Sex Difference in the Association Between Sedentary Behavior and Sleep Quality: A Longitudinal Study Among Older Adults in Rural China

Abstract

Objectives: Sleep quality plays a vital role in maintaining health in older adults. Sedentary behavior may be a risk factor for poor sleep quality in older adults. This study aimed to explore the relationship between sedentary behavior and sleep quality among older adults in rural China and determine whether there is a sex difference in this association.

Design: A longitudinal design. The data used in this study were obtained from the Shandong Rural Elderly Health Cohort (wave 1: 2019, wave 2: 2020).

Setting and participants: Data were from 2731 individuals aged ≥60 years from rural areas in China.

Methods: Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sedentary behavior and control variables were measured using self-reported questions. Multivariable logistic regression and generalized estimating equations were used to assess the associations.

Results: After full adjustment, the association between sedentary behavior and poor sleep quality was statistically significant [odds ratio (OR) 1.49, 95% CI 1.20-1.85]. Specifically, a longer sedentary time was associated with worse subjective sleep quality, less sleep latency, and lower habitual sleep efficiency (OR 1.39-1.58). A significant association was observed in women but not men.

Conclusions and implications: Older adults who spend more time engaging in sedentary activities have poorer sleep quality and more sleep problems. Prolonged sedentary time is more detrimentally associated with poor sleep quality in women than men. There is a need for tailored exercise prescriptions and guidelines to stimulate older adults of different sexes to change their sedentary behavior, which may improve sleep quality in older adults.

Keywords: Sedentary behavior; lifestyle; rural China; sex differences; sleep quality.