Sleep quality and related factors in individuals aged 20 and over consulting primary health care centers

Year 2024, Volume: 22 Issue: 1, 87 - 101, 26.04.2024

Zeynep Ceyda Buran , Beyhan Özyurt

https://doi.org/10.20518/tjph.1388481

Abstract

Objective: This cross-sectional study aimed to evaluate the prevalence of poor sleep quality and to identify related factors among adults.
Methods: This study was among adults aged ≥20 years registered at Primary Health Care Center in August-September 2022. Primary outcome was sleep quality, which was assessed by Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes were sociodemographic, lifestyle, health characteristics, sleep-related factors, anxiety-depression. Chi-square test for categorical variables was used in univariate analysis, logistic regression models in multivariate analysis was used. SPSS version 23.0 was used for analysis, type-1 error accepted as 0.05.
Results: Participant’s average age was 40.98±13.68 years. 34.6% of participants had poor sleep quality. 12.7% of them had abnormal level anxiety while 8.5% had abnormal level depression. Between total PSQI score and anxiety-depression, there was a moderate positive correlation (r=.375,p<0.001;r=.468,p<0.001,respectively). Being older (RR=1.07(95%CI=1.04-1.10)); being female (RR=5.1(95%CI=1.9-13.6)); living in semi-urban area (RR=2.9(95%CI=1.3-6.5)); shift/part-time work (RR=3.9(95%CI=1.1-14.0)); smoking (RR=2.7(95%CI=1.1-6.7)); sleeping in dim light (RR=6.0(95%CI=2.5-14.5)) or sleeping in bright light (RR=9.5(95%CI=3.3-27.5)); being stressed (RR=5.0(95%CI=1.7-14.3)); borderline (RR=3.6(95%CI=1.1-11.3)) or abnormal level (RR=9.5(95%CI=2.6-34.4)) anxiety was found to be related to poor sleep quality.
Conclusion: One out of three people had poor sleep quality. Increasing age, gender, low socioeconomic status, negative lifestyle, poor sleep hygiene and mental health were associated with poor sleep quality. Health-promoting activities should be held to encourage individual’s positive health behavior development, in chronic disease follow-ups, sleep quality should be questioned. Since sleep hygiene and mental health were important determinants of sleep quality, people should be informed about how to improve these.

Keywords

Sleep Quality, Sleep Hygiene, Anxiety, Primary Health Care

Ethical Statement

For this research, ethical approval numbered 2023/1643 (January 04,2023) was obtained from Manisa Celal Bayar University Faculty of Medicine Health Sciences Ethics Committee and informed consent from participants was obtained.

Thanks

We would like to thank Dr. Begüm BAŞ, Dr. Bengi ÇELEN, Dr. Başak TATAR, Dr. Aysu Nur ATMACI, Dr. Aykun ÇELİKER, Dr. Batuhan KARAKÖSE, Dr. Barış TUNÇ for their help in the data collection process.

References

• Karadağ, Mehmet. Uyku Bozuklukları Sınıflaması (ICSD-2). Türkiye Klinikleri Akciğer Arşivi. 2007;8(3):88-91.
• Hungs M, Mignot E. Hypocretin/orexin, sleep and narcolepsy. BioEssays. 2001;23(5):397-408. doi:10.1002/bies.1058
• Ertekin, Şükran. Hastanede Yatan Hastalarda Uyku Kalitesinin Değerlendirilmesi. Tez. Sivas Cumhuriyet Üniversitesi; 1998.
• Buysse DJ, Reynolds CF, 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. doi:10.1016/0165-1781(89)90047-4
• Sadock, BJ., Sadock, VA., Ruiz, P. Kaplan & Sadock Psikiyatri Davranış Bilimleri/Klinik Psikiyatri. Güneş Kitabevi; 2016.
• Miró E, Cano MC, Espinosa-Fernández L, Buela-Casal G. Time Estimation during Prolonged Sleep Deprivation and Its Relation to Activation Measures. The Journal of the Human Factors and Ergonomics Society. 2003;45(1):148-159. doi:10.1518/hfes.45.1.148.27227
• Nelson KL, Davis JE, Corbett CF. Sleep Quality: An Evolutionary Concept Analysis. Nursing Forum. 2022;57(1):144-151. doi:10.1111/nuf.12659
• Silva-Costa A, Griep RH, Rotenberg L. Associations of a Short Sleep Duration, Insufficient Sleep, and Insomnia with Self-Rated Health among Nurses. PLoS One. 2015;10(5):e0126844. doi:10.1371/journal.pone.0126844
• Bertisch SM, Pollock BD, Mittleman MA, et al. Insomnia With Objective Short Sleep Duration And Risk Of Incident Cardiovascular Disease And All-Cause Mortality: Sleep Heart Health Study. Sleep. 2018;41(6):zsy047. doi:10.1093/sleep/zsy047
• Türk Uyku Tıbbı Derneği. Erişkin Toplumda Ulusal Uyku Epidemiyolojisi Araştırması. Published online 2010.
• Pak MT. Aile Sağlığı Merkezlerine Başvuran Hastaların Uyku Kalitesi İle Hava Kirliliği Arasındaki İlişkinin Araştırılması. Tez. Dokuz Eylül Üniversitesi; 2022.
• Tekcan P. Lise Öğrencilerinin Uyku Kalitesi ve Uyku Kalitesini Etkileyen Faktörlerin Belirlenmesi. Tez. Nevşehir Hacı Bektaş Veli Üniversitesi; 2018.
• Ünal D. Sigara Maruziyetinin Uyku Kalitesi Üzerine Etkisinin Değerlendirilmesi. Tez. T.C. Sağlık Bilimleri Üniversitesi; 2021.
• Zeitlhofer J, Schmeiser-Rieder A, Tribl G, et al. Sleep And Quality Of Life In The Austrian Population. Acta Neurologica Scandinavica. 2000;102(4):249-257. doi:10.1034/j.1600-0404.2000.102004249.x
• Madrid-Valero JJ, Martínez-Selva JM, Couto BR do, Sánchez-Romera JF, Ordoñana JR. Age And Gender Effects On the Prevalence Of Poor Sleep Quality In The Adult Population. Gaceta Sanitaria. 2017;31:18-22. doi:10.1016/j.gaceta.2016.05.013
• Guo H, Zhou J, Chen H, Cao X. Prevalence And Associated Factors Of Poor Sleep Quality Among Chinese Retirees: A Multicenter Cross-Sectional Study. Journal of Affective Disorders. 2023;320:42-47. doi:10.1016/j.jad.2022.09.130
• Alamer WM, Qutub RM, Alsaloumi EA, Natto NK, Alshehri RM, Khafagy A. Prevalence of Sleep Disorders Among Patients With Type 2 Diabetes Mellitus in Makkah City: A Cross-Sectional Study. Cureus. 2022;14(12):e33088. doi:10.7759/cureus.33088
• Ramsawh HJ, Stein MB, Belik SL, Jacobi F, Sareen J. Relationship Of Anxiety Disorders, Sleep Quality, And Functional Impairment In A Community Sample. J Psychiatr Res. 2009;43(10):926-933. doi:10.1016/j.jpsychires.2009.01.009
• Léger D, Poursain B, Neubauer D, Uchiyama M. An International Survey Of Sleeping Problems In The General Population. Current Medical Research and Opinion. 2008;24(1):307-317. doi:10.1185/030079907X253771
• Tirgari B, Forouzi MA, Iranmanesh S, Shahraki SK. Predictors of Sleep Quality and Sleepiness In The Iranian Adult: A Population Based Study. Journal of Community Health Research. 2013;1(3):144-152.
• Çiftçi T. Meram Tıp Fakültesi Öğrencilerinde Uyku Kalitesi Üzerine Fiziksel Aktivite, Anksiyete Ve Depresyon Durumunun Etkisinin Araştırılması. Tez. Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi; 2019.
• Menezes Júnior LAA de, Lourenção LG, Andrade AC de S, Carraro JCC, Machado-Coelho GLL, Meireles AL. Determinants Of Poor Sleep Quality İn Adults During The Coronavirus Disease Pandemic: COVID-Inconfidentes, A Population-Based Study. Sao Paulo Med J. Published online October 28, 2022:S1516-31802022005027202. doi:10.1590/1516-3180.2022.0139.R1.19082022
• Özcan B. Pamukkale Üniversitesi Öğrencilerinde Uyku Kalitesi Ve Akıllı Telefon Bağımlılığı İle İlişkisi. Tez. Pamukkale Üniversitesi; 2019.
• Fatima Y, Doi SAR, Najman JM, Mamun AA. Exploring Gender Difference In Sleep Quality Of Young Adults: Findings From A Large Population Study. Clin Med Res. 2016;14(3-4):138-144.
• Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361-370. doi:10.1111/j.1600-0447.1983.tb09716.x
• Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane Anksiyete ve Depresyon Ölçeği Türkçe Formunun Geçerlilik ve Güvenilirlik Çalışması. Türk Psikiyatri Dergisi. 1997;8:280-287.
• Ağargün MY, Kara H, Anlar Ö. Pittsburgh Uyku Kalitesi İndeksi’nin Geçerliği ve Güvenirliği. Türk Psikiyatri Dergisi. 1996;7(2):107-115.
• Asghari A, Farhadi M, Kamrava SK, Ghalehbaghi B, Nojomi M. Subjective Sleep Quality In Urban Population. Archives of Iranian Medicine. 2012;15(2):95-98.
• Tang J, Liao Y, Kelly BC, et al. Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China. Sci Rep. 2017;7(1):43690. doi:10.1038/srep43690
• Adjaye-Gbewonyo D, Ng AE, Black L. Sleep Difficulties in Adults: United States, 2020. NCHS Data Brief, no 436 Hyattsville, MD: National Center for Health Statistics. 2022;436. doi:https://dx.doi.org/10.15620/ cdc:117490.
• McDowall K, Murphy E, Anderson K. The Impact Of Shift Work On Sleep Quality Among Nurses. Occupational Medicine. 2017;67(8):621-625. doi:10.1093/occmed/kqx152
• Toker Uğurlu T. Kadın Tekstil İşçilerinde Vardiyalı Çalışmanın Uyku Ve Ruhsal Durum Üzerine Etkileri. Tez. Pamukkale Üniversitesi; 2014.
• Cho JR, Joo EY, Koo DL, Hong SB. Let There Be No Light: The Effect Of Bedside Light On Sleep Quality And Background Electroencephalographic Rhythms. Sleep Medicine. 2013;14(12):1422-1425. doi:10.1016/j.sleep.2013.09.007
• Taşdemir Yiğitoğlu G, Yılmaz A, Yılmaz H. The Effect Of Covid-19 On Sleep Quality, Anxiety And Depression On Healthcare Staff At A Tertiary Hospital İn Turkey. Archives of Psychiatric Nursing. 2021;35(5):504-510. doi:10.1016/j.apnu.2021.07.001