Multidimensional Sleep Health and Its Association with Traditional Chinese Medicine Constitution Types Among Community-Dwelling Older Adults: A Cross-Sectional Study

OBJECTIVES: This study explored co-occurrence patterns between multidimensional sleep impairments and Traditional Chinese Medicine (TCM)-informed constitution patterns in community-dwelling older adults. Specifically, we examined these associations without assuming diagnostic equivalence or causal direction. METHODS: A cross-sectional study of 305 adults (aged ≥ 65 years) in Kinmen, Taiwan, used structured, face-to-face interviews. Assessments included the Pittsburgh Sleep Quality Index (PSQI) and Body Constitution Questionnaire (BCQ), which evaluates Yin-Xu (diminished nourishing/cooling), Yang-Xu (reduced metabolic vitality), and Stasis (impaired circulation). RESULTS: Participants (mean age 75.2 years; 66.2% women) showed a 51.5% prevalence of sleep impairment (PSQI ≥ 5). Individuals with PSQI ≥ 5 exhibited significantly higher Yin-Xu, Yang-Xu, and Stasis scores compared to those with PSQI < 5. Higher constitutional imbalances consistently correlated with poorer global sleep and specific PSQI components (Cohen's d > 0.9). CONCLUSIONS: Multidimensional sleep impairments were associated with TCM-defined constitutional imbalances. The BCQ may serve as a complementary, culturally relevant tool for characterizing constitution-related vulnerability profiles alongside standard sleep assessment. CLINICAL IMPLICATIONS: Integrating BCQ-informed assessments into community care supports earlier recognition of subclinical sleep disturbances. This approach facilitates culturally sensitive communication, sleep-health education, and appropriate follow-up for older adults.