Association between Sleep and Multimorbidity in Community-Dwelling Older Adults in Hunan Province: A Cross-sectional Study

Abstract

Background The purpose of this study was to estimate the prevalence of sleep quality and chronic disease conditions, and to analyze the association between sleep and multimorbidity among community-dwelling older adults in China. Methods This is a cross-sectional study and a stratified multistage random sampling method was used to collect data on demographic characteristics, Pittsburgh Sleep Quality Index (PSQI), and chronic condition assessment. Chi-squared tests, t-tests, variance analysis, Wilcoxon rank sum test, binary logistic regression analysis and multiple stepwise regression analysis were used to test the association between sleep and multimorbidity. Results Of the 1173 community elders enrolled, the mean total PSQI score was 7.25 ± 4.23. Of these, 588 (50.1%) had a total PSQI score > 7 (with sleep disorders) and 920 (78.4%) had chronic diseases. And 43.8% (403/920) had one chronic disease and 56.2% (517/920) had multimorbidity. And the pattern of multimorbidity among community-dwelling older adults was dominated by a combination of binary and ternary chronic diseases. Overall, the prevalence of sleep disorders with multimorbidity among older adults in the community was 57.6% (298/517). And the prevalence of sleep disorders in older adults with multimorbidity was 1.30 times higher than without multimorbidity. The prevalence of sleep disorders increased with an increasing number of chronic conditions, and females had a higher prevalence of sleep disorders than males. T-test and variance analysis showed statistically significant differences in all seven components of PSQI between with and without multimorbidity, and different numbers of chronic conditions (P < 0.05). Gender, number of morbidities, BMI, marital status, and exercise frequency were included in the regression equation (R = 0.274, R2 = 0.075, F = 8.280, P<0.001). Conclusion The overall state of sleep and multimorbidity was not optimistic. In addition, older adults with multimorbidity in the community are more prone to sleep disorders. Also, the number of chronic conditions had additive effects on sleep disorders, and women reported poorer sleep quality than men. One of the most challenging aspects of falling asleep was for participants with multimorbidity. We also found that there may be an interaction between sleep and multimorbidity.