Are lifestyle pattern changes associated to poor subjective sleep quality?: a cross-sectional study by gender among the general Japanese population underwent specified medical checkups in 2014 and 2015.

Objectives: Subjective sleep quality (SSQ) is defined by the satisfaction of one’s overall sleep experience, and is composed of sleep depth and restfulness. It has not been clarified how poor SSQ is associated to changes in lifestyles. The purpose is to reveal the association of lifestyle pattern changes and poor SSQ.

Design: A cross-sectional study.

Setting: The data on basic attributes, SSQ, and lifestyle such as presence/absence of smoking, exercise, physical activity, supper time close to bedtime, drinking habits, and alcohol intake amount per day were obtained from database and questionnaire of specified medical checkups in FY 2014 and 2015 in Japan. The analysis was conducted in 2019.

Participants: The subjects comprised 49,483 residents (26,087 males and 23,396 females), aged 40 to 74 years who had undergone an annual specified medical checkup from 2014 to 2015 in Fukushima Prefecture, Japan.

Outcome measure: Status of SSQ in 2015 was assessed using a question asking whether or not the subjects usually got enough sleep. Poor SSQ in 2015 and lifestyle pattern changes in 2014-2015 were compared between those who were in healthy status both in 2014 and 2015 (referent) and non-referent, using binary logistic regression analysis.

Results: Unhealthy lifestyle pattern for 2014-2015 was significantly associated to poor SSQ in 2015: “absent to absent” in exercise for males (Odds ratio [OR] = 1.472; 95% confidence interval [CI] = 1.316, 1.647) and females (OR = 1.428; 95%CI = 1.285, 1.587), physical activity for males (OR = 1.420; 95%CI = 1.270, 1.588) and females (OR = 1.471; 95%CI = 1.322, 1.638), and “present to present” in supper time for males (OR = 1.149; 95%CI = 1.020, 1.294) and females (OR = 1.288; 95%CI = 1.102, 1.505).

Conclusions: Health care workers may be able to contribute to the improvement of SSQ, focusing on changeable lifestyles.

Methods
In this cross-sectional study, we used the data of 91,795 residents, aged 40 to 74 years, who had undergone an annual specified medical checkup in all years from 2014 to 2015 in Fukushima Prefecture, Japan, by the National Health Insurance Organization. Of 91,795 residents, individuals who had poor SSQ in 2014 and whose data on age, gender, body mass index (BMI), blood pressure, fasting plasma glucose, hemoglobin A1C (HbA1c), habits of smoking, exercise, physical activity, eating meals close to bedtime, drinking (frequency and volume of alcohol intake), and sleep quality were incomplete were excluded from the present study. The analysis was conducted in 2019, and the total number of participants was 49,483 (26,087 males and 23,396 females).