Prevalence and Risk Factors of Sleep Disturbance in Community Dwelling Adults in Korea

Heejung Choi; Beomjong Kim; Inja Kim

doi:10.7475/KJAN.2013.25.1.183

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Choi, Kim, and Kim: Prevalence and Risk Factors of Sleep Disturbance in Community Dwelling Adults in Korea

Original Research

Korean J Adult Nurs 2013;25(2):183-193.

Published online: 18 April 2013

DOI: https://doi.org/10.7475/KJAN.2013.25.1.183

Prevalence and Risk Factors of Sleep Disturbance in Community Dwelling Adults in Korea

Heejung Choi¹, Beomjong Kim², Inja Kim^3,

^¹Department of Nursing, Kunkuk University, Chungju

^²Department of Business Administration, Seowon University, Cheongju

^³Department of Nursing, Daejeon University, Daejeon, Korea

Corresponding author: Kim, Inja Department of Nursing, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 300-716, Korea. Tel: +82-42-280-2655, Fax: +82-42-280-2785, E-mail: inja@dju.kr

Received 25 October 201222 April 2013 Accepted 23 April 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify the prevalence and risk factors of sleep disturbance among community dwelling adults in Korea.

Methods

Data were collected from nine hundred fifty nine adults dwelling in a metropolitan city in Korea. Subjects were older than 45 years, did not take medication for sleep problems on a regular basis, and did not work at night. The Pittsburgh Sleep Quality Index was used to collect data about sleep disturbance. Sociodemographic, life style, and health related factors were included as risk factors. Chi square test and logistic stepwise regression were used to identify the risk factors.

Results

The prevalence of sleep disturbance was 13.1%. The significant risk factors were being female, age, number of toilet use at night, perceived health, and pain. Risk factors were somewhat different by gender. Emotional and job status were the risk factors only for men and menopausal status were for women.

Conclusion

Prevalence of sleep disturbance in community dwelling adults in Korea was not greater than those dwelling in other countries. Females, older adults, the number of toilet use at night, perceived health, and pain were the most important risk factors for sleep disturbances. Gender was a factor in reported sleep disturbances. It might be useful to investigate the factors that contribute to the number of toilet use at night as this might have some underlying factors that could be corrected.

Keywords: Sleep, Prevalence, Risk factors

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Table 1.

Difference Test on Sociodemographic, Life Style, and Health related Factors

Variables	Characteristics	Categories		Total	Sleep disturbance		x² or t	p
				n (%)	No	Yes
				n (%)	n (%)	n (%)
Sociodemographic	Age (year)	45~54		320 (33.4)	297 (92.8)	23 (7.2)	25.02	＜.001
		55~64		320 (33.4)	282 (88.1)	38 (11.9)
		≥65		319 (33.3)	254 (79.6)	65 (20.4)
	Gender	Male		480 (50.1)	430 (89.6)	50 (10.4)	6.24	.013
	Gender	Female		479 (49.9)	403 (84.1)	76 (15.9)	6.24	.013
	Education	＜Elementary school		124 (12.9)	97 (78.2)	27 (21.8)	12.30	.006
		Middle school		166 (17.4)	141 (84.9)	25 (15.1)
		High school		546 (56.9)	482 (88.3)	64 (11.7)
		≥College		123 (12.8)	113 (91.9)	10 (8.1)
	Job	Having a job		547 (57.0)	502 (91.8)	45 (8.2)	27.45	＜.001
		No job		247 (25.8)	196 (79.4)	51 (20.6)
		Housewife		165 (17.2)	135 (81.8)	30 (18.2)
Life style	Number of toilet use at night	None		301 (31.4)	283 (94.0)	18 (6.0)	62.54	＜.001
		1		545 (56.8)	476 (87.3)	69 (12.7)
		2		76 (7.9)	53 (69.7)	23 (30.3)
		≥3		37 (3.9)	21 (56.8)	16 (43.2)
	Smoking	Yes		205 (78.6)	180 (87.8)	25 (12.2)	0.20	.727
	Smoking	No		754 (21.4)	653 (86.6)	101 (13.4)	0.20	.727
	Drinking	Yes		456 (47.5)	399 (87.5)	57 (12.5)	0.31	.632
	Drinking	No		503 (52.5)	434 (86.3)	69 (13.7)	0.31	.632
	Regular exercise	Yes		372 (38.8)	313 (84.1)	59 (15.9)	3.94	.050
	Regular exercise	No		587 (61.2)	520 (88.6)	67 (11.4)	3.94	.050
	Stressful events	Yes		120 (12.5)	89 (74.2)	31 (25.8)	19.37	＜.001
	Stressful events	No		839 (87.5)	744 (88.7)	95 (11.3)	19.37	＜.001
Health related	Illness	Yes		393 (41.0)	284 (75.5)	92 (24.5)	68.18	＜.001
	Illness	No		566 (59.0)	533 (94.2)	33 (5.8)	68.18	＜.001
	Type of illness	Hypertension	Yes	266 (27.7)	204 (76.7)	62 (23.3)	19.37	＜.001
		Hypertension	No	693 (72.3)	629 (90.8)	64 (9.2)	19.37	＜.001
		DM	Yes	101 (10.5)	81 (80.2)	20 (19.8)	4.39	.043
		DM	No	858 (89.5)	752 (87.6)	106 (12.4)	4.39	.043
		Heart disease	Yes	31 (3.2)	25 (80.6)	6 (19.4)	1.09	.212
		Heart disease	No	928 (96.8)	808 (87.1)	120 (12.9)	1.09	.212
		Respiratory disease	Yes	21 (2.2)	12 (57.1)	9 (42.9)	16.62	.001
		Respiratory disease	No	938 (97.8)	821 (87.5)	117 (12.5)	16.62	.001
		Arthritis	Yes	90 (9.4)	66 (73.3)	24 (26.7)	15.93	.001
		Arthritis	No	869 (90.6)	767 (88.3)	102 (11.7)	15.93	.001
		Urinary incontinence	Yes	24 (2.5)	16 (66.7)	8 (33.3)	8.80	.008
		Urinary incontinence	No	935 (97.5)	817 (87.4)	118 (12.6)	8.80	.008
		Cancer	Yes	13 (1.4)	9 (69.2)	4 (30.8)	3.59	.079
		Cancer	No	946 (98.6)	824 (87.1)	122 (12.9)	3.59	.079
		Others	Yes	41 (4.28)	28 (68.3)	13 (31.7)	12.94	.001
		Others	No	918 (95.72)	805 (87.7)	113 (12.3)	12.94	.001
	Medication	Yes		334 (34.8)	248 (74.3)	86 (25.7)	71.40	＜001
	Medication	No		625 (65.2)	585 (93.6)	40 (6.4)	71.40	＜001
	Perceived health	Good		807 (84.2)	747 (92.6)	60 (7.4)	145.14	＜.001
	Perceived health	Bad		152 (15.8)	86 (56.6)	66 (43.4)	145.14	＜.001
	Menopausal status	Pre		67 (14.0)	66 (98.5)	1 (1.5)	12.40	.002
		During		28 (5.8)	24 (85.7)	4 (14.3)
		Post		384 (80.2)	313 (81.5)	71 (18.5)
	Pain	Yes		292 (30.4)	197 (67.5)	95 (32.5)	138.39	＜.001
	Pain	No		667 (69.6)	636 (95.4)	31 (4.6)	138.39	＜.001
	Emotion	Good		175 (18.2)	159 (90.9)	16 (9.1)	2.99	.050
	Emotion	Bad		784 (81.8)	674 (86.0)	110 (14.0)	2.99	.050
	BMI	Underweight		12 (1.3)	9 (75.0)	3 (25.0)	13.36	.004
		Normal		359 (37.4)	324 (90.3)	35 (9.7)
		Overweight		343 (35.8)	302 (88.0)	41 (12.0)
		Obese		245 (25.5)	198 (80.8)	47 (13.1)

DM=diabetes mellitus; BMI=body mass index.

Table 2.

Logistic Regression on Sleep Disturbance

Variables	Characteristics	Categories	Step 1	Step 2	Step 3
Variables	Characteristics	Categories	OR (CI)	OR (CI)	OR (CI)
Sociodemographic variables	Age (year)	45~54	Ref	Ref	Ref
		55~64	1.61 (0.91~2.85)	1.41 (0.78~2.54)	1.30 (0.68~2.40)
		≥65	2.48 (1.33~4.62)∗∗	2.18 (1.14~4.17)∗	2.39 (0.66~2.91)
	Gender	Male	Ref	Ref	Ref
	Gender	Female	1.31 (0.83~2.09)	1.26 (0.77~2.07)	1.00 (0.58~1.73)
	Education	≤6	Ref	Ref	Ref
		7~≤9	0.78 (0.42~1.44)	0.76 (0.39~1.46)	0.77 (0.37~1.62)
		10~≤12	0.96 (0.54~1.71)	0.99 (0.54~1.82)	1.40 (0.69~2.85)
		＞12	0.79 (0.33~1.89)	0.84 (0.34~2.09)	1.25 (0.45~3.45)
	Job	Yes	Ref	Ref	Ref
		No	1.90 (1.15~3.14)∗	1.33 (0.77~2.28)	1.09 (0.59~2.01)
		Housewife	1.76 (0.96~3.21)	1.84 (0.98~3.45)∗	1.28 (0.62~2.65)
Lifestyle related variable	Number of toilet use at night	None		Ref	Ref
		1		2.03 (0.16~0.54)∗	1.38 (0.75~2.54)
		2		5.06 (2.45~10.42)∗∗∗	3.01 (1.35~6.71)∗∗
		≥3		8.90 (3.73~21.23)∗∗∗	4.10 (1.53~10.97)∗∗
	Regular exercise	Yes		Ref	Ref
	Regular exercise	No		0.67 ((0.45~1.00)∗	0.64 (0.41~1.00)∗
	Stressful event	No		Ref	Ref
	Stressful event	Yes		0.38 (0.23~0.63)∗∗∗	0.71 (0.41~1.27)
Health related variables	Illness	No			Ref
	Illness	Yes			1.28 (0.49~3.33)
	Med	No			Ref
	Med	Yes			1.29 (0.51~3.26)
	Perceived health	Good			Ref
	Perceived health	Bad			2.79 (1.61~4.86)∗∗∗
	Pain	No			Ref
	Pain	Yes			4.80 (2.83~8.17)∗∗∗
	Emotion	Bad			Ref
	Emotion	Good			0.51 (0.27~.98)
	BMI	Under			Ref
		Norm			0.29 (0.06~1.47)
		Over			0.29 (0.06~1.48)
		Obese			0.44 (0.09~2.25)

^∗ p＜.05;

^∗∗ p＜.01;

^∗∗∗ p＜.001.

Table 3.

Logistic Regression Analysis on Sleep Disturbance by Gender

Variables	Characteristics	Categories	Step 1		Step 2		Step 3
Variables	Characteristics	Categories	OR (CI) of Male	OR (CI) of Female	OR (CI) of Male	OR (CI) of Female	OR (CI) of Male	OR (CI) of Female
Sociodemogrphic variables	Age (year)	45~54	Ref	Ref	Ref	Ref	Ref	Ref
		55~64	0.92 (0.37~2.23)	2.15 (1.02~4.54)∗	0.68 (0.26~1.79)	2.09 (0.95~4.61)	0.60 (0.19~1.84)	1.60 (0.55~4.67)
		≥65	1.34 (0.48~3.74)	3.18 (1.39~7.28)∗∗	1.09 (0.37~3.21)	2.95 (1.22~7.14)∗	0.50 (0.13~1.90)	1.47 (0.46~4.70)
	Education	≤6	Ref	Ref	Ref	Ref	Ref	Ref
		≤9	0.51 (0.17~1.58)	0.90 (0.43~1.89)	0.44 (0.13~1.47)	0.95 (0.42~2.119)	0.08 (0.02~0.37)	1.32 (0.53~3.26)
		≤12	0.93 (0.36~2.39)	0.93 (0.45~1.93)	0.84 (0.31~2.29)	1.03 (0.46~2.29)	0.53 (0.16~1.81)	1.67 (0.67~4.20)
		＞12	0.56 (0.17~2.05)	0.87 (0.24~3.10)	0.62 (0.17~2.27)	0.91 (0.23~3.60)	0.61 (1.36~2.80)	1.31 (0.29~6.02)
	Job	Yes	Ref	Ref	Ref	Ref	Ref	Ref
		No	3.80 (1.71~8.47)∗∗	1.08 (0.54~2.16)	3.09 (1.30~7.33)∗	0.65 (0.30~1.41)	4.10 (1.36~12.40)∗	0.49 (0.20~1.17)
		Housewife		1.26 (0.67~2.39)		1.24 (0.63~2.42)		0.77 (.35~1.70)
Lifestyle related variable	Number of toilet use at night	None			Ref	Ref	Ref	Ref
		1			2.78 (1.10~7.04)∗	1.64 (0.81~3.35)	2.15 (0.75~6.18)	1.18 (0.53~2.65)
		2			2.80 (0.79~9.94)	7.25 (2.87~18.33)∗∗∗	0.98 (0.21~4.61)	6.40 (2.11~19.47)∗∗∗
		≥3			18.55 (4.75~72.44)∗∗∗	5.96 (1.80~19.74)∗∗	15.82 (2.87~87.11)∗∗	3.42 (0.89~13.16)
	Regular exercise	Yes			Ref	Ref	Ref	Ref
	Regular exercise	No			0.63 (0.34~1.19)	0.67 (0.39~0.52)	0.54 (0.24~1.20)	0.73 (0.40~1.35)
	Stressful event	No			Ref	Ref	Ref	Ref
	Stressful event	Yes			0.61 (0.24~1.56)	0.27 (0.15~0.52)∗∗∗	0.89 (0.26~3.05)	0.59 (0.27~1.18)
Health related variables	Illness	No					Ref	Ref
	Illness	Yes					5.21 (1.30~20.96)∗	0.27 (0.05~1.50)
	Med	No					Ref	Ref
	Med	Yes					0.45 (0.12~1.75)	4.38 (0.84~22.93)
	Perceived health	Good					Ref	Ref
	Perceived health	Bad					3.29 (1.13~9.56)∗	3.06 (1.48~6.24)∗∗
	Menopause	Pre						Ref
		During						16.10 (1.44~179.51)∗
		Post						7.40 (0.76~71.74)
	Pain	No					Ref	Ref
	Pain	Yes					10.82 (4.44~26.36)∗∗∗	4.64 (2.18~9.89)∗∗∗
	Emotion	Bad					Ref	Ref
	Emotion	Good					0.06 (0.01~0.34)∗∗∗	0.73 (0.33~1.61)
	BMI	Under					ref	Ref
		Norm					0.04 (0.00~0.50)	0.73 (.051~10.44)
		Over					0.03 (0.00~0.46)	0.70 (0.05~10.08)
		Obese					0.06 (0.00~0.73)	1.03 (0.07~14.77)

BMI=body mass index;

^∗ p＜.05;

^∗∗ p＜.01;

^∗∗∗ p＜.001.

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