背景：隨著人口高齡化，維持老年期的生活品質已成為重要的公共衛生議題。睡眠是構成生理與心理健康的基本要素，並可能在維持老年期生活品質方面扮演重要角色。目前針對退休高齡者特定夜間睡眠變項與生活品質之間是否存在雙向關聯的證據仍有限。本研究旨在探討臺灣退休族群的床上時間、入睡潛伏期、睡眠中斷、就寢時間與生活品質之間的雙向關聯。
方法：本研究資料取自於「臺灣退休規劃與退休歷程對退休後健康狀況之影響調查」中的50至74歲之參與者，共2,185人。夜間睡眠變項包括床上時間、入睡潛伏期、睡眠中斷及就寢時間；生活品質則以生理健康與心理健康成分摘要分數評估，皆採經驗證之自陳式測量工具。研究採用交叉滯後縱貫模型檢驗夜間睡眠變項與生活品質之間的雙向關聯，並進一步調整社會人口學特徵、憂鬱症狀及共病情形。
結果：夜間睡眠變項與生活品質之間未觀察到雙向關聯。基線時較晚的就寢時間與追蹤時較高的生理健康成分摘要有關，有睡眠中斷則與追蹤時較低的心理健康成分摘要相關。反向關聯中，基線時較高的生理健康成分摘要與追蹤時較高的床上時間（6-9小時）之可能性及追蹤時較短的入睡潛伏期（< 60分鐘）相關。基線心理健康成分摘要則與後續各項夜間睡眠變項皆無顯著關聯。
結論：本研究未觀察到退休高齡者之夜間睡眠變項與生活品質之間存在雙向關聯，但不同睡眠特徵與生活品質面向之間存在特定的縱向關聯。未來發展退休高齡者健康老化策略時，考量個別睡眠特徵，以及生活品質之身體與心理面向，可能具有重要性。

Introduction: As populations age, maintaining quality of life (QoL) in later life has become an important public health priority. Sleep is a fundamental component of physical and psychological health and may play an important role in maintaining QoL in later life. Evidence on whether specific nighttime sleep parameters are bidirectionally associated with QoL among retired older adults remains limited. This study examined bidirectional associations between time in bed, sleep latency, nocturnal awakenings, sleep timing, and QoL in a Taiwanese retired population.
Methods: Participants aged 50-74 years were drawn from the Taiwan Health and Retirement Study (n=2,185). Nighttime sleep parameters (time in bed, sleep latency, nocturnal awakenings, and sleep timing) and QoL (physical and mental component summary scores) were assessed using validated self-reported measures. Cross-lagged panel models were used to examine bidirectional associations between sleep parameters and QoL. Models were additionally adjusted for sociodemographic characteristics, depressive symptoms, and comorbidity.
Results: No bidirectional associations were observed between nighttime sleep parameters and QoL. Later sleep timing at baseline was associated with higher PCS at follow-up, whereas more frequent nocturnal awakenings were associated with lower follow-up MCS. In the reverse direction, higher baseline physical QoL was associated with a greater likelihood of spending 6-9 hours in bed and shorter sleep latency (<60 minutes) at follow-up. Baseline MCS was not associated with subsequent sleep parameters.
Conclusions: No bidirectional associations were observed between nighttime sleep parameters and QoL among retired older adults, although specific longitudinal associations were identified across different sleep characteristics and QoL dimensions. These findings highlight that considering specific sleep characteristics and the physical and mental domains of QoL may be important when developing healthy aging strategies for retired older adults.

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