Objective To analyze the sleep quality and associated factors among community-dwelling adults aged ≥ 60 years in the urban areas of Nanjing, China, thus providing evidence for optimizing sleep quality in this population.

Methods From July to December 2023, a multi-stage stratified sampling method was used to randomly select 2 851 adults aged ≥ 60 years from urban communities in Nanjing. Face-to-face questionnaire surveys were conducted to systematically collect data on general demographic characteristics, daily lifestyle behaviors, and medical history. The Pittsburgh sleep quality index (PSQI) was adopted to assess sleep quality.

Results The older adults in the urban areas of Nanjing presented the mean PSQI score of 5.31 ± 3.27, with the poor sleep quality detection rate of 40.3%. Multivariate analysis revealed that the individuals aged 70–79 (OR = 1.24, 95%CI: 1.04–1.47) and ≥ 80 years (OR = 1.69, 95%CI: 1.30–2.19) had worse sleep quality than those aged 60–69 years. Additionally, the presence of cardiovascular diseases (OR = 1.50, 95%CI: 1.19–1.88), other chronic diseases (OR = 1.68, 95%CI: 1.19–2.38), depressive symptoms (OR = 2.04, 95%CI: 1.24–3.37), and anxiety symptoms (OR = 2.69, 95%CI: 1.88–3.86) were also significant influencing factors for poor sleep quality (all P < 0.05).

Conclusions Poor sleep quality is common among older adults in the urban areas of Nanjing, and its occurrence is associated with age, cardiovascular diseases, other chronic diseases, depressive symptoms, and anxiety symptoms.