Impact of living environment on sleep quality in older adults and the mediating role of depression: a cross-sectional study.

Abstract

Sleep quality significantly affects the well-being of older adults. This study aimed to analyse the current state of sleep quality among older adults in China and to examine the effects of living environment and depression on sleep quality, as well as their interrelationship(s). A survey was conducted using a self-designed questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire Depression Scale (PHQ-9), targeting a sample of adults ≥ 60 years of age in the central province of China, yielding 6211 valid responses. Correlation analysis indicated that the living environment was negatively correlated with both depression and PSQI score (r = - 0.140, p < 0.01; r = - 0.174, p < 0.01). The living environment (β = - 0.049, p < 0.001) was a negative predictor of PSQI, while depression (β = 0.477, p < 0.001) was a positive predictor. Mediation analysis revealed that depression acted as a mediator between the living environment and sleep quality, contributing 61.7% of the overall effect. Further analysis through hierarchical regression and simple slope plotting indicated that in a favourable living environment, the impact of depression on sleep quality was more pronounced. These findings suggest that a supportive living environment has a protective effect against poor sleep hygiene among older adults and that depression plays a significant mediating role. Intervention strategies should focus on improving living environments and implementing mental health measures to enhance sleep quality among older adults.