Association of Cold/Heat Sensation with Sleep Quality and Insomnia in Middle-aged Women

Sujeong Mun; Kihyun Park; Kwang-Ho Bae; Younghwa Baek; Siwoo Lee; Mun, Sujeong; Park, Kihyun; Bae, Kwang-Ho; Baek, Younghwa; Lee, Siwoo

doi:10.13048/jkm.24008

JKM > Volume 45(1); 2024 > Article

Mun, Park, Bae, Baek, and Lee: Association of Cold/Heat Sensation with Sleep Quality and Insomnia in Middle-aged Women

Original Article

The Journal of Korean Medicine 2024; 45(1): 125-136.

Published online: March 1, 2024

DOI: https://doi.org/10.13048/jkm.24008

Association of Cold/Heat Sensation with Sleep Quality and Insomnia in Middle-aged Women

Sujeong Mun

, Kihyun Park

, Kwang-Ho Bae

, Younghwa Baek

, Siwoo Lee

KM Data Division, Korea Institute of Oriental Medicine

Correspondence to: Siwoo Lee, Korea Institute of Oriental Medicine, Yuseongdaero 1672, Yuseong-gu, Daejeon, Republic of Korea, Tel: +82-42-868-9555, E-mail: ifree72@gmail.com

본 연구는 2024 년도 한국한의학연구원의 “빅데이터 기반 한의 예방 치료 원천기술 개발 (KSN1732121)” 과제의 지원을 받아 수행되었습니다.

Received January 17, 2024 Revised February 9, 2024 Accepted February 16, 2024

Abstract

Objectives

Cold extremities have been suggested to correlate with sleep disturbances. This study aims to explore the relationship between thermal sensations in body, encompassing both cold and heat sensations, with sleep quality and insomnia.

Methods

Self-administered questionnaires were utilized to assess thermal sensations in body, sleep quality and symptoms of insomnia in middle-aged women. A multiple logistic regression analysis was performed to ascertain the association between thermal sensations in body and both sleep quality and insomnia symptoms.

Results

Among 899 participants, 255 (28.4%) were categorized in the cold sensation group, 95 (10.6%) in the heat sensation group, 70 (7.8%) in the group with both cold and heat sensations, and 479 (53.3%) in the no-sensation group. Pittsburgh Sleep Quality Index and Insomnia Severity Index were notably higher in the group experiencing both sensations when compared to the no-sensation group. After adjustments for covariates, the odds ratios for poor sleep quality, moderate/severe insomnia, and long sleep latency were significantly elevated in the group with both sensations when compared to the no-sensation group. The odds ratios for poor sleep quality in the cold sensation group and for moderate/severe insomnia and low sleep efficiency in the heat sensation group were significantly higher when compared to the no-sensation group.

Conclusions

The risk for sleep disturbances varied depending on the presence of thermal sensations in body, with the greatest risk observed for low sleep quality and insomnia in individuals experiencing both cold and heat sensations.

Keywords: Sleep Quality, Insomnia, Thermosensing, Middle Aged, Women

Supplementary Information

jkm-45-1-125-Supplementary-table-1.docx

jkm-45-1-125-Supplementary-Fig-1.docx

Fig. 1

Distribution of Pittsburgh Sleep Quality Index component scores according to group

None, no-sensation group; Cold, cold sensation; Heat, heat sensation; Both, cold and heat sensations; PSQI, Pittsburgh sleep quality index

Fig. 2

Distribution of Insomnia Severity Index item scores according to group

None, no-sensation group; Cold, cold sensation; Heat, heat sensation; Both, cold and heat sensations; ISI, insomnia severity index.

Fig. 3

Odds ratios for sleep disturbances

CI, confidence interval; *, P < 0.05; **, P < 0.01; ***, P < 0.001; Model 1: adjusted for age, body mass index; Model 2: adjusted for variables in Model 2, smoking, alcohol consumption, physical activity, education, household income, marital status, and menopause; Model 3: adjusted for variables in Model 2, EuroQol-visual analogue scales, Beck Depression Inventory score, and use of sleeping medication; Reference group: no-sensation group.

Table 1

Characteristics of Study Participants

		No sensation (N=479)	Cold sensation (N=255)	Heat sensation (N=95)	Both sensations (N=70)	P
Age (years)		47.7 ± 6.5	45.5 ± 6.5	48.8 ± 6.3	47.8 ± 6.4	< 0.001

BMI (kg/m²)		23.9 ± 3.3	23.0 ± 3.3	25.2 ± 4.3	24.0 ± 3.2	< 0.001

PSQI global score		4.9 ± 2.9	5.8 ± 3.1	6.3 ± 3.3	7.3 ± 3.9	< 0.001

ISI score		4.8 ± 4.6	6.6 ± 5.2	7.1 ± 6.0	9.4 ± 6.4	< 0.001

Sleep duration (hours)		6.6 ± 1.1	6.5 ± 1.3	6.1 ± 1.4	6.2 ± 1.3	0.006

Sleep latency (min)		22.3 ± 24.0	25.1 ± 28.0	27.6 ± 30.6	39.4 ± 41.8	< 0.001

Sleep efficiency (%)		92.8 ± 9.3	91.5 ±10.7	88.6 ±13.2	88.6 ±12.0	< 0.001

Physical activity	Low	165 (34.4%)	87 (34.1%)	25 (26.3%)	28 (40.0%)	0.361
	Moderate	153 (31.9%)	95 (37.3%)	34 (35.8%)	22 (31.4%)
	High	161 (33.6%)	73 (28.6%)	36 (37.9%)	20 (28.6%)

Smoke	Never	459 (95.8%)	239 (93.7%)	94 (98.9%)	63 (90.0%)	0.115
	Former	10 (2.1%)	6 (2.4%)	0 (0.0%)	2 (2.9%)
	Current	10 (2.1%)	10 (3.9%)	1 (1.1%)	5 (7.1%)

Drink	Abstainers	237 (49.5%)	148 (58.0%)	42 (44.2%)	30 (42.9%)	0.123
	Responsible drinking	216 (45.1%)	91 (35.7%)	46 (48.4%)	34 (48.6%)
	Hazardous drinking	17 (3.5%)	14 (5.5%)	4 (4.2%)	4 (5.7%)
	Harmful drinking	9 (1.9%)	2 (0.8%)	3 (3.2%)	2 (2.9%)

Education	≤ High school	188 (39.2%)	85 (33.3%)	45 (47.4%)	28 (40.0%)	0.337
	University	270 (56.4%)	158 (62.0%)	48 (50.5%)	39 (55.7%)
	Graduate school	21 (4.4%)	12 (4.7%)	2 (2.1%)	3 (4.3%)

Household Income (10,000 won/month)	<300	132 (27.6%)	75 (29.4%)	32 (33.7%)	21 (30.0%)	0.433
	300–399	79 (16.5%)	40 (15.7%)	15 (15.8%)	5 (7.1%)
	400–499	75 (15.7%)	42 (16.5%)	19 (20.0%)	16 (22.9%)
	≥ 500	193 (40.3%)	98 (38.4%)	29 (30.5%)	28 (40.0%)

Marital status	Married	412 (86.0%)	215 (84.3%)	85 (89.5%)	62 (88.6%)	0.407
	Unmarried	23 (4.8%)	18 (7.1%)	7 (7.4%)	3 (4.3%)
	Others	44 (9.2%)	22 (8.6%)	3 (3.2%)	5 (7.1%)

Menopause		160 (33.4%)	59 (23.1%)	43 (45.3%)	25 (35.7%)	< 0.001

EQ VAS		73.9 ± 13.9	70.1 ± 14.6	71.5 ± 13.4	66.3 ± 17.7	< 0.001

BDI score		7.0 ± 6.1	9.0 ± 7.4	10.6 ± 7.8	13.1 ± 9.4	< 0.001

Data are presented as mean ± standard deviation or number (%). BMI, body mass index; PSQI, Pittsburgh sleep quality index; ISI, insomnia severity index, EQ-VAS, EuroQol-visual analogue scales; BDI, Beck Depression Inventory.

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