Prevalence of sleep disturbances and associated factors among Chinese residents: A web-based empirical survey of 2019

Background To identify the prevalence of sleep disorders in China through a large sample study. To explore the relevant social determinants affecting resi-dents' sleep status at both individual and provincial levels based on the theo-retical framework of the Dahlgren-Whitehead model. Methods A nationwide cross-sectional web-based survey was conducted from January 20 to February 28, 2019 across 31 provinces of China. The Pittsburgh Sleep Quality Index was used to evaluate residents' sleep quality. Multilevel linear regression analysis was used to analyse the influencing factors of sleep disorder. Results A sample of 107 650 residents completed the survey, and 94 454 ques-tionnaires were included in the final analysis. The crude incidence rate and the age-adjusted rate of sleep disorder in Chinese residents were 19.16% and 21.25%, respectively. Those who were older, female, smokers, drinkers, mar-ried, divorced, or widowed, retired, more educated (regression coefficient (b) = 0.172, P < 0.05), had worse self-perceived economic status, and lived far away from community health services (b = 0.758, P < 0.05) were more likely to have sleep problems. Physical exercise, social support (b =-1.705, P< 0.05), and greening coverage of residential areas (b =-1.769, P < 0.05) were protective fac-tors for residents' sleep quality. Conclusions Sleep disorders are prevalent in the Chinese population, with varying incidence rates across provinces. To improve sleep quality, the Chinese government and health management departments should pay more attention to vulnerable groups and promote healthy lifestyles through education. Addi-tionally, the social network can be utilized to provide social support. Improv-ing the ecological environment and daily living environment is also essential.