Sleep Quality Disparities by Urban-Rural Status and Housing Type among the Korean Older Adults

초록

Background: Although sleep quality is a key determinant of healthy aging, evidence on how residential environments contribute to sleep disparities among older adults remains limited. This study aimed to investigate the association between residential characteristics and poor sleep quality among older adults in Korea and assess the socioeconomic variations in these relationships. Methods: This cross-sectional study analyzed the data from the 2024 Korea Community Health Survey, including 81,470 adults aged 65 years or older. Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index, with “poor sleep” defined as a score of >6. The residential region was classified as urban or rural, and the housing type as apartment or detached house. Multivariable logistic regression models were applied after the adjustment for demographic, socioeconomic, behavioral, clinical, and psychological factors. Subgroup analyses were performed to determine potential effect modification. Results: Overall, 43.4% of the participants had poor sleep quality. Poor sleep was more prevalent among urban residents and apartment dwellers. Based on the subgroup analyses, the association between urban residence and poor sleep was consistently observed across the age, exercise, and stress groups, with relatively larger effect estimates among participants aged <75 years. The association between apartment living and poor sleep was significant across most subgroups but not statistically significant among participants reporting stress. Conclusion: Residential context is considered significantly associated with sleep quality among older adults in Korea, with important socioeconomic heterogeneity. These findings highlight the need to incorporate residential environmental factors into strategies to better address sleep health disparities in later life.

키워드