California Center for Population Research

Study Objectives: Insomnia is influenced by psychosocial and environment factors. This study aims to examine the differential of insomnia symptoms between rural-to-urban migrants and non-migrants in China. Design: A cross-sectional study. Setting: Ten townships throughout China. Patients or Participants: One hundred and ninety-seven Chinese adults aged 18 to 64 years, with an oversample of migrants. Measurements and Results: Professional interviewers and community doctors used a questionnaire to collect information on migration, insomnia symptoms, and other variables. Multivariable binomial logistic regression models were used to examine the relations between migration status and presence of at least one insomnia symptom, while adjusting for age, sex, education, income, number of chronic medical conditions, depression, and other covariates. The numbers of permanent urban residents, rural non-migrants, and rural-to-urban migrants in the study were 93 (47%), 47 (24%), and 57 (29%), respectively. The probability of reporting at least one of the five insomnia symptoms measured was 40% for permanent urban residents, 62% for rural non-migrants, and 68% for migrants (P = 0.001). Using permanent urban residents as the reference group, the multiply-adjusted odd ratios of having at least one insomnia symptom were 3.00 (95% CI: 1.36 – 6.62) for migrants and 1.86 (95% CI: 0.73 – 4.74) for rural non-migrants. The adjusted odd ratio for insomnia symptoms predicted from each additional chronic medical condition was 1.71 (95% CI: 1.13 – 2.60). 2 Conclusions: Compared to permanent urban residents, rural-to-urban migrants in China have higher prevalence of insomnia symptoms. The number of chronic medical conditions reported is also independently related to sleep disturbance. Key words: migration status, insomnia, China