Wong Beverly W X, Chan Yiong Huak, Kramer Michael S, Sundström-Poromaa Inger, Logan Susan, Cauley Jane A, Yong Eu-Leong
Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, 119228, Singapore.
Yong Loo Lin School of Medicine, Biostatistics Unit, National University of Singapore, 117597, Singapore.
Sleep Med X. 2022 Dec 9;5:100060. doi: 10.1016/j.sleepx.2022.100060. eCollection 2023 Dec.
To examine factors associated with poor sleep quality in community-dwelling midlife women.
Healthy women (aged 45-69 years) of Chinese, Malay and Indian ethnicities attending well-women clinics at the National University Hospital, Singapore, completed the Pittsburgh Sleep Quality Index (PSQI). A PQSI score >5 denoted poor sleep quality. The women filled out validated questionnaires covering menopausal and genito-urinary symptoms, and mental health. Physical performance was measured. Bone mineral density and visceral adiposity were assessed by dual energy X-ray absorptiometry. Binary logistic regression analyses assessed independent factors for poor sleep.
Poor sleep quality was reported in 38.2% of women (n = 1094, mean age: 56.4 ± 6.2 years). Indian women had higher sleep disturbance scores than Chinese women (mean ± SD: 1.33 ± 0.58 vs 1.17 ± 0.49). Malays experienced more daytime dysfunction (0.54 ± 0.60 vs 0.33 ± 0.55) and had a higher overall PSQI score (6.00 ± 3.31 vs 5.02 ± 2.97) than the Chinese. A low education level (aOR: 1.76, 95% CI: 1.01-3.05), feelings of irritability (2.67, 1.56-4.60) and vaginal dryness (1.62, 1.03-2.54) were associated with poor sleep quality in the adjusted multivariable model. Women with moderate to severe disability were ∼3 times (2.99, 1.20-7.44) more likely to experience less than ideal sleep quality, while urinary incontinence (1.53, 1.08-2.17) and breast cancer history (2.77, 1.36-5.64) were also associates of poor sleep quality.
Self-reports of education level, irritability, vaginal dryness, disability, urinary incontinence, and breast cancer history were independently related to poor sleep. Ethnic differences suggest the need for targeted interventions among the ethnic groups.
研究社区中年女性睡眠质量差的相关因素。
在新加坡国立大学医院的妇女健康诊所就诊的年龄在45 - 69岁之间、具有中国、马来和印度族裔的健康女性完成了匹兹堡睡眠质量指数（PSQI）测评。PSQI得分>5表示睡眠质量差。这些女性填写了经过验证的问卷，内容涵盖更年期和泌尿生殖系统症状以及心理健康状况。测量了她们的身体机能。通过双能X线吸收法评估骨密度和内脏脂肪含量。二元逻辑回归分析评估了睡眠质量差的独立影响因素。
38.2%的女性（n = 1094，平均年龄：56.4 ± 6.2岁）报告睡眠质量差。印度女性的睡眠障碍得分高于中国女性（均值±标准差：1.33 ± 0.58 vs 1.17 ± 0.49）。马来女性比中国女性经历更多的日间功能障碍（0.54 ± 0.60 vs 0.33 ± 0.55），且总体PSQI得分更高（6.00 ± 3.31 vs 5.02 ± 2.97）。在调整后的多变量模型中，低教育水平（调整后比值比：1.76，95%置信区间：1.01 - 3.05）、易怒情绪（2.67，1.56 - 4.60）和阴道干燥（1.62，1.03 - 2.54）与睡眠质量差相关。中度至重度残疾的女性睡眠质量不理想的可能性约为3倍（2.99，1.20 - 7.44），而尿失禁（1.53，1.08 - 2.17）和乳腺癌病史（2.77，1.36 - 5.64）也与睡眠质量差有关。
教育水平、易怒情绪、阴道干燥情况、残疾状况、尿失禁以及乳腺癌病史的自我报告与睡眠质量差独立相关。种族差异表明需要针对不同种族群体进行有针对性的干预。
