To investigate the prevalence and influencing factors of insufficient sleep and excessive sleep among Chinese adults from 2010 to 2020, thereby providing a basis for policies aimed atimproving sleep conditions for adults.

Data from the China Family Panel Studies (CFPS) between 2010 and 2020 were utilized. Self-reported nighttime sleep duration was measured, with less than 7 hours classified as insufficient sleep and 9 hours or more classified as excessive sleep. Chi-square tests and Poisson regression models were employed to analyze the frequency and influencing factors.

A total of 9,505 individuals were included in the study. The results indicated that 45.84% of adults reported never experiencing insufficient sleep, while 48.27% of adults reported never experiencing excessive sleep. Poisson regression analysis indicated that females (RR=1.073, 95% CI: 1.028-1.119), increasing age (RR=1.404, 95% CI: 1.305-1.511; RR=1.887, 95% CI: 1.755-2.030; RR=2.092, 95% CI: 1.934-2.263), urban areas (RR=1.219, 95% CI: 1.178-1.260), eastern region (RR=1.346, 95% CI: 1.287-1.409) and central region (RR=1.430, 95% CI: 1.370-1.492), general health (RR=1.114, 95% CI: 1.075-1.154) and unhealthy status (RR=1.164, 95% CI: 1.109-1.221), and higher depression symptom scores (RR=1.018, 95% CI: 1.014-1.022) are risk factors for increased frequency of insufficient sleep. Married/cohabiting (RR=0.894, 95% CI: 0.816-0.980), high school (RR=0.951, 95% CI: 0.904-1.000) and college or above (RR=0.894, 95% CI: 0.828-0.965), BMI<18.5 kg/m² (RR=0.932, 95% CI: 0.871-0.996) are protective factors against increased frequency of insufficient sleep. Aged 30-44 years (RR=0.757, 95% CI: 0.712-0.806) and aged 45-59 years (RR=0.834, 95% CI: 0.783-0.888), married/cohabiting (RR=0.920, 95% CI: 0.847-0.999), junior high school (RR=0.822, 95% CI: 0.789-0.856), high school (RR=0.667, 95% CI: 0.627-0.709) and college or above (RR=0.416, 95% CI: 0.371-0.467), urban (RR=0.737, 95% CI: 0.709-0.766), eastern region (RR=0.698, 95% CI: 0.667-0.730) and central region (RR=0.768, 95% CI: 0.737-0.799) are protective factors against increased frequency of excessive sleep, while unhealthy (RR=1.100, 95% CI: 1.046-1.158) is a risk factor for increased frequency of excessive sleep.

The frequency of insufficient sleep and excessive sleep among Chinese adults is closely related to various sociodemographic factors, physical and mental health conditions, and smoking habits. The government and all sectors of society should prioritize high importance on the sleep conditions of adults and take effective measures to improve sleep health literacy among adult population, ultimately promoting overall health and well-being.