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Research article
Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan Rural Cohort
Mao Zhenxing
Zhengzhou University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5171-1169
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Objectives The epidemiological evidence on the effect of sleep quality on anxiety symptoms has been inconclusive. This study aimed at exploring the relationship between sleep quality and anxiety symptoms in rural China and investigated whether age, lifestyle and chronic diseases modified the association.
Methods A total of 27,911 participants aged 18–79 years from the Henan Rural Cohort Study were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as PSQI ≥6. Anxiety symptoms were evaluated with the two-item generalized anxiety disorder scale (GAD-2). A score ≥6 was view as having anxiety symptoms. Logistic regression and restricted cubic spline was conducted to examine the association of sleep quality with anxiety symptoms.
Results Altogether, 6,087(21.80%) were poor sleepers and 1,557(5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of PSQI score after fitting restricted cubic splines. And the poor sleep qualitywas associated with a higher possibility of anxiety symptoms (4.60, 3.70-5.72) in men, and (3.56, 3.10-4.09) in women on multivariable analysis. Further stratified analyses showed that the effect of sleep quality and anxiety symptoms could be modified by age, marital status, smoking status, drinking status, hypertension andtype 2 diabetes mellitus.
Conclusions A dose-response association between PSQI score and anxiety symptoms was found. In addition, relationship between poor sleep quality and anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease.
Keywords
PSQI, sleep quality, anxiety symptoms, rural population
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CURRENT STATUS: Published
Version 2
Posted 20 May, 2020
Published
On 27 Aug, 2020
No community comments so far
Editorial decision: Major revision
On 24 May, 2020
Review #1 received
Received 16 May, 2020
Reviewer #2 agreed
On 11 May, 2020
Review #2 received
Received 11 May, 2020
Reviewer #1 agreed
On 09 May, 2020
Editor assigned
On 08 May, 2020
Reviewers invited
Invitations sent on 08 May, 2020
Editor invited
On 07 May, 2020
Submission checks complete
On 27 Feb, 2020
No comments provided
Editorial decision: Major revision
On 08 Apr, 2020
Review #2 received
Received 04 Apr, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Review #1 received
Received 08 Dec, 2019
Reviewer #1 agreed
On 07 Dec, 2019
Reviewers invited
Invitations sent on 11 Nov, 2019
Editor assigned
On 24 Oct, 2019
Submission checks complete
On 23 Oct, 2019
Editor invited
On 23 Oct, 2019
First submitted
On 23 Sep, 2019
Metrics
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PDF Downloads: ...
HTML Views: ...
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan Rural Cohort
Mao Zhenxing
Zhengzhou University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5171-1169
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 20 May, 2020
Published
On 27 Aug, 2020
No community comments so far
Editorial decision: Major revision
On 24 May, 2020
Review #1 received
Received 16 May, 2020
Reviewer #2 agreed
On 11 May, 2020
Review #2 received
Received 11 May, 2020
Reviewer #1 agreed
On 09 May, 2020
Editor assigned
On 08 May, 2020
Reviewers invited
Invitations sent on 08 May, 2020
Editor invited
On 07 May, 2020
Submission checks complete
On 27 Feb, 2020
No comments provided
Editorial decision: Major revision
On 08 Apr, 2020
Review #2 received
Received 04 Apr, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Review #1 received
Received 08 Dec, 2019
Reviewer #1 agreed
On 07 Dec, 2019
Reviewers invited
Invitations sent on 11 Nov, 2019
Editor assigned
On 24 Oct, 2019
Submission checks complete
On 23 Oct, 2019
Editor invited
On 23 Oct, 2019
First submitted
On 23 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Objectives The epidemiological evidence on the effect of sleep quality on anxiety symptoms has been inconclusive. This study aimed at exploring the relationship between sleep quality and anxiety symptoms in rural China and investigated whether age, lifestyle and chronic diseases modified the association.
Methods A total of 27,911 participants aged 18–79 years from the Henan Rural Cohort Study were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as PSQI ≥6. Anxiety symptoms were evaluated with the two-item generalized anxiety disorder scale (GAD-2). A score ≥6 was view as having anxiety symptoms. Logistic regression and restricted cubic spline was conducted to examine the association of sleep quality with anxiety symptoms.
Results Altogether, 6,087(21.80%) were poor sleepers and 1,557(5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of PSQI score after fitting restricted cubic splines. And the poor sleep qualitywas associated with a higher possibility of anxiety symptoms (4.60, 3.70-5.72) in men, and (3.56, 3.10-4.09) in women on multivariable analysis. Further stratified analyses showed that the effect of sleep quality and anxiety symptoms could be modified by age, marital status, smoking status, drinking status, hypertension andtype 2 diabetes mellitus.
Conclusions A dose-response association between PSQI score and anxiety symptoms was found. In addition, relationship between poor sleep quality and anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease.
Figure 1
Figure 2