关键词: 睡眠质量, 吸烟, 匹兹堡睡眠质量指数, 吸烟指数 , 河北

Abstract: Background　Sleep problems are highly prevalent nowadays，especially in the elderly.Studies have shown that sleep quality is associated with nicotine exposure，and may be varied by the level of smoking. But there is lack of studies about the influence of smoking on the sleep quality in the elderly. Objective　To investigate the relationship between smoking and sleep quality in the elderly based on analyzing the sleep quality in elderly smokers in Hebei Province. Methods　Data were part of the results of an epidemiological survey of mental diseases conducted in Hebei Province in 2016 using multistage，stratified and random sampling，including general demographic information，smoking history，Pittsburgh Sleep Quality Index（PSQI），and so on. Sleep quality was compared in terms of subscales of PSQI across non-smokers，light，moderate and heavy smokers divided by the Smoking Index to analyze the influence of smoking on sleep quality. Logistic regression analysis was used to evaluate the relationship between smoking and sleep quality. Results　A total of 5 343 cases were included，with an average age of （68.4±7.0） years，including 3 973 non-smokers（74.36%），536 light smokers（10.03%），512 moderate smokers （9.58%），and 322 heavy smokers （9.77%）. The 4 groups had significant differences in average age，gender ratio，ratio of living in urban areas to rural areas，distribution of education level，prevalence of independent living，medical insurance situation，average monthly household income，drinking，cardiovascular disease and tumor（P<0.05）. Moreover，the group also demonstrated significant differences in the average scores of subscales of PSQI：subjective sleep quality，sleep latency，sleep duration，habitual sleep efficiency，sleep disturbances，use of sleeping medication，daytime dysfunction and PSQI total score（P<0.05）. Multivariate logistic regression analysis showed that after adjusting for age，gender，education level，prevalence of independent living，monthly household income，exercise frequency，drinking，cardiovascular disease and tumor，smokers had an increased risk of sleep disorders〔OR（95%CI）=2.452（1.738，3.461）〕generally.And the risk of sleep disorder increased with the level of smoking：light smokers〔OR（95%CI）=1.622（1.032，2.549）〕，moderate smokers〔OR（95%CI）=2.753（1.833，4.137）〕，heavy smokers〔OR（95%CI）=3.554（2.304，5.483）〕. Conclusion　Among elderly Chinese people，sleep disorders are more common in smokers than in nonsmokers. Sleep quality may vary by the level of smoking.Higher smoking index may be associated with worse sleep quality.

Key words: Sleep quality, Smoking, Pittsburgh Sleep Quality Index, Smoking index