www.nature.com/scientificreports OPEN received: 25 August 2016 accepted: 30 January 2017 Published: 06 March 2017 Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China Jinsong Tang1,2, Yanhui Liao1,2, Brian C. Kelly3, Liqin Xie4, Yu-Tao Xiang5, Chang Qi1, Chen Pan6, Wei Hao1, Tieqiao Liu1, Fengyu Zhang1 & Xiaogang Chen1 Insomnia and the inability to sleep affect people’s health and well-being However, its systematic estimates of prevalence and distribution in the general population in China are still lacking A population-based cluster sampling survey was conducted in the rural and urban areas of Hunan, China Subjects (n = 26,851) were sampled from the general population, with a follow-up using the Pittsburgh Sleep Quality Index (PSQI) for interview to assess quality of sleep and Insomnia (PSQI score >5) While the overall prevalence of insomnia was 26.6%, and little difference was found between males (26.3%) and females (27.0%); the mean PSQI score was 4.26 (±2.67), and significant higher in females (4.32 ± 2.70) than males (4.21 ± 2.64, p = 0.003) Individuals in the rural areas tended to report a higher PSQI score (4.45 ± 2.81) than urban residents did (4.18 ± 2.60) (p