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BackgroundAs one of the disabling pains, low back pain seriously affects the quality of life of patients and causes a huge economic burden to them. Studies have shown that poor sleep quality has a certain effect on the occurrence of low back pain, but the dose-response relationship between sleep time and the risk of low back pain has been currently unclear, and there is a lack of relevant research in this area in China.ObjectiveTo explore the effect of sleep time and sleep quality on the risk of low back pain among the middle-aged and elderly people in China.MethodsUsing the longitudinal data of China Health and Retirement Longitudinal Study (CHARLS) between 2011 to 2015, all middle-aged and elderly people with a baseline age >45 year sat baseline from the three surveys in 2011, 2013, and 2015 were selected as the research subjects. The cut-off time of follow-up was 2015-12-31, and the self-reported low back and back pain was used as the outcome event, and follow-up was terminated upon the occurrence of the outcome event. Multivariate Cox proportional hazards regression analysis was used to assess the effect of sleep time and sleep quality on the risk of low back pain and the combined effect of them. Restricted cubic spline model was used to analyze the dose-response relationship between sleep time and the risk of low back pain.ResultsA total of 4 459 subjects were included, with an average follow-up of (3.6±0.8) years; sleep duration: 0.05) , sleep time