Associations Between Sleep Quality and Self-Reported Health Status in Middle-Aged and Older Adults: A Community-Based, Cross-Sectional Study in Northern Taiwan

Healthcare (Basel). 2025 May 28;13(11):1272. doi: 10.3390/healthcare13111272.

Abstract

Background/Objectives: Poor sleep quality is a prevalent health concern among older adults, impacting cognitive and physical functions. This study aimed to determine the association between sleep quality and self-reported health status among middle-aged and older adults in northern Taiwan. Methods: This cross-sectional study, conducted from April to October 2017, assessed participants using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) with a cut-off of 5; scores above 5 indicated poor sleep quality. The self-reported health status was evaluated using a questionnaire. Statistical analyses included the chi-squared test, one-way ANOVA, Cochran-Armitage trend test, and multiple logistic regression models. Results: This study included 850 adults (243 males and 607 females). The participants were grouped according to their self-reported health status as follows: good (n = 278), fair (n = 499), and poor (n = 73). Poor health status was associated with worse sleep quality components, including sleep latency, efficiency, disturbances, medication use, and daytime dysfunction (p for trend < 0.001). The multiple logistic regression analysis showed higher dissatisfaction with health status among the participants with a CPSQI score of >5 (odds ratio, 4.12; 95% CI 2.26-7.50; p < 0.001). A poor health status was reported by 19.51% of the participants sleeping < 5 h, compared to 6.97% of the participants sleeping 5-6 h, 6.60% of the participants sleeping 6-7 h, and 6.34% of the participants sleeping > 7 h, showing a trend toward a shorter sleep duration (p for trend = 0.002). Conclusions: Our study findings indicate that a poor sleep quality and short sleep duration were independent risk factors for poor self-reported health status in middle-aged and older adults in Taiwan. Addressing sleep quality is crucial for implementing preventive health measures in this demographic group.

Keywords: community-based; middle-aged and older people; self-reported health status; sleep quality.