–8 Epub 2017/08/16.CrossRef Goes ACJ, Reis LAB, Silva MBG, Kahlow BS, Skare TL. Rheumatoid arthritis and sleep quality. Rev Bras Reumatol. 2017;57(4):294–8 Epub 2017/08/16.CrossRef
25.
go back to reference Chen HC, Hsu NW, Chou P. The association between sleep duration and hand grip strength in community-dwelling older adults: the yilan study, Taiwan. Sleep. 2017;40(4):1-8. Epub 017/02/16. Chen HC, Hsu NW, Chou P. The association between sleep duration and hand grip strength in community-dwelling older adults: the yilan study, Taiwan. Sleep. 2017;40(4):1-8. Epub 017/02/16.
26.
go back to reference Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry. 2005;66(10):1254–69 Epub 2005/11/02.CrossRef Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry. 2005;66(10):1254–69 Epub 2005/11/02.CrossRef
27.
go back to reference Barclay NL, Eley TC, Buysse DJ, Rijsdijk FV, Gregory AM. Genetic and environmental influences on different components of the Pittsburgh sleep quality index and their overlap. Sleep. 2010;33(5):659–68 Epub 2010/05/18.CrossRef Barclay NL, Eley TC, Buysse DJ, Rijsdijk FV, Gregory AM. Genetic and environmental influences on different components of the Pittsburgh sleep quality index and their overlap. Sleep. 2010;33(5):659–68 Epub 2010/05/18.CrossRef
Metadata
Title
Subjective sleep quality and association with depression syndrome, chronic diseases and health-related physical fitness in the middle-aged and elderly
Authors
Min-Fang Hsu
Kang-Yun Lee
Tsung-Ching Lin
Wen-Te Liu
Shu-Chuan Ho
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-021-10206-z

Other articles of this Issue 1/2021

BMC Public Health 1/2021 Go to the issue