Research Article

Evaluating the Relationship between Sleep Quality and Temperament in Older Adults: Data from Tabriz Older People Survey (TOPS)


The quality of sleep changes with age and a reduction in sleep duration is observed in the elderly. Mizaj (temperament) is a fundamental theory in traditional Persian medicine. It is defined as all sides of personality describing a person’s morphological, psychological, and physiological situations. Although the evidence showed that temperament and sleep quality are related, no research has evaluated this issue statistically so far. Hence, this study aimed to evaluate the correlation between sleep quality and temperament. This cross-sectional study included 1,359 elderly people (aged 60) in Tabriz, Iran in 2019. An interviewer accomplished the Tabriz Older People Survey (TOPS), Temperament and Sleep Quality Test, and Pittsburgh Sleep Quality Index (PSQI). A p value less than 0.05 was considered as significant. Our findings indicated that there was a significant relationship between global PSQI and wet temperament (p value = 0.036). In addition, hot-cold temperament was statistically related to demographical items like gender, marital status, and occupational status (p value ≤ 0.05). A similar statistically significant relationship was also seen for wet-dry temperament (p value ≤ 0.05). Moreover, the global PSQI score in female and illiterates subjects and those who lived in detached houses was high, meaning that the sleep quality was poor in these groups. According to our findings, Mizaj affects the quality of sleep in older adults. Also, living conditions of the elderly, such as gender, type of residence, level of education, and job, affect the Mizaj of the elderly people.

Azfar M, Saleem M, Jamal Y, Study of sleep, wake pattern in healthy individuals with reference to different Mizaj, Int J Unani Integr Med 2020;4:14-17.

Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev 2011;21:41-53.

Foley D, Monjan A, Brown S. Sleep complaints among elderly persons: an epidemiologic study of three communities, Sleep 1995;18:425-432.

Liu X, Liu L, Sleep habits and insomnia in a sample of elderly persons in China, Sleep 2005;28: 1579-1587.

Chen Y S. Association between chronic insomnia and depression in elderly adults. J Chin Med Assoc 2012;75:195-196.

Ancoli-Israel S, Sleep problems in older adults: putting myths to bed, Geriatrics 1997;52:20-30.

Stepnowsky Jr CJ, Ancoli-Israel S, Sleep and its disorders in seniors, Sleep Med Clin 2008;3: 281-293.

Buysee DJ, Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.

Feyzabadi Z, Jafari F, Feizabadi PS, Ashayeri H, Esfahani MM, et al. Insomnia in Iranian traditional medicine. Iran Red Crescent Med J 2014;16:e15981.

Araj-Khodaei M, Sanaie S, Nejadghaderi SA, Sullman MJM, Samei S, et al. The Tabriz Older People Survey (TOPS-2019): A community-based cross-sectional study, Res Sq 2021 – InPress-.

Araj-Khodaei M, Sanaie S, Nejadghaderi SA, Sullman MJ, Samei-Sis S, et al. Profile of Tabriz Older People Health Survey (TOPS-2019): a representative community-based cross-sectional study. 2022;12:1-11.

Mojahedi M, Naseri M, Majdzadeh R, Keshavarz M, Ebadini M, et al. Reliability and validity assessment of Mizaj questionnaire: a novel self-report scale in Iranian traditional medicine, Iran Red Crescent Med J 2014;16:e15924.

Ağargün MY, Kara H, Anlar Ö, The validity and reliability of the Pittsburgh Sleep Quality Index. Turk J Psychiatry 1996;7:107-111.

Bixler EO, Kales A, Jacoby JA, Soldatos CR, Vela-Bueno A .Nocturnal sleep and wakefulness: effects of age and sex in normal sleepers, Int J Neurosci 1984;23:33-42.

Březinová V, The number and duration of the episodes of the various EEG stages of sleep in young and older people, Electroencephalogr Clin Neurophysiol 1975;39:273-278.

Gillin JC, Duncan WC, Murphy DL, Post RM, Wehr TA, et al. Age-related changes in sleep in depressed and normal subjects, Psychiatry Res 1981;4:73-78.

Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, et al. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18:425-432.

Li J, Dong Q, Liu J-J, Dong Y-H, Yang L-S, et al. Sleep and quality of life among rural elderly in Anhui province, Zhonghua Liu Xing Bing Xue Za Zhi 2010;31:405-408.

de Belvis AG, Avolio M, Spagnolo A, Damiani G, Sicuro L, et al. Factors associated with health-related quality of life: the role of social relationships among the elderly in an Italian region, Public Health 2008;122:784-793.

Mohagheghi Kamal H, Zare H, Beiglarian A. Elderly quality of life: a comparison between pensioners of social security organization and national retirement fund (Qom County, 2006), J of health admin 2007;10:49-56.

Cartwright RD, Wood E, Adjustment disorders of sleep: the sleep effects of a major stressful event and its resolution, Psychiatry Res 1991;39:199-209.

Reynolds 3rd CF, Hoch CC, Buysse DJ, Houck PR, Schlernitzauer M, et al. Electroencephalographic sleep in spousal bereavement and bereavement-related depression of late life. Biol Psychiatry 1992;31:69-82.

Babacan Gümüş A, Engin E, Özgür G, Bir huzurevinde yaşayan ve bilişsel bozukluğu olmayan yaşlıların uyku düzeni özelliklerinin incelenmesi, Türk J Geriatrics 2009;12:138-146.

Yao K-W, Yu S, Cheng SP, Chen IJ. Relationships between personal, depression and social network factors and sleep quality in community-dwelling older adults. J Nurs Res 2008;16:131-139.

Luo J, Zhu G, Zhao Q, Guo Q, Meng H, et al. Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai aging study, PLoS One 2013;8:e81261.

Jackson WA. A short guide to humoral medicine. Trend Pharmacol Sci 2001;22:487-489.

Petramfar P, Zarshenas MM, Moein M, Mohagheghzadeh A. Management of insomnia in traditional Persian medicine. Forsch Komplementmed 2014;21:119-125.

Naz S, Sherani FS, Determination of human temperament based on the literature of Unani system of medicine, JAHM 2014;2:38-43.

Mushtaq S, Jabeen A, Fasihuzaman, Mushtaq M, Jilani S, et al. Insomnia and its management in Unani medicine. Int J Adv Pharm Med Bioallied Sci 2014;2:51-53.

Minae MB, Soltani S, Besharat M, Karimi F, Nazem E. Temperament determination for melatonin: a bridge from Iranian traditional to modern sleep medicine, Afr J Tradit Complement Altern Med 2013;10:340-342.

IssueVol 7, No 4, 2022 QRcode
SectionResearch Article(s)
Sleep quality Older adults Temperament Traditional medicine Persian medicine

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How to Cite
Sanaie S, Azizi-Zeinalhajlou A, Yousefi Z, Bagherzadeh-Karimi A, Jahanjoo F, Matlabi H, Araj-Khodaei M. Evaluating the Relationship between Sleep Quality and Temperament in Older Adults: Data from Tabriz Older People Survey (TOPS). Trad Integr Med. 2022;7(4):369-374.