Sleep disturbance and risk of incident incontinence in middle-aged and older Chinese adults: a 4-year national cohort study

作者：Yuefan Shen, Weixin Zhang, Jianguo Gao, Sihai Shao · 发表于：BMJ Open · 年份：2026 · DOI：10.1136/bmjopen-2025-108424 · 研究领域：Sleep and related disorders、Pelvic floor disorders treatments、Obstructive Sleep Apnea Research

OBJECTIVES: This study aimed to investigate the longitudinal association between sleep disturbance and the risk of new-onset incontinence in middle-aged and older Chinese adults and to explore whether chronic lung diseases mediate this relationship. DESIGN: A prospective cohort study based on a nationally representative survey. SETTING: Data were obtained from the China Health and Retirement Longitudinal Study, a national survey of middle-aged and elderly community-dwelling Chinese adults. PARTICIPANTS: A total of 7098 participants aged ≥50 years who were continent at baseline in 2011 and completed follow-up in 2015 were included in the analysis. MEASURES: Sleep disturbance was assessed via self-report and categorised into good versus poor quality. Incident incontinence was defined as a new onset of difficulty in controlling urination or defecation. Multivariable logistic regression models were used to estimate the association between baseline sleep disturbance and incident incontinence, adjusting for sociodemographic, behavioural and health-related covariates. Mediation analysis was conducted to evaluate the indirect role of chronic lung disease in the sleep-incontinence pathway. Subgroup and interaction analyses assessed whether key demographic or health factors influenced the sleep-incontinence association. RESULTS: Sleep disturbance at baseline was significantly associated with a higher risk of developing incontinence over 4 years (adjusted OR 1.34, p=0.040). This associa...