Ding R, Liu XY, Ding Y, Leng MM, Yang LJ, Zhang AH. Correlation analysis between sleep quality and depressive symptoms among rural elderly in China: An observational study. World J Psychiatry 2025; 15(12): 112672 [PMID: 41357932 DOI: 10.5498/wjp.v15.i12.112672]
Corresponding Author of This Article
Ai-Hua Zhang, Professor, Department of Nursing, Shandong First Medical University, No. 619 Changcheng Road, Daiyue District, Tai’an 271016, Shandong Province, China. zhangah818@163.com
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Psychology
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Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 19, 2025 (publication date) through Dec 10, 2025
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World Journal of Psychiatry
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2220-3206
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Ding R, Liu XY, Ding Y, Leng MM, Yang LJ, Zhang AH. Correlation analysis between sleep quality and depressive symptoms among rural elderly in China: An observational study. World J Psychiatry 2025; 15(12): 112672 [PMID: 41357932 DOI: 10.5498/wjp.v15.i12.112672]
World J Psychiatry. Dec 19, 2025; 15(12): 112672 Published online Dec 19, 2025. doi: 10.5498/wjp.v15.i12.112672
Correlation analysis between sleep quality and depressive symptoms among rural elderly in China: An observational study
Ran Ding, Xiao-Yu Liu, Yi Ding, Min-Min Leng, Li-Juan Yang, Ai-Hua Zhang
Ran Ding, Xiao-Yu Liu, Ai-Hua Zhang, Department of Nursing, Shandong First Medical University, Tai’an 271016, Shandong Province, China
Yi Ding, Department of Respiratory Medicine, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Min-Min Leng, Li-Juan Yang, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Author contributions: Zhang AH and Yang LJ designed the study; Ding R was responsible for the main writing of the manuscript, data analysis and statistics; Leng MM provided funding support; Ding Y and Liu XY conducted literature review and assisted in data collection; all authors have read and approved the final manuscript.
Supported by China Postdoctoral Science Foundation, No. 2023M732119; Natural Science Foundation of Shandong Province, No. ZR2024QG032.
Institutional review board statement: The study was approved by the Ethics Committee of Shandong Provincial Hospital, No. 2024-234.
Informed consent statement: All participants signed the informed consent forms prior to the start of the survey.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The raw data have not been made publicly available yet. For legitimate purposes such as academic verification or scientific research cooperation, researchers or institutions in need of the raw data may apply through the corresponding author of this article. The research team will provide support on the premise of complying with research ethics standards and data privacy protection requirements.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ai-Hua Zhang, Professor, Department of Nursing, Shandong First Medical University, No. 619 Changcheng Road, Daiyue District, Tai’an 271016, Shandong Province, China. zhangah818@163.com
Received: August 4, 2025 Revised: August 27, 2025 Accepted: October 13, 2025 Published online: December 19, 2025 Processing time: 117 Days and 7.3 Hours
Abstract
BACKGROUND
The rural elderly in China have a high prevalence of depressive symptoms, which is closely linked to poor sleep quality. This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions. We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population.
AIM
To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China.
METHODS
This cross-sectional study enrolled 5136 older adults (≥ 60 years) recruited between April and June 2024. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index, and depressive symptoms were assessed with the Patient Health Questionnaire-9. Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults.
RESULTS
The prevalence of depressive symptoms was 19.5%, and the overall rate of sleep disorders was 40.13%. Among the rural elderly, six sleep dimensions were found to be statistically significantly associated with depressive symptoms (all P < 0.05), with the following odds ratios (ORs) and 95% confidence intervals (CIs): Subjective sleep quality (OR = 2.066, 95%CI: 1.709-2.497), sleep onset latency (OR = 2.476, 95%CI: 2.062-2.972), sleep efficiency (OR = 1.686, 95%CI: 1.369-2.076), sleep disturbances (OR = 2.092, 95%CI: 1.566-2.795), daytime dysfunction (OR = 3.378, 95%CI: 2.882-3.959), and use of hypnotic medications (OR = 1.662, 95%CI: 1.093-2.525).
CONCLUSION
Poor subjective sleep quality, prolonged sleep onset latency, reduced sleep efficiency, sleep disturbances, daytime dysfunction, and use of hypnotic medications are associated with depressive symptoms in the elderly. Therefore, healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.
Core Tip: This cross-sectional study included 5136 rural elderly (≥ 60 years old) in China, using the Pittsburgh Sleep Quality Index and Patient Health Questionnaire-9 to assess sleep quality and depressive symptoms. It found 19.5% depressive symptoms prevalence and 40.13% sleep disorder rate; six sleep dimensions were significantly associated with depressive symptoms, providing a basis for targeted interventions for rural elderly.
