ArticleBMC public health2020
Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan rural cohort.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Association of sleep quality and sleep duration with anxiety symptoms in older adults: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Pooled it
- Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Educating Outpatients for Bowel Preparation Before Colonoscopy Using Conventional Methods vs Virtual Reality Videos Plus Conventional Methods: A Randomized Clinical Trial.JAMA network open · 2021Trial
- Sleep quality, duration, and multi-trajectories as predictors of rheumatoid arthritis: evidence from the english longitudinal study of ageing.Arthritis research & therapy · 2026Article
- Longitudinal relationship between anxiety and sleep quality in community residents: the mediating effect of loneliness.BMC psychiatry · 2025Article
- Feasibility of rTMS combined with dexmedetomidine in chronic insomnia disorder.Scientific reports · 2025Article
- Methods and exploratory findings of the first Swiss agricultural health cohort FarmCoSwiss.Scientific reports · 2025Article
- The triangulation of multimorbidity: A systematic review of primary sleep disorders, hypertension, and psychiatric disorders.PLOS global public health · 2025Article
- Psychological well-being of rural left-behind women in Northwest China and its associated factors: a regional, population-based study.Frontiers in public health · 2024Article
- Relationship of sleep-quality and social-anxiety in patients with breast cancer: a network analysis.BMC psychiatry · 2023Article
- Exposure to secondhand smoke is associated with poor sleep quality among non-smoking university students in Bangladesh: a cross-sectional survey.Scientific reports · 2023Article
- Association of Insomnia with Anxiety and Depression in Type 2 Diabetic Patients: A Cross-Sectional Study.Iranian journal of medical sciences · 2023Article
- Pathways from Neuroticism, Social Support, and Sleep Quality to Antenatal Depression during the Third Trimester of Pregnancy.International journal of environmental research and public health · 2022Article
- Independent and combined effects of sleep quality and night sleep duration on health-related quality of life in rural areas: a large-scale cross-sectional study.Health and quality of life outcomes · 2022Article
- Social outbreak and its association with insomnia and daytime sleepiness in Chile.Sleep science (Sao Paulo, Brazil)Review
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe epidemiological evidence on the association of sleep quality on anxiety symptoms has been inconclusive. This study aimed to explore the association between sleep quality and anxiety symptoms in rural Chinese population and investigate whether age, lifestyles, and chronic diseases modified this association.
methodsA 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) scale. Poor sleep quality was defined as PSQI ≥6. Anxiety symptoms were evaluated with the two-item generalized anxiety disorder scale (GAD-2). Individual with score ≥ 3 was viewed as having anxiety symptoms. Logistic regression and restricted cubic spline were conducted to examine the association of sleep quality with anxiety symptoms.
resultsAltogether, 6087 (21.80%) participants were poor sleepers and 1557 (5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of PSQI score after fitting restricted cubic splines. The poor sleep quality was associated with a higher possibility of anxiety symptoms [odd ratio (OR): 4.60, 95% confidence interval (CI): 3.70-5.72] in men, and (OR: 3.56, 95% CI: 3.10-4.09) in women for multivariable analysis. Further, stratified analyses showed that the effect of sleep quality on anxiety symptoms could be modified by age, marital status, smoking status, drinking status, hypertension, and type 2 diabetes mellitus.
conclusionsA dose-response association between PSQI score and anxiety symptoms was found. In addition, the relationship between poor sleep quality and greater anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease.
trial registrationThe trial was prospectively registered on July 6, 2015 and available online at ClinicalTrials.gov ID: ChiCTR-OOC-15006699 .
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