Sleep Quality among the Elderly in 21st Century Shandong Province, China: A Ten-Year Comparative Study.

Background: Despite the enormous changes observed in China since entering the 21st century, little is known about changes in sleep quality among older adults.
Aims: The purpose of this study is to explore the changes, features, and influence factors of sleep quality among the elderly in a ten-year period, providing evidence for sleep-quality enhancement.
Methods: The data were obtained from the data of epidemiological sampling surveys on mental disorders in Shandong province in 2004 and 2015. A total of 4451 subjects (aged ≥ 60 years) in 2004 and 10,894 subjects (aged ≥ 60 years) in 2015 were selected by the multistage stratified sampling method. The demographic information and Pittsburgh Sleep Quality Index (PSQI) were collected.
Results: The adjusted 1-month prevalence of poor sleep in 2015 was 22.5% (95% CI:21.7-23.3), which is lower than that in 2004 (24.8%) (95% CI:23.5-26.0, p = 0.002). The total score of the PSQI in 2015 (4.74 ± 3.96) was lower than that in 2004 (4.97 ± 4.18, p = 0.002). In 2015, a binary multi-factor logistic and stepwise regression analysis showed that being female, living in a rural area, living alone, being older, spending less years in school, and being jobless/unemployed made the participants more likely to develop poor sleep ( p < 0.05, p < 0.01).
Conclusions: In 2015, the overall sleep quality of the elderly (aged ≥ 60) in Shandong province was significantly improved compared to 2004. After more than 10 years, the characteristics of the elderly with sleep disturbances in Shandong province has changed. Therefore, more attention should be paid to gender, location of residence (rural or urban), living arrangement, age, education, occupation, and other factors to improve the sleep quality of the elderly.