Association between religious and spiritual engagement and sleep disturbance among older Vietnamese adults: A latent class and sex-stratified analysis
Abstract
OBJECTIVES: Sleep disturbance is a common yet heterogeneous condition in later life. This study aimed to identify profiles of sleep disturbance among older Vietnamese adults and examine sex-specific associations with religious and spiritual engagement. METHODS: Data were drawn from the 2018 Longitudinal Study of Aging and Health in Vietnam (LSAHV) (n = 4901; aged ≥60 years). Latent class analysis identified sleep disturbance profiles using 6 self-reported indicators. Sex-stratified multinomial logistic regression models estimated associations, adjusting for sociodemographic, physical health, behavioral, and psychosocial factors. RESULTS: Three profiles were identified: mild (29.4%), moderate (45.6%), and severe (25.0%). The moderate and severe profiles showed similarly high insomnia symptoms but differed in perceived sleep quality, restfulness, and medication use. Religious and spiritual engagement showed sex-specific patterns. Among women, engagement was associated with a 6.0 percentage-point higher probability of belonging to the mild profile after adjustment for sociodemographic, environmental, and physical health confounders. This association was attenuated by 2.0 percentage points after further adjustment for psychosocial and behavioral factors and was no longer statistically significant. No significant associations were observed among men. CONCLUSIONS: Sleep disturbance among older Vietnamese adults reflects meaningful variation in subjective sleep experiences rather than a uniform consequence of aging. Religious and spiritual engagement was associated with a higher probability of belonging to the mild profile among women, whereas no significant association was observed among men. These findings highlight the importance of considering subjective sleep experiences, broader psychosocial contexts, and sex-specific patterns in understanding sleep health in later life.
