| Objective:The purpose of this study was to investigate the sleep classification of the elderly and identify heterogeneous subgroups in the elderly population.On this basis,to explore the factors affecting the sleep of the elderly with different sleep types.To analyze the relationship between different sleep types and the health-related quality of life in the elderly.In order to improve the elderly sleep quality to provide reference.Methods:A total of 3800 people aged 60 and above were selected from Taiyuan(6 municipal districts,3 counties,and 1 county-level city)by multistage cluster random sampling method.The general situation questionnaire,Pittsburgh Sleep Quality Index (PSQI),European Fivedimensional Health Scale (EQ-5D-5L),International Physical Activity Questionnaire(IPAQ) and Short Form Geriatric Depression Scale(GDS-15) as survey tools.A total of 3637 valid questionnaires were collected.The chi-square test was used to compare the differences in demographic characteristics of elderly people of different genders.The frequency and percentage were used to describe the status quo of sleep quality and health-related quality of life of the elderly.The Latent Profile Analysis(LPA)was used to fit the sleep potential categories of the elderly.The Chi-square test and Multinomial Logistic Regression were used to explore the influencing factors of different sleep types in the elderly.The One-way analysis of variance was used to compare the differences of health-related quality of life in the elderly with different sleep types.And,Tobit regression model was used to analyze the relationship between different sleep types and health-related quality of life in the elderly.Results:In this study,3637 elderly people had a total sleep status score of (5.43±3.16)points,1114(30.6%) had sleep disorders,and 2523 (69.4%) had normal sleep.Among them,the scores of subjective sleep quality (1.16±0.40),time to fall asleep(0.94±0.77) and actual sleep time (0.90±0.88) were higher.The EQ-5D-5L scale measures that the health utility value of the elderly in this study was (0.879±0.222),and the self-rated health status score of 90 or above accounts for the highest proportion(34.3%).The results of Latent Profile Analysis showed that the elderly sleep was divided into four categories,namely “normal sleep quality group”,“good sleep quality group”,“poor sleep and no hypnotics group” and “sleep disorder and use hypnotics group”.The Multinomial Logistic Regression showed that,compared with the “good sleep quality group”,the influencing factors of “normal sleep quality group” included gender,living area,education level,drinking status,physical activity intensity,physical pain,depression,and anxiety (P<0.05).The influencing factors of “poor sleep and no hypnotics group” were gender,age,living area,education level,relationship with spouse,paying attention to healthy diet,drinking status,physical pain,chronic disease,depression and anxiety (P<0.05).Elderly people living in rural areas,poor relationship with spouse,not paying attention to healthy diet,low physical activity intensity,accompanied by physical pain,depression,and anxiety were more likely to enter the “sleep disorder and use hypnotics group”(P<0.05).The results of Tobit regression model showed that sleep was an important factor affecting the health-related quality of life of the elderly.The “normal sleep quality group”,the “poor sleep and no hypnotics group”,and the “sleep disorder and use hypnotics group”were all negatively correlated with health utility values(P<0.001).Among them,the “sleep disorder and use hypnotics group” had the greatest impact on the health utility value (b =-0.412,P<0.001).Conclusions:The detection rate of sleep disorders among the elderly in Taiyuan was 30.6%.Among them,poor subjective sleep quality,difficulty in falling asleep,insufficient sleep and other problems were more serious,suggesting that attention should be paid to them.The elderly sleep can be divided into 4 categories with obvious group heterogeneity.Gender,age,living area,education level,pre-retirement occupation,relationship with spouse,attention to healthy diet,drinking status,physical activity intensity,physical pain,chronic illness,depression,and anxiety were the significant influencing factors for sleep types of the elderly.The physiological and psychological problems caused by sleep disorders in the elderly seriously affect their overall health level.It is suggested that targeted intervention strategies should be developed for different types of elderly to improve sleep quality and health-related quality of life. |
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