Physician versus patient use of AI for diabetes prevention: public perceptions and comfort levels.

Self-reported health is a widely recognized indicator of individuals’ perceived overall health. Despite its simplicity, this measure has been consistently linked to objective outcomes such as mortality, morbidity, and health-related quality of life . Middle adulthood (aged 40-64 years) is a period characterized by heightened vulnerability to chronic illness and psychosocial stress. Poor self-reported health during this stage has been associated with an increased risk of premature mortality, cardiovascular disease, diabetes, and depression , as well as subsequent cognitive and functional decline . Identifying modifiable contributors to health perception is therefore essential for nursing interventions aimed at strengthening well-being and preventing long-term deterioration. Sleep quality has emerged as an important factor in this context. Nonrestorative sleep―commonly defined as the subjective experience of unrefreshing sleep―has been strongly associated with hypertension, diabetes, and depression . National Health and Nutrition Survey data from Japan indicate increasing sleep complaints among middle-aged adults, with nonrestorative sleep frequently reported . However, the relationship between nonrestorative sleep and self-reported health remains underexplored, particularly in this demographic, which faces rising sleep disturbances and chronic disease burden. While prior research has emphasized objective outcomes, fewer studies have addressed perceived health status―a gap with critical implications for nursing assessment and preventive care. Therefore, this study examines cross-sectional associations between nonrestorative sleep and poor self-reported physical and mental health among middle-aged adults in Japan.