ArticleBMC public health2026
Association of nighttime sleep duration and quality with low back pain in middle-aged and elderly Chinese: a nationwide longitudinal cohort study.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThere are few studies on the association between nighttime sleep duration and sleep quality with low back pain (LBP) in the Chinese population. This study aimed to investigate the longitudinal associations between middle-aged and older adults in China.
methodsThis study is a large-sample longitudinal cohort study and the data used in this study were from the China Health and Retirement Longitudinal Study (CHARLS) survey. Nighttime sleep duration was obtained from the self-reported of the participants and was divided into five groups of < 6 h, 6 to < 7 h, 7 to < 8 h, 8 to < 9 h, and ≥ 9 h. Sleep quality was defined as days of restless sleep during the past week and was divided into four groups of < 1 day, 1–2 days, 3–4 days, and 5–7 days. Multiple logistic regression models were used to analyze the relationship between nighttime sleep duration and sleep quality with LBP. Restricted cubic spline (RCS) was used to construct a dose-response relationship between nighttime sleep duration and LBP.
resultsA total of 11,233 participants were included in this study, and after 4 years of follow-up, the incidence of LBP was 9.51% (1068/11,233). Multiple logistic regression analyses showed that compared to participants who slept for 7–8 h, sleep duration of < 6 h and ≥ 9 h were associated with a significant risk of LBP (Odds ratio (OR) = 1.66, 95% confidence interval (CI): 1.28–2.15; OR = 1.52, 95% CI: 1.07–2.16, respectively). And participants with 5–7 days of restless sleep were associated with a significant risk of LBP (OR = 1.64, 95% CI: 1.31–2.05). RCS analysis showed that a nighttime sleep duration of 7 h had the lowest risk of LBP. Subgroup analysis revealed that participants aged under 58 years with sleep duration of < 6 h were more likely to experience LBP (OR = 1.51, 95% CI: 1.08–2.12). However, when age was > 58 years, all participants were associated with a significant incidence of LBP, and those with sleep duration < 6 h and > 9 h had a higher potential for LBP occurrence (OR = 2.38, 95% CI: 1.59–3.59; OR = 1.94, 95% CI: 1.11–3.38).
conclusionsShort or long nighttime sleep, as well as poor sleep quality, are associated with an increased risk of incident LBP.
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