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The relationship between sleep and fatigue within community-residing older individuals aged 60 years or above in
Fei Xu1, Qing Ye1, Zhiyong Wang1
1Nanjing Medical University Affiliated Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China.
Objectives:
To examine associations of sleep quality and duration with physical and mental fatigue among community-residing older inhabitants in Nanjing municipality, China.
Methods:
Residents aged 60 years or above were randomly selected from Nanjing in 2023 in this cross-sectional study. The outcome measures, physical and mental fatigue, were evaluated using the validated Chinese version of Pittsburgh Fatigability Scale. The independent measures, sleep quality and duration, were assessed with the Chinese version of Pittsburgh Sleep Quality Index (PSQI) and specific question items, separately. Mixed-effect logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95%CIs) for investigating associations of sleep quality and duration with fatigue.
Results:
Among 5,484 participants, 59.0% (95%CI = 57.7, 63.0) and 51.1% (95%CI = 49.8, 52.4) perceived physical and mental fatigue, separately. After control for confounders, subjects with good PSQI-based sleep quality were less likely to report physical (OR = 0.61, 95%CI = 0.53, 0.70) and mental fatigue (OR = 0.65, 95%CI = 0.56, 0.74) compared to those with poor sleep quality, while no link was observed between self-rated sleep quality and fatigue (OR = 0.88, 95%CI = 0.74, 1.04 for physical fatigue; OR = 0.92, 95%CI = 0.78, 1.09 for mental fatigue). Moreover, the odds were 1.52 (95%CI = 1.26, 1.83), 1.47 (95%CI = 1.26, 1.72), 1.09 (95%CI = 0.94, 1.26) and 1.46 (95%CI = 1.17, 1.81) for experiencing physical fatigue, and 1.60 (95%CI = 1.33, 1.92), 1.43 (95%CI = 1.23, 1.66), 1.07 (95%CI = 0.92, 1.23) and 1.37 (95%CI = 1.11, 1.69) for reporting mental fatigue, respectively, among participants with daily sleep duration of <6.0, 6.0-6.9, 8.0-8.9 and ≥9.0 h relative to those with sleep duration of 7.0-7.9 h/day.
Conclusion:
PSQI-based, not self-rated, sleep quality was negatively associated with fatigue, and a U-shape relationship was examined between sleep duration and fatigue among older community-dwelling people in regional China. This study has significant public health implications in this rapidly-aging world for building a healthy-aging society, suggesting that population-level fatigue may be improved through interventions of healthy sleep.
