Health status and behavior influencing sleep quality among community-dwelling elderly in Chanthaburi province, Thailand


  • Chanisa Siripanich College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
  • Ratana Somrongthong College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
  • Phitsanuruk Kanthawee School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand


Health status, Sleep quality, Elderly, Thailand


Purpose - The trend of sleep disorder is typically common in age changes due to health status and behavior leading to poor quality of sleep. The purpose of this study was to examine the rate and factors associated to sleep quality among community-dwelling elderly in Chanthaburi province, Thailand.

Design/methodology/approach - A cross-sectional study was conducted among 208 elderly by multi-stage sampling. All participants were interviewed by questionnaire. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Sleep quality score ≥ 5 indicates poor sleep quality. Chi-square tests and multivariate logistic regression models were performed to find significant associations. 

Findings - Approximately, 66.3% of respondents had poor sleep quality with score of ≥ 5 PSQI. The adjusted odds ratio (AOR) for gender, age, and BMI, and the multivariate logistic regression model showed that elders who had never participated social activities increased poor sleep quality 5.962-fold odds (p-value<0.05; 95% CI 1.459 – 24.361). Elders who had never prayed before sleep increased poor sleep quality 1.478-fold odds (p-value<0.05; 95% CI 0.273 – 0.838). Perception of musculoskeletal problem increased poor sleep quality 2.288-fold odds (p-value<0.05; 95% CI 1.249 – 4.192). Bladder problem perception (p-value<0.05; 95% CI 1.084 – 6.327), depression (p-value<0.05; 95% CI 1.179 - 9.095), and smoking (p-value<0.05; 95% CI 1.062 – 4.340) increased poor sleep quality.

Originality/value - Strategic development by promoting health activities and social participation among elderly should be done in order to prevent chronic diseases, depression and sleeping disorder.


1. U.S. Department of Health and Human Services. Your guide to healthy sleep. U.S. Department of Health and Human Services; 2011.

2. Chaput JP, Wong SL, Michaud I. Duration and quality of sleep among Canadians aged 18 to 79. Health Rep. 2017 Sep 20; 28(9): 28-33.

3. Tang J, Liao Y, Kelly BC, Xie L, Xiang YT, Qi C, et al. Gender and regional differences in sleep quality and insomnia: a general population-based study in hunan province of China. Sci Rep. 2017 Mar; 7: 43690. doi: 10.1038/srep43690

4. Lou P, Qin Y, Zhang P, Chen P, Zhang L, Chang G, et al. Association of sleep quality and quality of life in type 2 diabetes mellitus: a cross-sectional study in China. Diabetes Res Clin Pract. 2015 Jan; 107(1): 69-76. doi: 10.1016/j.diabres.2014.09.060

5. Harvard Medical School, Division of Sleep Medicine. Healthy sleep: Sleep and disease risk. [updated: 2007 Dec 18; cited 2018 May 25]. Available from:

6. Troxel WM, Robles TF, Hall M, Buysse DJ. Marital quality and the marital bed: examining the covariation between relationship quality and sleep. Sleep Med Rev. 2007 Oct; 11(5): 389-404. doi: 10.1016/j.smrv.2007.05.002

7. Chaudhary NS, Grandner MA, Jackson NJ, Chakravorty S. Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample. Nutrition. 2016 Nov-Dec; 32(11-12): 1193-9. doi: 10.1016/j.nut.2016.04.005

8. Mike TB, Shaw DS, Forbes EE, Sitnick SL, Hasler BP. The hazards of bad sleep-Sleep duration and quality as predictors of adolescent alcohol and cannabis use. Drug Alcohol Depend. 2016 Nov; 168: 335-9. doi: 10.1016/j.drugalcdep.2016.08.009

9. Sabanayagam C, Shankar A. The association between active smoking, smokeless tobacco, second-hand smoke exposure and insufficient sleep. Sleep Med. 2011 Jan; 12(1): 7-11. doi: 10.1016/j.sleep.2010.09.002

10. Aburub A, Khalil H, Al-Sharman A, Alomari M, Khabour O. The association between physical activity and sleep characteristics in people with multiple sclerosis. Mult Scler Relat Disord. 2017 Feb; 12: 29-33. doi: 10.1016/j.msard.2016.12.010

11. Garcia A, Ramirez C, Aguillon A, Tirado V, Paredes L, Ibarra A, et al. Smartphone use during sleep time in Mexican adolescents. Sleep Med. 2017 Dec; 40: E106-E7. doi: 10.1016/j.sleep.2017.11.310

12. King AC, Pruitt LA, Woo S, Castro CM, Ahn DK, Vitiello MV, et al. Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. J Gerontol A Biol Sci Med Sci. 2008 Sep; 63(9): 997-1004. doi: 10.1093/gerona/63.9.997

13. Chellappa SL, Steiner R, Blattner P, Oelhafen P, Gotz T, Cajochen C. Non-visual effects of light on melatonin, alertness and cognitive performance: can blue-enriched light keep us alert? PLoS One. 2011 Jan; 6(1): e16429. doi: 10.1371/journal.pone.0016429

14. Portas CM, Krakow K, Allen P, Josephs O, Armony JL, Frith CD. Auditory processing across the sleep-wake cycle: Simultaneous EEG and fMRI monitoring in humans. Neuron. 2000 Dec; 28(3): 991-9. doi: 10.1016/S0896-6273(00)00169-0

15. Anantapong K, Pitanupong J, Werachattawan N. Prevalence of depression, and its associated factors among the elderly in Songkhla Province, Thailand: Two-stage cluster sampling study. Journal of Clinical Gerontology & Geriatrics. 2017 Jun; 8(2): 58-63. doi: 10.24816/jcgg.2017.v8i2.04

16. Sitasuwan T, Bussaratid S, Ruttanaumpawan P, Chotinaiwattarakul W. Reliability and validity of the Thai version of the Pittsburgh Sleep Quality Index. J Med Assoc Thai. 2014 Mar; 97(Suppl 3): S57-67.

17. Wu CY, Su TP, Fang CL, Yeh Chang M. Sleep quality among community-dwelling elderly people and its demographic, mental, and physical correlates. J Chin Med Assoc. 2012 Feb; 75(2): 75-80. doi: 10.1016/j.jcma.2011.12.011

18. Choombuathong A, Chalopatham W, Dhongyooyen P, Chokchaiworrarat S, Thamwattana K, Changsap B, et al . Sleep quality and factors related to sleep and self-esteem in the elderly. Journal of Health Science. 2015; 24(5): 833-43. (in Thai)

19. Tel H. Sleep quality and quality of life among the elderly people. Neurol Psychiatry Brain Res. 2013; 19(1): 48-52. doi: 10.1016/j.npbr.2012.10.002

20. National Sleep Foundation. Smoking, head injury, esticide use may be risk factors for rare sleep disorder. [updated: 2012 Jun 27; cited: 2018 May 25]. Available from:

21. Chaiarj S, Panya P. Insomnia and related factors. The Thai Journal of Nursing Council. 2005 Apr-Jun; 20(2): 1-12. (in Thai)

22. Shimizu N, Nagai Y, Yamamoto Y, Minami T, Hayashi T, Tsuji H, et al. Survey on lower urinary tract symptoms and sleep disorders in patients treated at urology departments. Nat Sci Sleep. 2013; 5: 7-13. doi: 10.2147/NSS.S40618

23. Matsuda R, Kohno T, Kohsaka S, Fukuoka R, Maekawa Y, Sano M, et al. The prevalence of poor sleep quality and its association with depression and anxiety scores in patients admitted for cardiovascular disease: A cross-sectional designed study. Int J Cardiol. 2017 Feb; 228: 977-82. doi: 10.1016/j.ijcard.2016.11.091

24. Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci. 2008; 10(4): 473-81.

25. National Sleep Foundation. Depression and sleep. [cited: 2018 June 17]. Available from:




How to Cite

Siripanich, C., Somrongthong, R., & Kanthawee, P. (2018). Health status and behavior influencing sleep quality among community-dwelling elderly in Chanthaburi province, Thailand. Journal of Health Research, 32(Suppl.2), S151-S158. Retrieved from