ArticleBMC public health2026
Area of residence modifies the association between sleep disorders and health-related quality of life in older adults: a cross-sectional analysis of two cohort studies in Mexico.
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
backgroundSleep disorders are often associated with reduced physical and mental well-being in older adults. Although regional variations in sleep disorders have been observed, evidence remains limited as to how these differences may relate to health-related quality of life (HRQoL), especially in rural populations. The objective was to determine whether the association between insomnia, poor sleep quality, sleepiness and naps with HRQOL is modified according to place of residence (rural vs. urban).
methodsCross-sectional data from two cohort studies in Mexico were used: the Cohort of Rural Frailty (2018; n = 514) and the Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults (2019; n = 431). Sleep disorders and related factors were measured through the Athens Insomnia Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and self-reported long naps (≥ 1 h per episode). HRQoL was assessed with the SF-36 Health Survey. Linear regression models were fitted for the proposed associations.
resultsIn rural areas, insomnia and poor sleep quality were significantly associated with lower HRQoL scores in both physical and mental components; while long naps (≥ 1 h per episode) were associated with lower scores on the physical component, and sleepiness with the mental component. No significant relationships were observed for urban area residents.
conclusionsInsomnia, long naps (≥ 1 h per episode), and poor sleep quality reduce HRQoL of older adults in rural areas, these findings have important implications for public health policies, that should focus in improving awareness, detection and treatment of sleep disorders by primary care especially in vulnerabilized areas such as rural Mexico.
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