Investigating the relationship of indoor temperature and humidity with sleeping quality in private residential care homes for persons with disabilities in Hong Kong.
Lee H & Wong N • Frontiers in public health • 2026
Significant associations were observed between sleep quality and indoor temperature, relative humidity, sleeping periods, and self-perceived humidity in private residential care homes for persons with disabilities in Hong Kong, with many residents experiencing poor sleep quality especially in summer.
Key Findings
Results
A high proportion of residents in PRCHDs experienced poor sleep quality, particularly during summer months.
Poor sleep quality was defined as a Pittsburgh Sleep Quality Index (PSQI) score greater than 5.
The proportion of participants with poor sleep quality ranged from 30% to 73% during summer.
Thirty residents with disabilities residing in PRCHDs completed four surveys across the study period.
The study was conducted over 6 months from August 2024 to February 2025 across three PRCHDs in Hong Kong.
Results
Indoor temperatures in PRCHDs frequently exceeded outdoor temperature levels, particularly during warmer months.
Smart sensors monitored indoor temperature and relative humidity in both dining areas and bedrooms.
Time-series analysis was used to compare indoor conditions with outdoor data.
The exceedance of indoor over outdoor temperatures was most pronounced during warmer months.
This pattern was observed across three separate PRCHD facilities.
Results
Sleep quality showed statistically significant associations with indoor temperature, relative humidity, sleeping periods, and self-perceived humidity.
All reported associations were statistically significant at p < 0.05.
Statistical models were used to analyze associations between PSQI scores and environmental factors.
Both objective environmental measures (indoor temperature and relative humidity) and subjective measures (self-perceived humidity) were significantly associated with sleep quality.
Sleeping periods were also identified as a significant factor in the statistical models.
Methods
The study used the Pittsburgh Sleep Quality Index (PSQI) administered across four survey rounds to assess sleep quality in PRCHD residents.
Thirty residents with disabilities participated in the study.
Each participant completed four surveys over the 6-month pilot study period.
The PSQI is a validated instrument for assessing sleep quality, with scores above 5 indicating poor sleep quality.
The study population was described as 'a vulnerable and under-researched population.'
Conclusions
The findings led to recommendations for improving environmental conditions in PRCHDs, particularly during summer.
Recommendations included improving ventilation in PRCHD facilities.
Increased air conditioning use was recommended, particularly during warmer months.
Promoting outdoor activities was suggested as a measure to enhance sleep quality and overall well-being.
The authors highlighted the need to improve environmental conditions specifically during summer months.
What This Means
This research suggests that the indoor environment of residential care homes for people with disabilities in Hong Kong is directly linked to how well residents sleep. In a 6-month study across three care homes, researchers used smart sensors to track temperature and humidity in bedrooms and common areas, while also surveying 30 residents four times about their sleep quality. They found that indoor temperatures often climbed higher than outdoor temperatures during warmer months, and that between 30% and 73% of residents were experiencing poor sleep quality during summer — well above the threshold considered normal on a standard sleep quality scale.
The study found statistically significant links between poor sleep and multiple environmental factors: indoor temperature, indoor humidity levels, the time periods during which residents slept, and residents' own perceptions of how humid the environment felt. This suggests that both measurable environmental conditions and how residents personally experience those conditions matter for sleep health. Notably, indoor temperatures frequently surpassed outdoor temperatures, pointing to inadequate cooling or ventilation as a key problem.
This research suggests that care homes for people with disabilities may need to invest in better ventilation systems, more consistent use of air conditioning during warmer periods, and opportunities for residents to spend time outdoors. People with disabilities living in institutional settings are often overlooked in environmental health research, and these findings highlight that the physical conditions of their living spaces may be meaningfully affecting their sleep and overall well-being.
Lee H, Wong N. (2026). Investigating the relationship of indoor temperature and humidity with sleeping quality in private residential care homes for persons with disabilities in Hong Kong.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1748619