The Concomitant Pattern of Association Between Subjective Global Sleep Quality and Daytime Dysfunction in Hypnotic-Treated Older Adults: The Yilan Study, Taiwan

OBJECTIVE: The relationship between improvements in subjective sleep quality and restoration of daytime function remains unclear. This study aimed to examine the concomitant pattern between subjective sleep quality and daytime dysfunction in hypnotic-treated older adults. METHODS: This was a community-based, cross-sectional study. Participants comprised community-dwelling adults aged ≥ 65 years. Individual items from the Pittsburgh Sleep Quality Index (PSQI) were adopted to evaluate subjective global sleep quality and daytime dysfunction. Daytime dysfunction included composite scores of daytime dysfunction in the PSQI and its two sub-components: “staying awake” and “maintaining enthusiasm.” Based on hypnotic use and status in subjective sleep quality, participants were categorized into four groups: “healthy control,” “treated with good sleep quality (T+GSQ),” “treated with poor sleep quality (T+PSQ),” and “not treated with poor sleep quality (NT+PSQ)”. The associations between these four groups and daytime dysfunction were analyzed using logistic regression. RESULTS: In total, 2622 individuals participated in the study. After controlling for covariates, the T+PSQ group was more likely to have daytime dysfunction, including “composite daytime dysfunction” (OR: 6.41; 95% CI: 3.90–10.55), “poor at staying awake” (OR: 3.04; 95% CI: 1.45–6.37), and “poor at maintaining enthusiasm” (OR: 7.42; 95% CI: 4.33–12.70) compared to the T+GSQ group. However, the healthy control group was less likely than the T+GSQ group to present with daytime dysfunction, including “composite daytime dysfunction” (OR: 0.43; 95% CI: 0.26–0.72) and “poor at maintaining enthusiasm” (OR: 0.39; 95% CI: 0.22–0.68). CONCLUSION: Subjective sleep quality attributed to hypnotic use did not necessarily indicate restoration of daytime dysfunction.