Sleep quality and its relationship with pain and psychological well-being in community-dwelling older adults in Jordan: cross-sectional study

Abstract

Sleep disturbance, chronic pain and mental health symptoms frequently co-occur in older adults, but data from the Middle East remain limited. This study aimed to examine sleep quality and its associations with pain and mental health symptoms among community-dwelling older adults in Jordan. A cross-sectional study was conducted among adults aged ≥60 years recruited from geriatric clinics and rehabilitation centres. Sleep quality (primary outcome) was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Insomnia Severity Index (ISI), International Restless Legs Syndrome Severity Rating Scale (IRLS), daytime sleepiness via the Epworth Sleepiness Scale (ESS), Depression Anxiety Stress Scale (DASS-21) and the Brief Pain Inventory were measured. Correlation and multiple linear regression models by domain (demographic, lifestyle/health, sleep-specific, mental health and pain), followed by a fully adjusted model, were performed. A total of 121 participants (mean age 67.9 ± 7.5 years, 44.6% female) were included. Mean PSQI score was 13.5 ± 3.2, indicating poor sleep quality. In bivariate analysis, higher ISI, IRLS, ESS, DASS-21 and pain severity/interference were significantly associated with poorer sleep quality (all p < 0.01). Domain-specific models identified insomnia severity, depressive and anxiety symptoms and pain variables as significant predictors. In the fully adjusted model (adjusted R 2 = 0.268), only insomnia severity remained as an independent predictor of poorer sleep quality, with retirement showing a borderline association. Poor sleep quality is highly prevalent among community-dwelling older adults in Jordan and is driven primarily by insomnia severity rather than demographic or health factors. Targeting insomnia may yield the greatest improvements in sleep quality in this population.