Who reports insufficient and disturbed sleep? Results from a representative population-based health survey in Hong Kong.

Laura Elizabeth Bedford ; Eric Ho Man Tang ORCID logo ; Weinan Dong ; Carlos King Ho Wong ORCID logo ; Emily Tsui Yee Tse ORCID logo ; Amy Pui Pui Ng ORCID logo ; Bernard Man Yung Cheung ; Tingting Wu ; Esther Yee Tak Yu ORCID logo ; Cindy Lo Kuen Lam ; (2022) Who reports insufficient and disturbed sleep? Results from a representative population-based health survey in Hong Kong. BMJ open, 12 (9). e058169-. ISSN 2044-6055 DOI: 10.1136/bmjopen-2021-058169
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OBJECTIVES: To highlight the prevalence of sleep problems and identify associated risk factors among a representative sample recruited from the general population of Hong Kong. DESIGN, SETTING AND PARTICIPANTS: Participants included 12 022 individuals (aged 15 or above) who took part in the Population Health Survey 2014/15, a territory-wide survey conducted by the Department of Health of the Government of the Hong Kong Special Administrative Region. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes were the prevalence of (1) insufficient sleep (<6 hours sleep per day) and (2) any sleep disturbance (difficulty initiating sleep, intermittent awakenings, early awakening) ≥3 times per week in the past 30 days. Multivariable logistic regression identified associations between sleep problems and sociodemographic, clinical and lifestyle factors. RESULTS: 9.7% of respondents reported insufficient sleep and 10.5% reported sleep disturbances ≥3 times a week. Female gender, monthly household income <$12 250 (Hong Kong dollar), lower education level, mental health condition and physical health condition were significantly associated with both insufficient and disturbed sleep (all p<0.05). Unemployment, homemaker, insufficient physical activity, current/former smoking status and harmful alcohol consumption were associated with sleep disturbances only (all p<0.01). CONCLUSIONS: Sleep problems are highly prevalent in Hong Kong. As such problems are associated with a range of health conditions, it is important to facilitate improvements in sleep. Our results show that harmful alcohol consumption, insufficient physical activity and current smoking are modifiable risk factors for sleep disturbances. Public health campaigns should focus on these risk factors in order to promote a healthy lifestyle and ultimately reduce sleep disturbances. Targeted interventions for high-risk groups may also be warranted, particularly for those with doctor-diagnosed physical and mental health conditions.


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