Prevalence of sleep problems and influencing factors among Chinese women aged 35-60 years

To investigate the prevalence of sleep problems and factors influencing sleep problems among Chinese women aged 35-60 years.

This study was a large-scale, nationwide cross-sectional survey. Using a multistage stratified random sampling method, a total of 52,665 women aged 35-60 years were selected from 12 provinces across China. Sociodemographic information, health status, and physiological indicators were collected. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. A stepwise logistic regression model was used to identify the factors associated with sleep problems.

The overall prevalence of sleep problems among Chinese women aged 35-60 years was 38.34%. Women aged 50-55 years had the highest prevalence, at 39.32%.The prevalence among premenopausal women (37.57%) was significantly lower than that among postmenopausal women (39.71%). Poor sleep efficiency was the most common problem, with a prevalence of 47.92%. The amount of green space per capita was significantly negatively associated with the occurrence of sleep problems, particularly among postmenopausal women. In analyses of specific sleep dimensions, the amount of green space was inversely associated with prolonged sleep latency and poor sleep efficiency, but positively associated with poor subjective sleep quality, short sleep duration, and sleep disturbances.

Sleep problems were prevalent among Chinese women aged 35-60 years and were influenced by a complex interplay of demographic characteristics, lifestyle behaviors, and residential environmental factors. The heterogeneous associations observed across menopausal status and sleep dimensions suggest that tailored prevention strategies addressing modifiable lifestyle factors and environmental conditions may be essential for improving sleep health and reducing the overall burden of sleep problems in midlife women.