Exploring the Relationship between Sleep Pattern and Quality of Life in the Middle-aged Population Based on Fuzzy-set Qualitative Comparative Analysis

This study aims to investigate the effects of 7 factors (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction), as measured by the Pittsburgh Sleep Quality Index, on the quality of life (QOL) in middle-aged individuals. A total of 194 middle-aged individuals aged 45 to 59 years participated in this study. The Chinese version of the medical outcomes study 36-item short-form health survey and the Pittsburgh Sleep Quality Index were used to assess the QOL and sleep quality, respectively. The relationship between sleep patterns and QOL was analyzed using fuzzy-set qualitative comparative analysis. Improvement in sleep disturbances and reduction in the use of sleeping medications are necessary conditions for enhancing QOL. Two configurations of sleep patterns positively influence QOL: the "sufficiency type" with high level of sleep duration, non-sleep disturbances, and non-daytime dysfunction as core conditions; and the "efficiency type" with high habitual sleep efficiency and non-daytime dysfunction as core conditions. Three configurations of sleep patterns negatively influence QOL: the "low-quality type" with non-high-level subjective sleep quality, sleep duration, and habitual sleep efficiency as core conditions; the "barrier type" with high level of sleep disturbances, non-high-level sleep latency, and non-high-level subjective sleep quality/sleep duration as core conditions; and the "drug-based type" with high level of use of sleeping medications and subjective sleep quality as core conditions. Using the fuzzy-set qualitative comparative analysis method, this study initially reveals that the influence of sleep patterns on QOL in middle-aged individuals is a holistic effect combining multiple elements. This deepens and enriches the understanding of the relationship between sleep patterns and QOL and expands new perspectives for more in-depth research on how to improve the QOL of middle-aged individuals through sleep interventions.