Gender Differences in Sleep Disturbance among Elderly Koreans: Hallym Aging Study

Exploring the relationship between early cognitive ability and age-60 sleep quality: The Newcastle Thousand Families Study birth cohort

OBJECTIVES

Poor sleep quality has been linked to adverse health outcomes. It is important to understand factors contributing to sleep quality. Previous research has suggested increased cognition and education duration have a protective effect on sleep quality in old age. This study aimed to assess the hypothesis that age-11 intelligence quotient and highest achieved education level are associated with subjective sleep quality at age 60.

METHODS

Participants are members of the Newcastle Thousand Families Study birth cohort, all born in 1947. Data included a calculated intelligence quotient score based on participant's 11-plus exam results, highest achieved education level, social class at ages 25 and 50 and global Pittsburgh Sleep Quality Index (PSQI) at age 60. Multivariable regression analysis was used to investigate effect sizes of variables on global PSQI, which formed the basis of a path analysis model.

RESULTS

After excluding participants with incomplete data, and those who had been diagnosed with sleep apnea, 251 participants were included in the path analysis model. Education level was associated with global PSQI (R=-0.653; 95% CI -1.161, -0.145; P = .012) but age-11 intelligence quotient was not. While a similar association was seen for women in the stratified analysis, no such associations were seen for men.

CONCLUSIONS

The results of this study show an inverse relationship between education level, but not childhood intelligence quotient, and sleep quality in later life, in women only. Future research is needed to examine the mechanism underlying this relationship.

Prevalence and associated factors of poor sleep quality among industrial workers in Addis Ababa, Ethiopia: findings from a cross-sectional study

OBJECTIVE

This study aimed to investigate the prevalence and associated factors of poor sleep quality among Bole Lemi Industrial Park workers in Addis Ababa, the capital of Ethiopia.

DESIGN

An institution-based cross-sectional study was conducted from July to August 2022. The data were collected using a validated and standardised Pittsburgh Sleep Quality Index Questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable binary logistic regression analysis was conducted to identify factors associated with poor sleep quality. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

SETTING

The study was conducted in Bole Lemi Industrial Park in Addis Ababa.

PARTICIPANTS

A total of 370 workers participated in this study.

OUTCOME MEASURES

The primary outcome of the study was the prevalence of poor sleep quality.

RESULTS

The total response rate was 87.7%. The majority (260, 70.3%) of the participants were female. The mean (±SD) age of the participants was 30.5 (±10.6) years. The prevalence of poor sleep quality during the last months was found to be 75.4% (n=279) (95% CI: 70.7% to 79.7%). Undiversified dietary intake (AOR: 1.63; 95% CI (1.09 to 2.78)), caffeine consumption more than 250 mg per day (AOR: 2.57; 95% CI (1.12 to 6.05)) and night shift work (AOR: 2.36; 95% CI (1.27 to 4.41)) were risk factors for poor sleep quality among sampled workers.

CONCLUSION

This study detected that poor sleep quality is highly prevalent among garment and textile industry workers, indicating that it is a significant public health issue that requires immediate attention. Therefore, modifications of the work environment involving night shift work and the improvement of workers' personal lifestyles involving dietary diversification and caffeine consumption are needed to minimise the burden of poor sleep quality among workers.

Trends and disparities in sleep quality and duration in older adults in China from 2008 to 2018: A national observational study

Background

Poor sleep status as a common concern is a risk factor for many health problems among older people. China with an aging society lacks relevant nationwide data on the sleep status among older people. Therefore, the purpose of this study was to investigate trends and disparities in sleep quality and duration among older adults, and exploring influencing factors of poor sleep in China between 2008 and 2018.

Method

We used the four-waves data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Sleep quality and average sleep hours per day was investigated by using questionnaires in the CLHLS. We categorized sleep duration as three groups including ≤5 h (short duration), 5-9 h (normal duration), or ≥9 h (long duration) per day. Multivariate logistic regression models were used to examine trends and risk factors of poor sleep quality, short sleep duration, and long sleep duration.

Results

The prevalence of poor sleep quality significantly increased from 34.87% in 2008 to 47.67% in 2018 (p < 0.05). Short sleep duration significantly increased from 5.29 to 8.37%, whereas long sleep duration decreased from 28.77 to 19.27%. Multivariate analysis showed that female sex, poor economic status, a greater number of chronic diseases, underweight, poor self-reported quality of life, and poor self-reported health were associated with poor sleep quality and short sleep duration (p < 0.05).

Conclusion

Our findings revealed that older adults had increased prevalence of poor sleep quality and short sleep duration from 2008 to 2018. More attention should be paid to the increased sleep problems among older adults and early interventions should be made to improve sleep quality and guarantee enough sleep time.

Prevalence and associated factors of poor sleep quality among Chinese retirees: A multicenter cross-sectional study

BACKGROUND

Sleep problems are common among older adults worldwide. The present study aims to determine the prevalence of poor sleep quality and its independent factors among retired people in health check-ups population in China.

METHOD

In this multicenter, cross-sectional survey in 2017, a group of retired people was invited to participate in an online survey of health status, and their data, including socio-demographic information, lifestyle, and medical characteristics, were recorded. Binary logistic regression was used to analyze the independent factors responsible for poor sleep quality.

RESULTS

Data from 17,408 responders who met the inclusion criteria were analyzed; among them, 53.04 % (95 % CI = 52 %-54 %) reported poor sleep quality. Binary logistic regression showed that poor sleep quality was associated with a number of factors, including being female (OR = 1.42, 95 % CI = 1.32-1.53), being single (OR = 1.35, 95 % CI = 1.18-1.54), non-smoker (OR = 1.12, 95 % CI = 1.03-1.22), physical inactivity (OR = 1.14, 95 % CI = 1.05-1.23), poor self-rated health status (OR = 1.69, 95 % CI = 1.43-2.00), long-term medication use (OR = 1.05, 95 % CI = 1.07-1.23), chronic pain (OR = 1.33, 95 % CI = 1.22-1.45), comorbidity (OR = 1.16, 95 % CI = 1.07-1.25), and depressive symptoms (mild depression: OR = 2.14, 95 % CI = 1.96-2.34; moderate depression: OR = 4.00, 95 % CI = 3.49-4.58, moderately severe depression: OR = 4.15, 95 % CI = 3.47-4.97, severe depression: OR = 4.27, 95 % CI = 2.93-6.22); while age (OR = 0.99, 95 % CI = 0.99-1.00) was negatively related to poor sleep quality.

CONCLUSION

The prevalence of poor sleep quality in the studied population is relatively high (53.04 %). Sleep problems are common among Chinese retirees, especially older females, and have a great impact on their quality of life. People living with depression, chronic diseases, and chronic pain were at a higher risk of developing sleep disorders. Therefore, it is critical to formulate effective management strategies for Chinese retirees with poor sleep quality in the context of healthy aging.

Lifestyle elements and risk of metabolic syndrome in adults

Background

The aim of the study was to investigate which elements of lifestyle are associated with metabolic health in adults, defined as the absence of components of metabolic syndrome (MetS) based on the International Diabetes Federation criteria.

Methods

Data from 10,277 individuals aged 40–65 years constituted the material of this study. Univariate and multivariate analyses with backward stepwise selection were carried out to identify the factors associated with the absence of metabolic disorders.

Results

No family history of cardiovascular disease increased the odds of being metabolically healthy 1.5-2-fold. Furthermore, the following factors were associated with higher odds of being metabolically healthy in men: abstinence from alcohol (healthy individuals vs. those with ≥3 [OR = 5.49 (2.23–13.52); p<0.001], ≥2 [OR = 4.52 (1.87–10.91); p = 0.001], and ≥1 components of MetS [OR = 3.04 (1.41–6.56); p = 0.005]), moderate alcohol use (healthy individuals vs. those with ≥3 [OR = 3.36 (1.54–7.32); p = 0.002], ≥2 [OR = 3.28 (1.52–7.10); p = 0.002], and ≥1 components of MetS [OR = 3.93 (1.64–9.42); p = 0.002]), moderate-to-vigorous physical activity (MVPA) >2 hours/day and sitting time of 3–6 hours/day. Drinking >2 cups of coffee per day (healthy vs. those with ≥3 [OR = 2.00 (1.47–2.71)], ≥2 [OR = 1.84 (1.38–2.45)], and ≥1 components of MetS [OR = 1.72 (1.30–2.28); all p<0.001]), limiting animal fats to <2 servings/day, MVPA >2 hours/day, and 7–8 hours of sleep per day were associated with higher odds of being metabolically healthy in women.

Conclusions

A healthy lifestyle increased the odds of being metabolically healthy. Some lifestyle modifications may appear effective in prevention of not only MetS, but also single metabolic risk factors.

Socio-cognitive Determinants of Healthy Sleep Behaviors Among Iranian Elderly: Application of the Theory of Planned Behavior

Background: Sleep quality and quantity disorders are among the most important problems in old age. Healthy sleep behaviors are among the best ways to deal with sleep disorders among the elderly. This study aimed to determine the socio-cognitive determinants predicting healthy sleep behaviors among the elderly who had been referred to the retirement centers in Hamadan, Iran. Methods: This cross-sectional study was performed among 288 elderly people who had been referred to the retirement centers in Hamadan, Iran in 2020, and were selected through stratified random sampling. Data were collected online using a self-administered questionnaire with items on demographic characteristics and the theory of planned behavior (TPB) constructs. Data were analyzed by SPSS software (version 16) using Pearson correlation, independent t test, one-way ANOVA, and linear regression tests at the significance level of 0.05. Results: The mean (±standard deviation) age of respondents in this study was 67.2 (±6.3) years. Perceived behavior control (β=0.409), attitude (β=0.251), and subjective norms (β=0.205) were stronger predictors of healthy sleep behavior intention among the elderly, respectively; collectively, they accounted for 28.5% of the variation in sleep health behavior intention. Behavioral intention (β=0.429) and perceived behavioral control (β=0.167) were also predictors of healthy sleep behaviors among the elderly. There was a statistically significant relationship between the educational level and healthy sleep behaviors (P<0.05). Conclusion: It seems that the development and implementation of educational programs based on the TPB for the improvement of attitudes, subjective norms, and perceived behavior control can play an effective role in promoting healthy sleep behaviors and sleep quality among the elderly.

Accumulated unhealthy behaviours and insomnia in Japanese dwellers with and without cardiovascular risk factors: a cross-sectional study

OBJECTIVES

To date, the association between accumulated unhealthy behaviours and insomnia in individuals stratified according to the presence or absence of major cardiovascular risk factors is unclear. This study aimed to examine the effect of accumulated unhealthy behaviours on insomnia in Japanese dwellers.

DESIGN

Cross-sectional study.

SETTING

Baseline data between April 2012 and March 2015.

PARTICIPANTS

Our study used cross-sectional data among Japanese aged 35-74 years in a rural community (N=9565), the attendees of annual municipal or work site health check-up programmes.

MAIN OUTCOME MEASURES

Insomnia was assessed by Athens Insomnia Scale, which was set at 6 points and greater; other scales were given. Participants were categorised into three groups by their number of unhealthy behaviours (no exercise habit, smoking, alcohol drinking, skipping breakfast and obesity): 0-1, 2-3, 4 or more. The association between accumulated unhealthy behaviours and insomnia was estimated by logistic regression analysis. Further analysis was done after stratification of cardiovascular risk factors assessed by anthropometrics and clinical biochemistry measurements.

RESULTS

The overall prevalence of insomnia was 13.3% for men and 19.3% for women. Men with unhealthy behaviour factors were more likely to have insomnia after adjusting for potential confounders, compared with the least unhealthy group (trend p=0.013). Women with four or more unhealthy behaviour factors were more likely to have insomnia, compared with the lowest groups (OR 1.175, 95% CI 1.077 to 1.282). Insomnia has an association with the unhealthy behaviours among men without cardiovascular risk factors (lowest groups: OR 1.133, 95% CI 1.037 to 1.238, trend p=0.026). Women without hypertension were more likely to have suspected insomnia, compared with the lowest group (OR 1.215, 95% CI 1.101 to 1.341).

CONCLUSION

The results showed accumulated unhealthy behaviours were associated with increased risk of insomnia in Japanese dwellers. For healthy population without cardiovascular risk factors, unhealthy behaviours should be considered as background conditions for insomnia.

Daytime Sleepiness among Medical Colleges’ Students in Jordan: Impact on Academic Performance

Introduction

Sleep disorders are extremely prevalent in the general population. College students are more susceptible to sleep problems. This is due to the increased competition in getting a job position and the current alterations in the labor market. Poor sleep is prevalent and has deleterious effects on college students, but its frequency among college students has not been documented in Jordan. So, the aims of this study are to assess the prevalence of daytime sleepiness among medical college students in Jordan and to look for any links between daytime sleepiness and academic performance.

Methods

A cross-sectional study performed on medical and paramedical specialties students and Epworth sleepiness Sscale (ESS) was used. To assess the students' academic performance, the cumulative grade point average was utilized.

Results

977 students from five medical colleges participated in the study. ESS scores were abnormal in 34.4% of students and were considered to have daytime sleepiness. Significant lower ESS scores were associated with students who reported good sleep quality than students who reported poor sleep quality. Significant lower ESS scores were reported by students who slept more than 7 hours compared with students who slept less than 6 hours. The ESS scores were not significantly associated with students' CPGA.

Conclusion

Daytime sleepiness is highly prevalent among medical students in Jordan. The data of this study might be very helpful to assess the academic policy makers to develop intervention strategies that resolve the sleep disturbances in college students and reduce its impact on the academic achievements.

Seeking bridge symptoms of anxiety, depression, and sleep disturbance among the elderly during the lockdown of the COVID-19 pandemic-A network approach

BACKGROUND

Besides physical changes, elderly adults are prone to have mental disorders such as anxiety, depression, and sleep disturbance, and the pandemic of COVID-19 worsened the situation. However, internal relationships and co-occurrence of psychopathologies were scarcely examined. Therefore, in the current study, through network analysis, we inspected relationships among symptoms of depression, anxiety, and sleep disturbance and identified key symptoms that espoused the disease.

METHODS

We asked 1,302 elderly adults to fill in Patient Health Questionnaire-2 (depressive symptoms), the Generalized Anxiety Disorder-2 (anxiety symptoms), and the Youth Self-rating Insomnia Scale (sleep disturbance) and then constructed three networks for elderly adults, male elderly, and female elderly. Via network analysis, we accomplished four goals. First, we identified symptom with the highest centrality (i.e., strength) index for each network; then, we found the strongest correlation (i.e., edges) in each network; thirdly, we confirmed specific nodes that could bridge anxiety, depression, and sleep disturbance; the last was to compare networks based on genders. Network stability and accuracy tests were performed.

RESULTS

Networks of elderly adults, male elderly, and female elderly were stable, accurate, and intelligible. Among all networks, "Nervousness"- "Excessive worry" (GAD-1- GAD-2) had the strongest correlation, and "Nervousness" (GAD-1) had the highest strength and bridge strength value. When we made a comparison between female elderly's and male elderly's networks, except for the significant difference in the mean value of "Difficulty initiating sleep" (YSIS-3), the findings showed that the two networks were similar. Network stability and accuracy proved to be reliable.

CONCLUSIONS

In networks of anxiety, depression, and sleep disturbance, anxiety played a conspicuous role in comorbidity, which could be a target for practical intervention and prevention.

Investigating Poor Sleep Quality and Associated Factors During the COVID-19 Pandemic: A Population-Based Survey in Bangladesh

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected the sleep quality of individuals, and is a poorly investigated area. This study aimed to investigate the prevalence estimate of poor sleep quality and its associated factors among Bangladeshi residents during the COVID-19 pandemic. Methods: An online cross-sectional survey was carried out from July 20 to August 5, 2020, involving 975 Bangladeshi residents (male: 54.2%; mean age: 26.7 ± 9.4 years; age range: 18-75 years). A self-reported questionnaire was answered by the respondents, covering information on demographic characteristics, perceived physical health status, COVID-19-related factors, COVID-19-induced anxiety assessment, and sleep quality. To assess sleep quality, the Bangla version of the Pittsburgh Sleep Quality Index was used. Logistic regression models were performed to analyze the factors associated with sleep quality. Results: The prevalence estimate of poor sleep quality was 55.1% among the Bangladeshi people during the COVID-19 pandemic. As per the multiple regression analysis, poor sleep quality was significantly higher among respondents who reported female gender, moderate/poor health status, indirect contact with COVID-19 infected patients, decreased household income due to the COVID-19 pandemic, fear of infection, and COVID-19-induced anxiety. Conclusion: Poor sleep quality was slightly prevalent among general people in Bangladesh during the COVID-19 pandemic. The findings indicate an immediate response for this vulnerable group to improve the sleep quality during the public health emergency of COVID-19.

Prevalence of sleep impairment in patients with tinnitus: a systematic review and single-arm meta-analysis

PURPOSE

This study aimed to comprehensively review the literature and synthesize relevant data to examine the pooled prevalence of poor sleep quality (sleep impairment) and assess overall sleep quality in patients with tinnitus.

METHODS

This meta-analysis systematically searched both English (PubMed, Embase, and Web of Science) and Chinese (Wanfang Data Chinese database, Veep Chinese Database, and Chinese National Knowledge Infrastructure) databases. Data extraction and quality assessment were independently performed by two authors. The pooled prevalence of sleep impairment and poor sleep quality was calculated via a random-effects model. Sub-group and sensitivity analyses were performed to explore the source of heterogeneity.

RESULTS

A total of seven studies were included with a total sample of 3041 tinnitus participants. The pooled prevalence of sleep impairment was 53.5% (95% confidence interval: 40.2-66.8%) and the I2 was 97.8% (Q = 7.90, p = 0.000). There were significant differences in the prevalence of poor sleep quality between males and females (39.1% vs. 44.6%, P = 0.034), between different PSQI cut-off values ≥ 7 and > 5 (53.1% vs. 53.8%, P = 0.000), and between sample sizes > 200 and ≤ 200 (54.0% vs. 52.7%, P = 0.000). In non-Asia area, the prevalence (56.6%, 95% CI: 42.6-70.5%) was lower than that in Asia areas (34.5%, 95% CI: 25.7-43.3%).

CONCLUSION

Sleep impairment is common among patients with tinnitus. Development of interventions for conditions associated with poor sleep quality should be recommended to offer a safe and efficacious solution for this population.

Impact of Retirement on Sleep Problems Among Older Workers and Their Partners

BACKGROUND AND OBJECTIVES

Sleep problems are a public health burden and have adverse health consequences in older adults. Despite sleep being a shared biological process between couples, to date there have not been any studies that have assessed the association between retirement and sleep, in older couples. The objective of this study was to examine the impact of retirement on diagnosed sleep problems in older Dutch couples.

RESEARCH DESIGN AND METHODS

This study used data from two waves of the NIDI Pension Panel Study for older Dutch adults living with a partner (n= 3,726). Logistic regression models examined the strength of association between retirement and sleep problems, while accounting for the moderating role of relationship characteristics.

RESULTS

Retirement was associated with decreased odds of sleep problems at wave 2 (OR= 0.60, 95%CI=0.46-0.78). Lower relationship quality was associated with increased odds of sleep problems in the fully adjusted model (OR=1.81, 95%CI=1.32-2.49). Having a partner with sleep problems was associated with increased risk of sleep problems as well (OR=1.51, 95%CI=1.07-2.13). There was evidence of effect modification by relationship quality (OR= 1.87, 95%CI =1.05-3.31).

DISCISSION AND IMPLICATIONS

Retirement and sleep do not occur in a social vacuum and have implications beyond the individual level. More research is therefore needed to understand the impact of sleep and its health consequences on older coupled workers. Such research may provide valuable insights for management and treatment of sleep problems and may have implications for public health of aging communities.

Comparison of Sleep Disturbances Between Older Nursing Home Residents in High- and Low-Altitude Areas

BACKGROUND AND OBJECTIVE

This study compared sleep disturbances between older adults living in nursing home located in high- and low-altitude areas and explored the association between sleep disturbances and quality of life (QoL).

METHOD

In total, 207 participants living in a high-altitude area and 437 participants in a low-altitude area were included. Sleep disturbances (ie, difficulty in initiating sleep, difficulty in maintaining sleep, and early morning awakening) were measured using standardized questions. The independent demographic and clinical correlates of sleep disturbances in high-altitude area were examined using multiple logistic regression analyses. Each type of sleep disturbance was entered as the dependent variable separately, while those with significant group differences in the univariate analyses (ie, male gender, married status, age and depressive symptoms) were entered as independent variables.

RESULTS

The prevalence of any type of sleep disturbances in the whole sample was 26.09%, with 41.54% in the high-altitude area and 18.76% in the low-altitude area. Physical, psychological, social, and environmental QoL domains were negatively associated with sleep disturbances in high-altitude area. Multiple logistic regression analyses revealed that male gender and married status were less likely to have sleep disturbances, while those with more severe depressive symptoms were more likely to have sleep disturbances in high-altitude area.

CONCLUSION

Sleep disturbance is common among older nursing home residents in high-altitude areas. Considering the negative impact of sleep disturbance on QoL, regular screening and treatment strategies need to be developed directly for this population.

Prevalence of Geriatric Syndromes and the Need for Hospice Care in Older Patients of the Emergency Department: A Study in an Asian Medical Center

Background

The prevalence of geriatric syndromes and the need for hospice care in the emergency department (ED) in Asian populations remain unclear. This study was conducted to fill the data gap.

Methods

Using a newly developed emergency geriatric assessment (EGA), we investigated the prevalence of geriatric syndromes and the need for hospice care in older ED patients of a tertiary medical center between September 1, 2016, and January 31, 2017.

Results

We recruited a total of 693 patients with a mean age of 78.0 years (standard deviation 8.2 years), comprising 46.6% of females. According to age subgroups, 37.4% of patients were aged 65-74 years, 37.4% were aged 75-84 years, and 25.2% were aged ≥85 years. The prevalence rates of geriatric syndromes were as follows: delirium (11.4%), depression (23.4%), dementia (43.1%), deterioration of activities of daily living (ADL) for <1 year (29.4%), vision impairment (22.2%), hearing impairment (23.8%), sleep disturbance (13.1%), any fall in <1 year (21.8%), polypharmacy (28.7%), pain (35.1%), pressure ulcer (5.6%), incontinence or retention (29.6%), indwelling device or physical restrain (21.6%), nutrition problem (35.7%), frequent use of medical resources (50.1%), lack of advance care planning (84.0%), caregiver problem (4.6%), socioeconomic problem (5.5%), and need for family meeting (6.2%). The need for hospice care was 11.9%. Most geriatric syndromes increased with advancing age except depression, sleep disturbance, polypharmacy, pain, nutrition problem, lack of advance care planning, caregiver problem, and socioeconomic problem.

Conclusion

Geriatric syndromes and the need for hospice care were common in the older ED patients. Further studies about subsequent intervention for improving geriatric care are needed.

Prevalence and socio-demographic correlates of poor sleep quality among older adults in Hebei province, China

Poor sleep quality is associated with negative health outcomes and high treatment burden. This study investigated the prevalence of poor sleep quality and its socio-demographic correlates among older adults in Hebei province, which is a predominantly agricultural region of China. A large-scale cross-sectional epidemiological survey was conducted from April to August 2016. The study used a multistage, stratified, cluster random sampling method. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). A total of 3,911 participants were included. The prevalence of poor sleep quality (defined as PSQI > 7) was 21.0% (95% CI 19.7–22.2%), with 22.3% (95% CI 20.9–23.8%) in rural areas and 15.9% (95% CI 13.4–18.4%) in urban areas. Multivariable logistic regression analyses found that female gender (P < 0.001, OR 2.4, 95% CI 2.00–2.82), rural areas (P = 0.002, OR 1.5, 95% CI 1.14–1.86), presence of major medical conditions (P < 0.001, OR 2.4, 95% CI 2.02–2.96) and family history of psychiatric disorders (P < 0.001, OR 2.7, 95% CI 1.60–4.39) were independently associated with higher risk of poor sleep quality. Poor sleep quality was common among older adults in Hebei province of China. Regular assessment of sleep quality and accessible sleep treatments for older population should be provided in agricultural areas of China.

The prevalence of poor sleep quality and associated risk factors among Chinese elderly adults in nursing homes: A cross-sectional study

Background

Sleep problems have become the most common complaints among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes.

Methods

A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined.

Results

The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70–79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86).

Conclusions

The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.

Factors affecting sleep among Thai people with dementia attending an outpatient psychiatric department

Sleep quality is a well-studied aspect of overall health, especially for those who have other compounded health issues like dementia. This study identified what factors affected sleep quality among Thai people with dementia who attended an outpatient psychiatric department. While we considered factors associated with poor sleep quality, we discussed the impact that family relationship specifically has on sleep quality for this population. A cross-sectional study was conducted among 80 patient–caregiver dyads. All patients were assessed by the TMSE, a neuropsychiatric assessment (Thai Mental State Examination). The PSQI (Pittsburgh Sleep Quality Index) was administered and multiple factors affecting sleep were investigated through face-to-face interviews with each patient and caregiver dyad. Interviews were conducted by a psychiatric nurse at a hospital offering outpatient psychiatric care. A chi-square test, t test, Spearman correlation, Pearson’s correlation, and logistic regression were applied to identify statistically significant associations. Overall, we found that the prevalence of poor sleep in our target population was 70%, with a high sleep score (8.14 ± 4.20). Factors affecting sleep included mental health problems, night-time cough and urinary frequency, pain and fever during the night, sleep environment problems, and stimulant use (63.8%, 57.5%, 47.5%, 20%, and 7.5%, respectively). Other factors previously associated with poor sleep quality in other studies were not associated in this study. Those with perceived poor family relationships are at a 5.57 times greater risk for poor sleep than those with perceived good family relationships. On the contrary, those without mental health problems significantly decreased their overall risk for poor sleep. Further investigation into these associations should be studied. In conclusion, health-care providers are encouraged to consider the impact of family context on sleep quality for people with dementia.

Prevalence and associated factors of poor sleep quality among Chinese older adults living in a rural area: a population-based study

Objective

To investigate the prevalence and associated factors of poor sleep quality among community-dwelling elderly population in a rural area of Northern China.

Methods

We conducted a cross-sectional survey in August–December 2014 and recruited 2195 participants who were aged 65 years or older and living in Yanlou Town of Yanggu County in western Shandong Province, China. Data on demographics, health-related behaviors, and clinical conditions were collected through structured interviews. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality and patterns. Poor sleep quality was defined as a PSQI score > 7. We employed multiple logistic models to relate poor sleep quality to various factors.

Results

The overall prevalence rates of poor sleep quality were 33.8% in the total sample, 39.2% in women and 26.3% in men (P < 0.01). The most common abnormal sleep domains were prolonged sleep latency (39.7%), decreased sleep duration (31.0%), and reduced habitual sleep efficiency (28.8%). Multiple logistic regression analyses revealed that poor sleep quality was significantly associated with female sex (OR = 1.76, 95% CI 1.46–2.12) and clinical comorbidities such as hypertension (OR = 1.28, 95% CI 1.06–1.54), coronary heart disease (OR = 1.60, 95% CI 1.27–2.00), and chronic obstructive pulmonary disease (OR = 1.82, 95% CI 1.34–2.49).

Conclusions

The sleep disorders were highly prevalent among the elderly in rural China. Modifiable risk factors such as cardiometabolic risk factors and disorders were associated with poor sleep quality, which might be potential targets for interventions to improve sleep quality in elderly population.

The Prevalence of Sleep Disturbances and Sleep Quality in Older Chinese Adults: A Comprehensive Meta-Analysis

Objective: This is a meta-analysis of the pooled prevalence of insomnia-specific sleep disturbances (sleep disturbances thereafter) and sleep quality in older Chinese adults. Method: Both English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure [CNKI], WanFang and SinoMed) databases were systematically searched. Data extraction and quality assessment were independently performed by two investigators. Random-effects model was performed to pool the prevalence of sleep disturbances and sleep quality. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. Funnel plots, Egger's regression model, and Begg's test were used to assess publication bias. Results: A total of 47 studies were included. The pooled prevalence of sleep disturbances was 35.9% (95% CI: 30.6%-41.2%). Older adults in rural areas had higher prevalence of sleep disturbances than their counterparts in urban areas. Sleep quality was measured by the Pittsburgh Sleep Quality Assessment (PSQI) in all studies with available data. In the 27 studies with available data, the pooled mean PSQI total score was 6.64 (95% CI: 6.14-7.13). There was no significant difference between genders and between rural and urban areas. Compared to men, women had higher mean scores in sleep latency (Q = 23.62, p < 0.001), sleep efficiency (Q = 12.08, p = 0.001), and use of sleep-promoting medications (Q = 4.07, p = 0.044). Conclusion: Sleep disturbances are common in older Chinese adults, particularly in older women.

Tossing and turning with degenerative arthropathy: an assessment of poor sleep quality in knee osteoarthritis

Objectives

To determine the frequency and predictors of sleep abnormalities among patients with knee osteoarthritis (OA) in Nigeria.

Material and methods

A multi-centre, hospital-based, cross-sectional study, involving 250 knee OA patients. Consenting patients 18 years and above, who satisfied the American College of Rheumatology (ACR) criteria for knee OA were recruited from five Nigerian tertiary centres over 3 months. An interviewer-administered questionnaire was used to collect demographic and relevant clinical information. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality with scores ≥ 5 indicating poor sleep. Other variables assessed were pain, depression, functional class and family functioning. Data were summarized using appropriate measures of central tendency and dispersion. Multiple logistic regression analysis was done to identify predictors of poor sleep. Analysis was done using SPSS version 21.0 with p < 0.05 considered significant. Study approval was obtained from the ethical committees of each of the study sites.

Results

Participants included 209 females (83.6%) with mean age 59.9 ±10.6 years. One hundred and forty-one participants (56.4%) had PSQI scores ≥ 5 (poor sleep). This was significantly associated with depression (p < 0.001), level of education (p = 0.001), higher pain scores (p < 0.001), body mass index (p = 0.040), medial knee OA (p = 0.032) and patello-femoral OA (p = 0.002). Higher level of education, worse depression scores and higher WOMAC pain scores were the best predictors of poor sleep quality.

Conclusion

Sleep quality was poor in over half of our knee OA patients and best predicted by depression, pain and level of education. Regular sleep quality assessment for knee OA patients is recommended.

Association of Sleep Duration and Obesity According to Gender and Age in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey 2007-2015

BACKGROUND

This study aimed to investigate associations between self-reported sleep duration and general and abdominal obesity in Korean adults stratified according to gender and age.

METHODS

Data from 41,805 adults, 18-110 years of age, collected by the Korea National Health and Nutrition Examination Survey (KNHANES) in 2007 and 2015, were analyzed. Multivariable logistic regression was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for obesity and abdominal obesity by sleep duration after controlling for sociodemographic and lifestyle variables.

RESULTS

Among individuals 30-49 years of age, there was an increased AOR for obesity only for sleep duration ≤ 5 hour/day compared with sleep duration 6 to 8 hour/day, both in men (OR, 1.25; 95% CI, 1.02-1.54) and women (OR, 1.56; 95% CI, 1.29-1.90), after controlling for covariates. Regarding women, there was increased AOR for abdominal obesity for sleep duration ≤ 5 hour/day (OR, 1.45; 95% CI, 1.18-1.78) and ≥ 9 hour/day (OR, 1.38; 95% CI, 1.09-1.76) compared with sleep duration 6 to 8 hour/day. However, for elderly individuals (≥ 65 years), there was a negative association between sleep duration ≤ 5 hour/day and obesity, but not with abdominal obesity, in both men and women.

CONCLUSION

This study demonstrated a significant association between sleep duration and obesity, which varied according to gender and age.