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Zhang Y, Lin C, Li H, Li L, Zhou X, Xiong Y, Yan J, Xie M, Zhang X, Zhou C, Yang L. The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping. BMC Psychiatry 2024; 24:346. [PMID: 38720293 PMCID: PMC11077779 DOI: 10.1186/s12888-024-05792-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. METHODS Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. RESULTS Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). CONCLUSIONS Anxiety and negative coping were important mediating factors for rural older adult's childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.
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Affiliation(s)
- Yuqin Zhang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Chengwei Lin
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Hongwei Li
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Lei Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Deyang Integrated Traditional Chinese and Western Medicine Hospital, Deyang, 618000, China
| | - Xueyan Zhou
- Centre for Aging Health Service of Deyang City, Deyang, 618000, China
| | - Ying Xiong
- Health Commission of Deyang City, Deyang, 618000, China
| | - Jin Yan
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Mengxue Xie
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xueli Zhang
- Sichuan Provincial Health Information Center, Chengdu, 610015, Sichuan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research,School of Public Health, Cheeloo College of Medicine,Shandong University, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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Duan X, Zhao W, Yang B, Lao L, Mei Y, Wu C, Liao Y, Wang Y, Feng Z, Chen W, Ge E, Deng H, Liu X. Association of residential greenness with obstructive sleep apnea among Chinese old adults and the mediation role of PM 2.5 and leisure-time physical activity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170120. [PMID: 38232829 DOI: 10.1016/j.scitotenv.2024.170120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
Few studies have investigated the association of residential greenness with obstructive sleep apnea (OSA). This study was to comprehensively examine the association of residential greenness exposure with OSA and explore the mediating effect of leisure-time physical activity (LTPA) and PM2.5 on the association among Chinese old adults. A prospective cohort study that enrolled 2027 adults aged ≥65 was conducted between 1st July 2015 and 30th September 2019 in Southern China. OSA was ascertained by Berlin Questionnaire. Greenness exposure was measured by contemporaneous and cumulative average normalized difference vegetation index (NDVI) in the 1000 m radius around each participant's residential address. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated by Cox proportional hazards model to assess the impact of greenness exposure on the incidence of OSA after adjusting for confounders. LTPA and PM2.5 were examined as potential mediators in the aforementioned models. A total of 293, nearly 14.5 %, participants developed OSA within 59,251 person-months of follow-up. When comparing the highest with lowest tertiles, both contemporaneous NDVI (>0.351 vs. ≤0.325: HR = 0.20, 95 % CI = 0.13-0.31) and cumulative NDVI (> 0.346 vs. ≤ 0.317: HR = 0.32, 95 % CI = 0.21-0.47) were associated with a reduced risk of OSA after adjusting for confounders. LTPA and PM2.5 significantly mediated the association between greenness and OSA. In conclusion, this study indicated that exposure to higher residential greenness could decrease OSA risk, and this benefit may be achieved by promoting physical activity and decreasing PM2.5 concentration. The findings suggest to formulate targeted interventional strategies by expanding residential greenness to prevent OSA and reduce disease burden.
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Affiliation(s)
- Xueru Duan
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China; Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Boyi Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lixian Lao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Yunting Mei
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chuchu Wu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yifu Liao
- Department of Neurology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Yongqi Wang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zuyi Feng
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
| | - Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China.
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
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Dzhambov AM, Lercher P, Botteldooren D. Childhood sound disturbance and sleep problems in Alpine valleys with high levels of traffic exposures and greenspace. ENVIRONMENTAL RESEARCH 2024; 242:117642. [PMID: 37996006 DOI: 10.1016/j.envres.2023.117642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Sound disturbance and sleep problems are regarded as the most common adverse effects of environmental noise but evidence of the role of air pollution and greenspace is scant. This is especially true for children who find themselves in a sensitive developmental period and experience their environment differently than adults. This study examined the joint effects of traffic exposures and residential greenspace on child sound disturbance and sleep problems via perceptions of neighborhood quality. We used cross-sectional data for 1251 schoolchildren (8-12 years) in the Tyrol region of Austria/Italy. Questionnaires provided information on sociodemographic and housing factors, perceived neighborhood quality, sound disturbance in different situations, and sleep problems. Modelled acoustic indicators included day-evening-night sound levels and the highest percentile level, and night-time sound level and a bespoke sleep disturbance index. Nitrogen dioxide served as a proxy for traffic-related air pollution. The normalized difference vegetation index was calculated as a measure of residential greenspace, and presence of a domestic garden was self-reported. Results showed that higher level of traffic-related exposures was positively associated with sound disturbance and sleep problems, while living in a greener area, especially in a house with a garden, was associated with lower sound disturbance and less sleep problems even in the presence of traffic. Traffic exposures contributed to more unfavorable, and greenspace to more positive perceptions in terms of traffic-related stressors, opportunities for outdoor recreation, and general satisfaction with the neighborhood. This indirect path seemed more important for greenspace than for traffic exposures. In conclusion, it seems advantageous to combine traffic-related mitigation with improving access to greenspace in interventions for supporting the acoustic comfort of children during day and nighttime. Even highly nature-dominated environments could still benefit from proximal green infrastructure, especially from domestic gardens.
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Affiliation(s)
- Angel M Dzhambov
- Environmental Health Division, Research Institute at Medical University of Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Austria; Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Bulgaria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Bulgaria.
| | - Peter Lercher
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Austria
| | - Dick Botteldooren
- Department of Information Technology, Research Group WAVES, Ghent University, Belgium
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Xu Y, Zhang L, Mao S, Zhang S, Peng S, Zhang Q, Wu W, Tan X. Sociodemographic determinants of life satisfaction among grandparent caregivers. Front Public Health 2023; 11:1044442. [PMID: 36778559 PMCID: PMC9909222 DOI: 10.3389/fpubh.2023.1044442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/04/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction It has become a common contemporary phenomenon for grandparents to provide care for young children in their family in both urban and rural areas. This study attempted to investigate psychological wellbeing and quality of life among grandparents involved in childcare in China, and to explore the relationships between sociodemographic characteristics, quality of life, and life satisfaction in this group. Methods Using stratified random cluster sampling, we conducted a survey of grandparent caregivers in Wuhan in November and December of 2020 (N = 1,640). Descriptive statistics to univariate analysis, multiple linear regression, and structural equation modeling were carried out. Results Across all respondents, mean scores on life satisfaction, sleep quality, and quality of life were 14.05 ± 3.50, 5.02 ± 3.37, and 74.51 ± 16.88, respectively. Marital status, income, chronic diseases, family relationships, and physical exercise were found to be associated with life satisfaction. The results of structural equation modeling indicated that quality of life, sleep quality, and sociodemographic characteristics may exert direct and indirect effects on life satisfaction. Mediating effects accounted for 30.0% of the total effects. Conclusion Overall, grandparent caregivers have poor life satisfaction, quality of life, and sleep quality. A higher household income, better relationships with family members, healthy lifestyle habits, and high-quality sleep may effectively help to improve life satisfaction among grandparent caregivers.
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Affiliation(s)
- Yi Xu
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Ling Zhang
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Shuyuan Mao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Si Zhang
- Central China Normal University, Wuhan, China
| | - Shuzhen Peng
- Huangpi District People's Hospital, Wuhan, China
| | - Qi Zhang
- Wuhan Health Medical Cosmetic Hospital, Wuhan, China
| | - Wenwen Wu
- School of Public Health, Hubei University of Medicine, Shiyan, China,Wenwen Wu ✉
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, Hubei, China,*Correspondence: Xiaodong Tan ✉
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